Introduction

The COVID-19 pandemic revealed several inequalities for people with disability, including inadequacies in key areas such as health care, education, and leisure. At the same time, accommodations such as the ability to work from home, long requested by this group, were made available and normalised. Digital technologies including smartphones became central to our daily existence and ability to engage in many aspects of life. However, again for people with disability, this is not always a straightforward proposition. As Ellcessor (2015) observes in relation to the iPhone, "[it] is a particularly useful case for dissecting the ways in which technologies, and their relationships to accessibility and disability, have blurred. The iPhone is mobile, it is both a mainstream and assistive technology, and it is proprietary." This relationship between accessibility, disability and communication technology is further problematized in a time of pandemic, with additional pressures placed on disability in relation to isolation and health emergency.

The COVID-19 pandemic emerged in Australia as our research team in the Centre for Culture and Technology at Curtin University was finalising a nation-wide survey of over 800 low vision or blind individuals about their use of smartphones (Locke etal., 2020). The survey had established that smartphones were a prominent part of the lives of people who are blind or have low vision: 79% stated they owned a smartphone (Locke etal., 2020). In contrast, a 2015 survey had found only 17% used a smartphone (Vision Australia, 2016). This showed a remarkable uptake in this technology, and we were interested in discovering how these devices were being used and whether they were accessible.

In this article, we explore the impact of the COVID-19 global pandemic on the smartphone usage of people with vision impairments in Australia. We do so by analysing the results of that survey and the follow-up interviews we conducted in response to the health crisis. We also provide a broader context of how people with disability responded to the COVID-19 pandemic and to the Australian government's use of smartphone technology to manage the health crisis.

The survey revealed a significant cross-generational uptake of smartphones by the blind community, while follow-up interviews found reflexive and creative use of these devices when faced with the impact of the pandemic, and the importance of geography – not simply in the distinctions between countries or states, but between urban and regional residents. The experience of digital technology also emerged as a prominent theme through our exploration of the voices and perspectives of disabled people as they were expressed through social media and in other online forums. This analysis sets the scene regarding the experience of disability in Australia and provides important background to the interviews discussed throughout this article.

Having explored how this group of people with disability were using smartphone technologies, we then turned our focus to how governments in Australia were trying to employ this technology to mitigate and control the impacts of the pandemic on the Australian population. We focus on the national government's COVIDSafe contact tracing app, and how this intervention was accessed and accepted by Australia's blind and low vision community. This contract tracing app was not well received by the blind and low vision community, with key concerns focusing on reliability, accessibility and privacy.

The Australian context

A large island continent with a geographically dispersed population clustered around the coast, Australia was in a unique position at the onset of the COVID-19 pandemic (marked as 25^th of January 2020 with the first confirmed case). After a long dry summer marred by the most extensive bush fires the country had experienced for decades, the emergence of cases of COVID-19 came at a time characterized by both 'disaster fatigue' and increased nationalism. As international travelers, and notably from cruise ships, became the first recorded cases of COVID-19 in the country, national and state governments began implementing restrictions on travelers entering Australia. The breach of quarantine restrictions at Sydney Harbor in the case of the Ruby Princess cruise ship preceded the closure of Australia's border to all non-resident international travelers and bans on Australians leaving the country. Border controls were not the only feature of the Australian Government strategy in the Australian Health Sector Emergency Response Plan for Novel Coronavirus, incorporating extensive contact tracing, self-isolation and enforced isolation regulations. The experience of COVID-19 in Australia became both geographically and politically segmented – each state or territory determining their own border controls and movements of Australian and international citizens. It was this capacity to control borders that ultimately affected the ability for Australia to manage and contain the spread of COVID-19.

In March 2020, the experience of the pandemic regulations was most widely felt in the closure of schools, shops and restaurants, work-from-home mandates, restrictions on gatherings and state-wide 'lockdowns'. It was at this moment, when the broader community began adapting to these new regulations, that our survey took place. For people with disabilities in Australia, the experience of the pandemic-led restrictions and regulations were distinct from other parts of the world in which health risks and concerns were far more acute. This is reflected in the responses we garnered from mainstream and social media between February and June of 2020 and our interviews conducted in May of that year.

The sudden introduction of nationwide restrictions in March 2020 meant that technological and digital accommodations were instigated virtually overnight. Though welcomed by people with disabilities, these changes were bittersweet. Writer and activist Adele Aria (2020) writes in a blog post in March 2020:

As my health and mobility has deteriorated, technological advances have changed the sense of connection and availability of alternatives. It is also somewhat galling to observe how quickly many of the systems that have denied access and inclusion to the disabled community have pivoted, almost overnight, to accommodate the pandemic demands for isolation and alternative arrangements. For those of us who are privileged to access functioning internet and computers, whether through a mobile device or PC[,] there is more out there that we can connect with than has been previously available.

