A Silent Killer: COVID-19 in the Neurodiverse Community

By Natasha Matta

First coined in 1998, neurodiversity is a relatively new concept that highlights the diversity of human brains and views the differences in how our brains are “wired” as natural variations. Instead of seeing the neurodiverse community as “suffering from deficit, disease, or dysfunction in their mental processing,” neurodiversity highlights differences in learning and thinking. It is an umbrella term encompassing conditions, such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), Tourette syndrome, and dyslexia. Neurodiversity is actually quite common: about 1 in 7 people are considered neurodiverse.

An issue that has largely gone unnoticed during the COVID-19 pandemic is its mental, emotional, and social effects on the neurodiverse community. Anxiety is a highly common condition in the neurodiverse community already. About 20-30% of males and 40% of females on the autism spectrum have an anxiety disorder. Similarly, around 20% of individuals with ADHD or dyslexia experience anxiety. The COVID-19 pandemic exacerbates anxiety with worries about loved ones’ health and safety, global developments, financial instability, and difficulty finding jobs. Before the COVID-19 pandemic, approximately 80% of adults on the spectrum were unemployed in the United States, and neurodivergent individuals are often the last to be hired and first to be fired. Thus, COVID-19’s impact on the economy exacerbates a host of already-existing issues and puts many neurodiverse people at risk of being furloughed or let go and increasing stress levels.

On a smaller scale, neurodivergent individuals thrive with predictability and a consistent daily schedule, and many aspects of this structure are disrupted by quarantine measures. People with ADHD already have difficulty focusing, staying on task, and keeping organized, which is exacerbated with asynchronous learning and work.

Neurodivergent individuals may struggle to follow new safety guidelines, specifically mask mandates: some people on the autism spectrum are hypersensitive to smell and pressure and find it difficult to keep a face mask on. In that vein, wearing masks muffles people’s voices and prevents lip-reading, which helps some neurodivergent individuals, particularly those with auditory disabilities, better receive information and communicate. Explaining quarantine measures to those with intellectual disabilities and ensuring they are followed correctly also poses a challenge.

With social distancing measures and school and work moving to a virtual format, social interaction is limited for everyone. Neurodivergent individuals have to adjust to new methods of communication, such as audio and video-conferencing, emailing, and texting. There is a common myth that people on the spectrum do not want to interact with others. However, many do crave social interaction and connections with friends and family, even if they find those interactions challenging. Social support at in-person school and work is now eliminated, so neurodiverse people have to re-adjust and learn how to foster and maintain relationships online. Similarly, students with visual or auditory disabilities need to find new technological accommodations for online school, which can be expensive and difficult to adjust to. Additionally, any service agencies and support networks are losing funding with the COVID-19 pandemic, so available support for neurodivergent individuals and their families may decrease.

Finally, people with autism and intellectual disabilities infected with COVID-19 have a higher mortality rate than the rest of the population. In Pennsylvania, these individuals had double the mortality rate of other Pennsylvania residents, who tested positive for COVID-19, and in New York, people with developmental disabilities had a 2.5 times greater mortality rate than other New York residents who contracted COVID-19. People on the autism spectrum and with intellectual disabilities are four times more likely to contract COVID-19 than the general population in the first place, and they are approximately twice as likely to die from the virus.

Breaking down the reasons behind this high mortality rate, people with developmental disabilities are more likely to have a pre-existing health condition, such as respiratory disease, that heightens their risk of contracting a severe case of COVID-19. Furthermore, neurodivergent individuals are more likely than the elderly to live with others or in a facility with staff, who may unintentionally introduce COVID-19 into that space.

The COVID-19 pandemic presents the neurodiverse community with unprecedented challenges and a high risk of infection and death. Thus, the United States government needs to allocate funding and resources to keep support networks afloat, provide mental health support for neurodivergent individuals as they cope with increased anxiety, create safer environments in group homes to limit the spread of coronavirus, provide technological accommodations for online school and work environments, protect disabled people’s jobs, and include neurodivergent individuals in the early phases of the COVID-19 vaccine allocation plan.

The current phased approach to COVID-19 vaccine allocation in the United States prioritizes high-risk populations, such as healthcare and essential workers, those with underlying health conditions, and the elderly. However, it is vital to include the neurodiverse community in this group as they face higher infection and mortality rates at the hands of COVID-19 than the general population. Further, conditions like ADHD and ASD have a high comorbidity rate with mental health conditions, such as anxiety, furthering putting their health at risk. People with mental illness often lead lifestyles that increase the risk of contracting COVID-19 and have underlying health conditions that increase the risk of contracting more severe cases of the disease. With many neurodivergent people having mental health conditions, living in group settings, and leading high-risk lifestyles, including the neurodiverse community in the early phases of COVID-19 vaccine allocation is a vital next step to combat their already high rates of COVID-19 infections and death.

The global pandemic is still ongoing, and there is currently a limited supply of vaccinations in the United States. The government needs to invest in resources and support for the neurodiverse community in terms of coping with mental health, protecting jobs, creating safer living environments, and adjusting to remote learning and work if they can not yet receive COVID-19 vaccines. Around 1 in 7 people are neurodivergent, but this population’s needs during the pandemic have gone ignored by the American government for far too long.