TY - JOUR T1 - COVID-19 health and social care access for autistic people: European policy review JF - BMJ Open JO - BMJ Open DO - 10.1136/bmjopen-2020-045341 VL - 11 IS - 6 SP - e045341 AU - Bethany Oakley AU - Julian Tillmann AU - Amber Ruigrok AU - Aurélie Baranger AU - Christian Takow AU - Tony Charman AU - Emily Jones AU - James Cusack AU - Mary Doherty AU - Pierre Violland AU - Agnieszka Wroczyńska AU - Emily Simonoff AU - Jan K Buitelaar AU - Louise Gallagher AU - Declan G M Murphy A2 - , Y1 - 2021/06/01 UR - http://bmjopen.bmj.com/content/11/6/e045341.abstract N2 - Background The global COVID-19 pandemic has had an unprecedented impact on European health and social care systems, with demands on testing, hospital and intensive care capacity exceeding available resources in many regions. This has led to concerns that some vulnerable groups, including autistic people, may be excluded from services.Methods We reviewed policies from 15 European member states, published in March–July 2020, pertaining to (1) access to COVID-19 tests; (2) provisions for treatment, hospitalisation and intensive care units (ICUs); and (3) changes to standard health and social care. In parallel, we analysed survey data on the lived experiences of 1301 autistic people and caregivers.Results Autistic people experienced significant barriers when accessing COVID-19 services. First, despite being at elevated risk of severe illness due to co-occurring health conditions, there was a lack of accessibility of COVID-19 testing. Second, many COVID-19 outpatient and inpatient treatment services were reported to be inaccessible, predominantly resulting from individual differences in communication needs. Third, ICU triage protocols in many European countries (directly or indirectly) resulted in discriminatory exclusion from lifesaving treatments. Finally, interruptions to standard health and social care left over 70% of autistic people without everyday support.Conclusions The COVID-19 pandemic has further exacerbated existing healthcare inequalities for autistic people, probably contributing to disproportionate increases in morbidity and mortality, mental health and behavioural difficulties, and reduced quality of life. An urgent need exists for policies and guidelines on accessibility of COVID-19 services to be updated to prevent the widespread exclusion of autistic people from services, which represents a violation of international human rights law.Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Should further details or materials be required, please contact the corresponding author. ER -