A silver lining, as it were, of the pandemic has been that the internet, mobile devices and computers have helped further access and inclusion, potentially enhancing connection and decreasing the isolation that many people with disabilities have experienced as a way of life. As Goggin and Ellis (2020) explain, COVID-19 regulations have rendered many everyday lived experiences of disability as 'the new normal' – working from home, limited access to public spaces and increased reliance on digital participation. The importance of smartphone technology in facilitating this new normal, particularly for the blind and low vision community in Australia, is the focus of this subsequent analysis. The changes in Australia from March 2020 represent a technology pivot where technology-enabled employment, health services, education and leisure activities that had long been sought after by the disability community (Ellis, 2020) were suddenly and unexpectedly necessitated and provided, with differing levels of suitability and success, across the Australian community.

Methodology

This transformation occurred just as we were conducting our previously-planned survey with Vision Australia into the use of smartphones by Australians who are blind or with low vision. As part of our survey research, we asked participants if they would be willing to be involved in a subsequent interview. Coinciding with the COVID-19 pandemic, these interviews became an exploratory study and provided a timely voice for the blind and low vision community in Australia in response to the rapid changes taking place in the face of the pandemic.

The survey provided a self-selecting sample of the blind and low vision community for interviews. Approximately ten percent of the survey respondents agreed to a further interview, although, perhaps reflecting the stresses on people's lives at the time, only a smaller fraction of this group was available when asked. We were able to conduct interviews with thirteen individuals across Australia, who were blind or had low vision. They were asked eight questions about their smartphone use during the COVID-19 pandemic, specifically if and how their use had changed due to individual health concerns, regulations around social distancing, and increased isolation via 'stay at home' mandates. Participants were contacted via phone and email, ten people completed this interview over the phone, and three via email. Researchers completed these semi-structured interviews with participants over a one-week period at the end of May 2020. The ages ranged from 23-83 years of age, in a mix of rural and urban locations, across Victoria, New South Wales, Queensland and Western Australia, all but one of whom owned a smartphone.

To provide broader context for this research, parallel to the interviews, we conducted a review of the responses, via blogs, articles, and social media, from Australians with disabilities to the pandemic, capturing the voices and perspectives of disabled people with a particular focus on those who are blind or have low vision. We conducted this scoping study between February and June of 2020. At the same time, we critically examined how governments in Australia were trying to employ smartphone technology to mitigate and control the impacts of the pandemic on the Australian population, notably through the COVIDSafe contact tracing app, and how these interventions were being accessed and accepted by Australia's blind and low vision community.

Australians with disabilities in a pandemic: responses in mainstream and social media

In Australia, people with disabilities spoke on media and social media of their experiences of COVID-19 on a number of issues. While in North America, where the virus had very swiftly taken hold over the population, such that disability activists like Alice Wong expressed trepidation over leaving their homes (Wong, 2020) and the possibility of doctors rationing medical treatments to de-prioritize people based on pre-existing disabilities (Vox, 2020), similar fears were relatively short-lived in Australia.

What was experienced more keenly, in the mandating of travel restrictions and stay-at-home measures, was the new emphasis on, and shift to, the digital. For example, in a Vision Australia Radio podcast from 27 March 2020, Rob Drummond, Senior Low Vision Consultant at Quantum, discussed how travel restrictions had led to the conversion of presentations that were intended originally for in person delivery into digitally accessible webinars for deaf/blind and blind people (Gipps, 2020). In a guest blog post from 17 November 2020, Scott Hollier (2020), the CEO of the Centre for Accessibility (CFA) Australia, reflected on digital accessibility in the era of COVID-19. Putting forward his "favourite equation" – "Technology + accessibility = independence" – he posits that, "there is little argument now, especially considering our reliance on the Internet during COVID-19, that access to online content is not just essential but a fundamental human right" (Hollier, 2020). Yet despite the immense potential for people with disability, Hollier (2020) tells a personal story of websites and apps that do not conform with the current international Web Content Accessibility Guidelines (WCAG) standard. Wishing to purchase tickets online for his children, and despite holding several information and communication technology (ICT) degrees including a PhD, he futilely attempted to navigate a website that did not conform to WCAG 2.1 standards (Hollier, 2020). "Acknowledging my loss of dignity and independence", he says, "I reluctantly had to ask my 12-year-old son to purchase his own tickets" (Hollier, 2020). This experience is supported by research by Dror et al, (2021) who found that health authority websites in most countries did not conform to WCAG 2.1 accessibility guidelines. This kind of failure of digital technology to serve the needs of people with disabilities prevents individuals from experiencing the dignity of full citizenship and inhibits access to critical health information.

