  A major strategy to prevent the spread of COVID-19 is through the limiting of
in-person contacts. However, for the many disabled people who live in the
community and require caregivers to assist them with activities of daily
living, limiting contacts is impractical or impossible. We seek to determine
which interventions can prevent infections among disabled people and their
caregivers. To accomplish this, we simulate COVID-19 transmission with a
compartmental model on a network. The networks incorporate heterogeneity in the
risks of different types of interactions, time-dependent lockdown and reopening
measures, and interaction distributions for four different groups (caregivers,
disabled people, essential workers, and the general population). Among these
groups, we find the probability of becoming infected is highest for caregivers
and second highest for disabled people. Our analysis of the network structure
illustrates that caregivers have the largest modal eigenvector centrality among
the four groups. We find that two interventions -- contact-limiting by all
groups and mask-wearing by disabled people and caregivers -- particularly
reduce cases among disabled people and caregivers. We also test which group
most effectively spreads COVID-19 by seeding infections in a subset of each
group and then comparing the total number of infections as the disease spreads.
We find that caregivers are the most effective spreaders of COVID-19. We then
test where limited vaccine doses could be used most effectively and we find
that vaccinating caregivers better protects disabled people than vaccinating
the general population, essential workers, or the disabled population itself.
Our results highlight the potential effectiveness of mask-wearing,
contact-limiting throughout society, and strategic vaccination for limiting the
exposure of disabled people and their caregivers to COVID-19.
