US map made of many people with empty space in the center that resembles a single spiky corona virion.

The Institutionalization Missing Data Problem

By Doron Dorfman and Scott Landes

One of the most important lessons from the ongoing COVID-19 pandemic needs to be about health surveillance of marginalized health populations — indeed, “who counts depends on who is counted.”

As disability scholars who use data and empirical tools in our work, we want to remind decision makers that advancing just law and policy depends on the systematic collection of accurate data. Without such data, our laws and policies will be fundamentally incomplete.

Read More

cells with the doors closed at a historic Idaho prison.

The Pandemic Prison

By Dan Berger

The pandemic prison has utilized several of the worst features of incarceration as a foundational part of how the institution governs “public health” for its captives. And because prisons are never as removed from society as proponents like to think, these protocols redound far beyond the prison system itself.

The scale of COVID-19 in jails, prisons, and detention centers was expected. These institutions are defined by close quarters, poor health care, and, at least initially, little or no personal protective equipment. From the earliest days of the pandemic, anyone paying attention to jails, prisons, and detention centers knew that they would be vectors of community spread.

Read More

Medical Hospital: Neurologist and Neurosurgeon Talk, Use Computer, Analyse Patient MRI Scan, Diagnose Brain. Brain Surgery Health Clinic Lab: Two Professional Physicians Look at CT Scan. Close-up.

Creating Brain-Forward Policies Amid a ‘Mass Deterioration Event’

By Emily R.D. Murphy

COVID-19 will be with us — in our society and in our brains — for the foreseeable future. Especially as death and severe illness rates have dropped since the introduction of vaccines and therapeutics, widespread and potentially lasting brain effects of COVID have become a significant source of discussion, fear, and even pernicious rumors about the privileged deliberately seeking competitive economic advantages by avoiding COVID (by continuing to work from home and use other peoples’ labor to avoid exposures) and its consequent brain damage.

This symposium contribution focuses specifically on COVID’s lasting effects in our brains, about which much is still unknown. It is critical to focus on this — notwithstanding the uncertainty about what happens, to how many, and for how long — for two reasons. First, brain problems (and mental health) are largely invisible and thus overlooked and deprioritized. And second, our current disability laws and policies that might be thought to deal with the problem are not up to the looming task. Instead, we should affirmatively consider what brain-forward policies and governance could look like, building on lessons from past pandemics and towards a future of more universal support and structural accommodation of diminishment as well as disability.

Read More

2020 San Pedro California April 30: Federal Correctional Institution Terminal Island prison. Half the inmates there were infected with coronavirus.

Carceral Health Care Is Designed to Fail

By Andrea C. Armstrong

COVID-19 is not the first pandemic within prisons. Modern history is littered with examples of disease outbreaks in carceral spaces, including tuberculosis, influenza, and MRSA. Like these earlier carceral pandemics, the over 620,000 COVID-19 infections and 3,100 related deaths among incarcerated individuals to date simply expose how U.S. health law and policy fails to protect people in custody.

Only incarcerated people have a constitutional right to healthcare in the United States. That right, however, is rendered toothless when supplied through a punitive system that lacks meaningful standards and robust oversight.

Here is what we know — despite the secrecy that shields penal institutions — about carceral health care.

Read More

The White House, Washington, DC.

The Years of Magical Thinking: Pandemic Necrosecurity Under Trump and Biden

By Martha Lincoln

From spring 2020 through the present day, Americans have endured levels of sickness and death that are outliers among not only wealthy democracies, but around the world. No other country has recorded as many total COVID-19 casualties as the United States — indeed, no other country comes close.

This situation is not happenstance. From early moments in 2020, the concept of a right to health — and indeed, even a right to life — has been discounted in American policy, discourse, and practice. Quite mainstream and influential individuals and institutions — physicians, economists, and think tanks — have urged leaders to shed public health protections — particularly masking — and “move away” from the pandemic. Over the past two years in the United States, leaders in both political parties have capitulated to — if not embraced — the doxa that a certain amount of death and suffering is inevitable in our efforts to overcome (or “live with”) the pandemic. In a piece written during the first months of COVID under Trump, I called this dangerous yet influential outlook necrosecurity: “the cultural idea that mass death among less grievable subjects plays an essential role in maintaining social welfare and public order.”

Read More

Washington DC 09 20 2021. More than 600,000 white flags honor lives lost to COVID, on the National Mall. The art installation " In America: Remember" was created by Suzanne Brennan Firstenberg.

Introduction to the Symposium: Health Law and Policy in an Era of Mass Suffering

By Chloe Reichel and Benjamin A. Barsky

Last spring, the United States crossed the bleak and preventable 1,000,000-death mark for lives lost during the COVID-19 pandemic. In this symposium, our hope is to acknowledge — and mourn — this current era of mass suffering and death.

In particular, we want to reckon with the role of health law and policy in shaping, and at times catalyzing, the impact that the pandemic has had on our loved ones and communities.

Read More

London, England, UK, January 22nd 2022, Long covid symptoms sign on pharmacy shop window UK.

Mobilizing Long COVID Awareness to Better Support People with Acquired Disabilities

By Marissa Wagner Mery

Long COVID exposes an often-unacknowledged facet of disability: that one is far more likely to develop a disability than be born with one.

Estimates suggest that, at present, approximately 10 – 20 million Americans are now afflicted with the array of debilitating symptoms we now call Long COVID, which include fatigue, shortness of breath, and cognitive dysfunction or “brain fog.”

The upswell of advocacy and awareness around Long COVID should be mobilized to call attention to and address the challenges faced by newly-disabled adults, particularly with respect to employment.

Read More

Gavel and stethoscope.

Long COVID and Physical Reductionism

By Leslie Francis and Michael Ashley Stein

Like plaintiffs with other conditions lacking definitive physiological markers, long COVID plaintiffs seeking disability anti-discrimination law protections have confronted courts suspicious of their reports of symptoms and insistent on medical evidence in order for them to qualify as “disabled” and entitled to statutory protection.

We call this “physical reductionism” in disability determinations. Such physical reductionism is misguided for many reasons, including its failure to understand disability socially.

Ironically, these problems for plaintiffs may be traced to amendments to the Americans with Disabilities Act (ADA) that were intended to expand coverage for plaintiffs claiming disability discrimination. Three provisions of the Americans with Disabilities Act Amendments Act (ADAAA) are appearing especially problematic for long COVID patients in the courts.

Read More

HVAC tech wearing mask and gloves changing an air filter

Providing Clean Air in Indoor Spaces: Moving Beyond Accommodations Towards Barrier Removal

By Jennifer Bard

One of the most persistently frustrating aspects of the Americans with Disabilities Act (ADA), as currently applied to schools and workplaces, is its emphasis on the eligibility of qualifying individuals for accommodation, rather than on population-based removal of barriers to participation.

This individualized approach has always been an uncomfortable fit, given the reality of changes in physical function throughout the lifespan, and is a particularly unsatisfying model for the collective threat of COVID-19, a novel virus that has not only caused at least a million deaths in the United States, but is likely to trigger a variety of disabling sequelae in many (perhaps most) of those who recover.

So far, however, there is mounting evidence that individuals who seek to protect themselves from infection with COVID-19 in school or in the workplace (very much including those who work in schools) are going to have to do based on their individual susceptibility to contracting COVID-19 or to being disproportionately affected by an infection.

Read More