How will Long-Covid Change the UX Accessibility Landscape?
I’m sitting here contemplating my new and rather mysterious condition Long-Covid and wondering how this is changing the way I, and many others, will interface with the world.
Long-Covid manifests in different ways with different people. There are lots of symptoms being monitored, such as:
- Brain Fog which is a rather general term for ‘cognitive impairment’
- Vision Problems
- Joint and Muscle Pain
- Peripheral Neuropathy
- Breathlessness
- Anxiety
- Heart Problems
- Depression
- Tinnitus
- Fatigue…
Articles by the UK Gov, the NHS, BBC, Guardian, WHO and others refer to over 55 symptoms identified so far, here is a list of 28 of them and these look like long-term problems as the NHS are already dealing with tens of thousands of people in the UK whose Post COVID symptoms have persisted for over a year.
I’m trying to absorb as much information as I can whilst also considering what I know, which is how the condition is manifesting in me. For the last 6 months, I have developed symptoms of breathlessness akin to asthma, brain fog and fatigue are definitely there… I am sleeping more and longer than ever before and need power naps to be able to work throughout the day, and I have lost contact with part of my right hand and a toe in my left foot. I can still move them but they have no feeling.
As far as cognitive function is concerned I often bill myself as a “walking bag of cognitive conditions”, ADHD and Dyslexia are diagnosed, Anomic Aphasia and a touch of the old ASD are speculations. I am definitely having more memory issues than before, especially words and names. Focus and bandwidth are definitely not what they were before the pandemic.
Anxiety? I’ve always had lots of that, not sure if this is the same anxiety or more anxiety as we are in the middle of a mental health as well as a COVID pandemic. Lastly is one we just started talking about last week in my family, which is the shakes. I periodically just start shaking. Not violently but noticeably and my fine motor control has definitely been affected.
It’s interesting reading about other’s experiences and it seems that my symptoms are on the mild to moderate side of the scale. This condition is affecting people across all age groups and does not seem to be confined to how severely COVID itself impacted you in the first place.
Looking at the early statistics this is not a small group of people identified so far, and the percentages are growing. Long-COVID centres have massive waiting lists which are growing every day.
Just in the UK these numbers are estimated to be over 2 million people so far identified and there are interesting insights from the Office of National Statistics:
Of study participants who tested positive for COVID-19, symptom prevalence at 12 weeks post-infection was higher for female participants (14.7%) than male participants (12.7%) and was highest among those aged 25 to 34 years (18.2%).
Of people with self-reported long-COVID, 697,000 first had (or suspected they had) COVID-19 at least 12 weeks previously, and 70,000 first had (or suspected they had) COVID-19 at least one year previously.
So what are the questions we could be asking? Maybe the following can get us started?
- What does this mean in terms of digital accessibility and UX design?
- What are the barriers this audience will experience that will need consideration?
- What can we do with our existing knowledge and tools to help?
- What’s new about this group that we need to start thinking about?
- What is the long-term scale of this change?
As an industry, we often compartmentalise our inclusive UX guidance into demographic groups. Blind, VI, Hearing, Motor and Cognitive and create approaches around the specific barriers experienced by these groups. Then, and only then, do we seem to focus on intersectionality. But with such an influx of need from an audience whose characteristics are so broad, we will need to take a more intersectional view to best ensure we support this audience’s needs. We also have a benefit in terms of research. This also exposes a weakness in current approaches to design research. The segregation of mainstream design research from research with people who experience barriers has always been flawed.
Usability issues are experienced by everyone but the degrees by which they impact individuals vary. Looking for those users in a study that can flag issues will now be easier with higher-value participants. You just have to filter them out by barrier and characteristic.
Out of all of these characteristics, Fatigue looks like a group we haven’t discussed before let alone supported, and yet fatigue is prevalent across a significant proportion of our existing target demographics.
I tried googling “accessibility+fatigue” and got nothing from any of the leading accessibility organisations. Most of the articles were about individuals managing the condition rather than ‘us’ as an industry considering the impacts of fatigue in our approach to design… so is Long-COVID showing us that we’ve been missing a trick all this time?
If we are going to prepare for this incoming demographic, how do we do that?
This is a tricky question as there is such a lack of research into the condition and the scale of its impact, however there could be a few things to consider:
Maybe a first step will be recognising and accepting that our disability and neurodivergent communities are expanding. Not everyone with Long-COVID will identify as having a disability or being neurodivergent, but their lived experiences and barriers will be ones that we are familiar with. The added benefit of more readily accommodating fatigue as a characteristic will also benefit the whole community.
For UX design researchers the recruitment landscape will change. There will be a higher percentage of people with particular human characteristics and therefore recruiting to accommodate more people these characteristics will be paramount if your test subject groups are to be representative of your audience.
There will also be new opportunities for research into intersectional barriers and a greater need to monitor the impact of design decisions on customer satisfaction against things like Fatigue. Fatigue in itself as an intersection with all existing barrier groups will be a fascinating area of research. Has anyone looked into fatigue for screen reader, switch, keyboard, magnifier or voice control users?
Looking at the diagnostic data published by the UK, Italy, and other countries, we can conclude that this is going to impact millions of people across the world. Some of us with existing conditions will experience new and additional barrier intersectional challenges, and for others they will experience permanent and profound change in their abilities for the first time.
In general, we are going to need more qualitative and quantitative data to make sure UX practice stays aligned with the needs of its audience.
In conclusion, we are going through a huge shift in the positive impact of accessibility and inclusive design practices. There has always been an appreciation that Accessibility has a positive impact on everyone, and this is just about to become even more relevant.
For a more scientific breakdown read this thread by Professor Christina Pagel https://twitter.com/chrischirp from the Clinical Operational Research Unit at University College London .