Participation in digital culture – let alone the basics of life such as housing – is still a privilege that not all people with disabilities enjoy. As blind writer and researcher Amanda Tink (2020) reminds us in a piece for Overland,

Some disabled people are not on social media because they don't have the internet, or don't have somewhere to live. Some need to have a break from social media because yet another day of hearing nondisabled people continually affirming that 'we are all in this together' – while remaining unconcerned that another 'high-risk' person has died – is too much.

The effects of disasters are not neutral (Kent & Ellis, 2015), and Tink's final example demonstrates that there are benefits of removing oneself from social media. But staying disconnected may not be ideal in the long run. Loneliness is common in adults who are blind or have low vision (Brunes et al., 2019), and this has led health experts to raise concerns that the potential detrimental outcomes of COVID-19 self-isolation may be amplified in this group (Allen & Smith, 2020). Yet, if social media is an important way for many people with disabilities to foster social connection (Ellis & Goggin, 2014; Ellis & Kent, 2017) then avoiding or lacking access to social media during the current pandemic – a period of physical social restrictions – might put them at increased risk of isolation and loneliness. One of the primary ways people maintain these connections and access to other services, particularly in an emergency situation, is through their smartphones. To better explore how this was done in relation to the COVID-19 pandemic we conducted a number of in-depth interviews with members of Australia's blind and low vision community.

The role of the smartphone during a pandemic

For our interviewees, the outbreak of the COVID-19 pandemic in Australia, saw a marked increase in smartphone use for all but one participant (who did not own a smartphone). The types of uses did not typically differ significantly:

I always did use social media to connect with many friends and family and that didn't change, other than, I did use it more often.

I've used it a lot more. It was very helpful as I was working from home.

I used my phone for a lot of different things before Covid, so I guess I generally just use it more. In particular, I used Teams and shopped more online.

Conversely, for people who were newly blind, or undergoing life changes, the COVID-19 pandemic had a more broad-ranging impact on the way they used their phones. For these individuals, different functions, apps and combined online/offline strategies were employed to adjust to social distancing regulations and the inability to use face-to-face services.

I'm newly blind, or have been for less than a year. I was going to get assessments, voice readers… but this was halted or attempted over Zoom. And Zoom was really challenging and hard for this.

I had just received my guide dog and we weren't able to finish training, and then the trainer couldn't come because of Covid. I used my smartphone to help finish the training.

For others, isolation was seen as an opportunity to use their smartphone for more leisure purposes, such as reading or watching television and videos.

I was connected to it 12 hours a day! A lot of streaming tv/ entertainment purposes.

I used the Vision Australia library a lot.

I used it for reading as I had more time.

Another participant noted however that other leisure practices, such as playing games on a smartphone, were limited for people with low vision, and COVID-19 highlighted inaccessibility in areas more prominently at a time in which we were more reliant on digital platforms.

Across all participants who used smartphones, there was an increase in use of, and reliance on, communication apps and features, such as Zoom, social media and various messaging apps. Zoom, Skype and Teams were utilized more in professional contexts, such as for people working at home, with several participants noting that learning how to use these apps was a challenging and frustrating process. Interestingly, despite accessibility barriers, most expressed that they would use the apps they adopted during COVID-19 again.

I will use YouTube more, not Zoom which I don't really like… its messy and you have to be very proficient to use it… I prefer Skype.

Learning how to set up Zoom meetings was difficult… but I will use Zoom again.

The context in which individuals became reliant on digital platforms thus both magnified accessibility issues and "fostered active and self-directed relationships" (Ellcessor, 2020) with digital media. Difficulties with setting up and using communication apps were also not always perceived as issues with the accessibility of the app itself – for example participants who used an app such as Zoom or Teams often stated it was 'easier' using programs on their computer. As Robinson (2020) explains,

As inhabitants of a material world that can be inaccessible to them, individuals who live with physical impairments sometimes must choose between two options: wait for someone to address disabling circumstances or find alternative ways to do the things they want and need to do in life (p. 306).

Moreover, over half of the participants interviewed asserted the shifts in increased use of smartphones and related technology during the pandemic would illicit a 'cultural shift' and continue beyond the alleviation of social distancing restrictions.

Our workplace is using Teams a lot more and I think they will continue to do this.

I will use the note taking app and online shopping from Woolworths. And I'll try and get a new, better phone. I assume I will use Zoom etc, as I think people will be working from home more, the office culture is changing anyway regardless of my vision.

These responses highlighted how the context of the COVID-19 pandemic was perceived as an opportunity to alleviate some barriers and challenges for people with and without disabilities, such as flexible and digital working arrangements (Ellis, 2020).

The cost associated with increased smartphone and associated technology use was varied; while many did not identify a direct increase, other participants experienced a financial impact through increased internet use, cost-per-minute services such as Aira, or a reliance on support workers, taxis and tech support. However, it should be noted that the interviews did not ask a question about the financial impact of COVID-19 on participants more broadly, with the question only pertaining to increased costs related to smartphone use. As Ellis and Goggin (2020) have noted, the pandemic was likely to have exacerbated economic inequalities for people with disabilities.

