DOI: 10.31662/jmaj.2023-0193
https://www.jmaj.jp/Editorial

Lesson Learned from Impact of COVID-19 Pandemic on People with Visual
Impairment
Kimiko Ueda
Key Words:
visual impairment, COVID-19 pandemic, difficulty in daily life
The COVID-19 pandemic affected the physical and mental
health of the entire population (1), (2) and limited their lives andactivities, especially for people with disabilities (3). The people
with visual impairment (VI), estimated over 349 million
worldwide (4), touch, tractile contact, and act upon objects every day. Exploring the difficulties caused by COVID-19 forpeople with VI will help us understand the criticality of thechallenges they face. It brings into sharp relief the difficultiesof people with VI before the COVID-19 pandemic.
To understand the overview of the COVID-19 challenges
on people with VI, we have to be aware of its impact on individuals across the spectrum of visual impairment (5). The letterof formal request from the Japan Federation of the VisuallyImpaired, the largest organization of people with VI in Japan,
is useful. It summarized the support needed for various daily
problems reported by members: priority distribution of necessary hygiene items (masks and rubbing alcohol) to people withVI and their caregivers; bailout program for people employing
acupuncture, moxibustion, and massages; guarantee and continuity of accompanying support system; provision of appropriate information to people with VI; appropriate information distribution and supports for people with VI on examination and treatment of COVID-19; tailored supports for children enrolled in special support schools. Hand hygiene wasmore important than usual for people with VI who understand using their hands. Accompanying supports are a guarantee of action and information for people with VI. However,
due to the COVID-19 pandemic, offices providing accompanying support were closed and the number of guide helpers
decreased, restricting in their lives. Information about COVID-19 changed day by day. Information from the national andlocal governments, dealers regarding changes in businesshours, infection countermeasures, and so on made it difficultfor people with VI to obtain information timely and appropriately, causing difficulties and anxiety among them. Regard-ing various support programs from the national and local governments such as special fixed benefits, sustainability benefits,
and livelihood welfare fund loan programs, people with VI experienced difficulties in obtaining information about these
support programs. Even if information was obtained, fillingout the application forms was challenging. In many cases, welfare services such as accompanying supports, in-home nursing
care, and substitute writing/reading support were required toprepare the application forms. Because these supports directly
affected the lives of people with VI, the national and local governments needed to take responsibility for the notification andapplication of these supports.
The sound environment is important for the daily routineof people with VI (6); however, COVID-19 greatly affected thesound environment, which in turn had a significant impact on
their daily lives. The main cues used by people with VI to walkand act alone are information from a white cane, sound, airflow, and smell. Contextually, sound, airflow, and smell information were considerably affected by COVID-19. People withVI use sound instead of sight to move and confirm their current position. A change in environment, such as the absenceor reduction of the usual sounds and voices, considerably affects their daily lives. When they walk, they can recognize
turns by the flow of air, but wearing masks made it difficult toperceive the flow of air. Additionally, the change in daily air
flow due to open doors (including automatic doors) for ventilation had a great impact on their daily lives. The same occurred for smells.
Considering these backgrounds, the COVID-19 pandemic impacted the quality of life and daily activities, as well asmental health (7). Ito et al focused on these conditions after theCOVID-19 pandemic (8). In a cross-sectional survey using aquestionnaire, they reported that even after the COVID-19
pandemic, the perceived daily difficulties of people with VI
were associated with health-related quality of life. Despite theFaculty of Health and Well-being, Kansai University, Osaka, Japan
Corresponding author: Kimiko Ueda, kimi-h-u@kansai-u.ac.jp
JMA J. 2024;7(1):120-121
Received: November 26, 2023 / Accepted: November 28, 2023 / Advance Publication: December 27, 2023 / Published: January 15, 2024
Copyright © Japan Medical Association120

DOI: 10.31662/jmaj.2023-0193
https://www.jmaj.jp/JMA Journal: Volume 7, Issue 1

limitation that the study was not comparative with the prepandemic situation and has a selection bias, results suggested
that people with VI might be affected by the COVID-19 pandemic longer than those without VI and take longer to returnto ordinal life postpandemic. Further research is needed in thefuture.
Even before the COVID-19 pandemic, people with VI
faced various challenges and poor health-related quality of lifein their daily lives, caused by low accessibility of information,
prejudice, and lack of understanding (9). The pandemic served
an opportunity to focus on their difficulties in life and bewidely recognized. Notably, people with VI are vulnerable inemergencies, and more adequate supports should be provided
and further understanding be achieved even in ordinary times.

Lancet. 2020;395(10239):1763-70.
4. GBD 2019 Blindness and Vision Impairment Collaborators onbehalf of the Vision Loss Expert Group of the Global Burden of
Disease Study. Trends in prevalence of blindness and distanceand near vision impairment over 30 years: an analysis for theglobal burden of disease study. Lancet Glob Health.
2021;9(2):e130-43.
5. Takeshita Y. [Japan Federation of the Visually Impaired. Letterof formal request regarding COVID-19 to Minister of Health,
Labor and Welfare and Minister of Education, Culture, Sports,
Science and Technology]. 2020. Japanese.
6. Shin Y. [COVID-19 and people with visual impairment walkingalone]. [Internet]. 2021 [cited 2023 Nov 20]. Available from:https://www.big-i.jp/news/post/000669.php. Japanese.
7. Bernard A, Weiss S, Rahman M, et al. The impact ofCOVID-19 and pandemic mitigation measures on persons withsensory impairment. Am J Ophthalmol. 2022;234:49-58.
8. Ito Y, Kiyohara H, Awamura K, et al. People with visual
impairment continue to experience difficulties in their daily lives
that affect their health-related quality of life after theCOVID-19 pandemic. JMA J. 2024;7(1):114-119.
9. Varma R, Wu J, Chong K, et al. Impact of severity andbilaterality of visual impairment on health-related quality of life.
Ophthalmology. 2006;113(10):1846-53.

Article Information
Conflicts of Interest

NoneReferences
1. WHO Coronavirus (COVID-19) Dashboard [Internet]. [cited2023 Nov 20]. Available from: https://covid19.who.int/
2. Pfefferbaum B, North CS. Mental health and the Covid-19
pandemic. N Engl J Med. 2020;383(6):510-2.
3. Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology,
clinical course, and outcomes of critically ill adults with
COVID-19 in New York City: a prospective cohort study.

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