  A major strategy to prevent the spread of COVID-19 is the limiting of
in-person contacts. However, this is impractical or impossible for the many
disabled people who do not live in care facilities, but still require
caregivers. We seek to determine which interventions can prevent infections
among disabled people and their caregivers. We simulate transmission with a
model that includes susceptible, exposed, asymptomatic, symptomatically ill,
hospitalized, and removed individuals. The networks on which we simulate
disease spread incorporate heterogeneity in the risks of different types of
interactions, time-dependent lockdown and reopening measures, and contact
distributions for four different groups (caregivers, disabled people, essential
workers, and the general population). We find the probability of becoming
infected is largest for caregivers and second largest for disabled people. Our
analysis of network structure illustrates that caregivers have the largest
modal eigenvector centrality. We find that two interventions --
contact-limiting by all groups and mask-wearing by disabled people and
caregivers -- most reduce the cases among disabled people and caregivers. We
also test which group spreads COVID-19 most readily by seeding infections in a
subset of each group. We find caregivers are the most potent spreaders of
COVID-19, particularly to other caregivers and to disabled people. We test
where to use limited vaccine doses most effectively and find (1) vaccinating
caregivers better protects disabled people than vaccinating the general
population or essential workers and (2) vaccinating caregivers protects
disabled people about as much as vaccinating disabled people themselves. 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.