Smartphones were also used creatively to circumnavigate the restrictions that COVID-19 brought on people's everyday lives. 'Creative' uses include everyday hacks, actor-object interventions, and work-arounds implemented to make technology usable and involved modified or non-prescribed uses of the smartphone.

My support walker would come and video the walks [with my new guide dog], I would send the videos to the trainer, and we would later call to discuss how things were going.

I took photos of my disability card, which allowed people to come and take me for a walk, and not be stopped by the police for breaking the rules.

Participants often used a combination of informal and formal strategies for mitigating COVID-19 regulations and an increased digitization of services or relationships. The alternatives put forward by our participants were never framed as 'creative' or 'innovative' approaches to an inaccessible technology, rather they were explained as everyday, mundane, ordinary discoveries, and often reluctant remedies to an accessibility challenge. For some participants, the smartphone provided a creative remedy to a problem. When health assessments were delayed due to COVID-19, one participant began using Google Keep to record information because it is backlit, enabling his use with a magnifying glass; another used their smartphone video to replace a face-to-face training activity. These tactics are described by Wästerfors (2020) as 'piggybacking', the use of features not explicitly designed for people with disabilities as an assistive technology. Ellis (2019) notes that, in turn, many specialized assistive technology innovations have become important 'mainstream' everyday devices. For other participants, the smartphone was not a remedy for but a source of exclusion, to which creative approaches and life hacks had to be applied. When 'everyone' was using Zoom or Skype for meetings, one participant learned to recognize the patterns for each app in order to navigate across small icons and links his magnifier did not reach. Many participants also noted the use of others (either family, friends or paid professionals) as important 'actors' in mitigating the challenges of using new or inaccessible smartphone apps. For example, five participants noted that partners/family members were used to set up, modify or download apps to their smartphone, evoking a type of everyday creative accessibility or 'life hack' (Robinson, 2020). The impetus that COVID-19 had on people (with or without low vision) to expand their smartphone use emphasized the ways in which the device places people "in situationally disabled conditions" (Ellcessor, 2015) where an understanding of access changes both across contexts (e.g. pre, during and post pandemic), disabilities and individual purpose and intent.

The smartphone as an icon of connectivity during COVID-19 thus epitomized a type of disability paradox – both providing a solution to the restrictions brought about by the health emergency, and as a source of exclusion, frustration, and inaccessibility. Goggin and Ellis (2020) explain that this paradox of experiences peppers the different ways disability has been addressed and experienced, highlighting clear structural exclusion and yet a normalizing of many of challenges people with a disability face, prior to and during a pandemic.

The Australian experience of the COVID-19 pandemic provides some unique insights into how people perceived the health concerns/threat, experienced isolation, and interacted with the social distancing regulations. Though infection rates in Australia rapidly increased for a brief time, the spread of the virus was relatively contained and experienced very differently in each state. For example, in Western Australia, the initial spread of COVID-19 and rapid rise in infections in mid-March elicited a state of emergency, along with a series of restrictions, including school closures, regional and 'hard' state border closures, and limits on social gatherings. However, by the time of the interviews in late May, there were no cases of local transmission, most restrictions had been lifted, other than the state border closures, and the fear of infection for many people was both brief and relatively localized. In comparison, after concluding the interviews, there was a significant increase in rates of infections in Victoria in late June, which would likely have affected the perceptions and experiences of people responding to the interview questions. Most of the people interviewed in May were not overly concerned about the impact of COVID-19 on their own health as they believed they had a statistically insignificant chance of contracting the virus. Many expressed that the threat of the virus was minimal in their area and did not affect everyday practices significantly.

I wasn't as worried as my area wasn't effected/there weren't cases near me. I used hand sanitizer etc more, just for peace of mind.

I didn't really avoid touching things or going places, I just washed my hands more.

My human guide/support worker still worked we just took more precautions. However where I live there was very few cases so I wasn't as concerned.

This feeling of being 'unaffected' by the pandemic was also reiterated in the response to the question about whether they had downloaded the Australian government's COVIDSafe app. The significance of geography, not simply the distinctions between countries or states, but between urban and regional residents, was evident in the responses of participants. In the interviews, in reference to the impact of COVID-19 on changes to their everyday lives or to their uptake of the COVIDSafe app, participants often noted, unprompted, if they lived in a regional or rural area. Several participants did not believe the app was relevant to them as they either lived in a rural/remote area, did not travel beyond their local area, nor use public facilities often.

Contact tracing and apps, privacy, validity and vulnerability

Such responses are consistent with the wider discourse surrounding the efficacy and efficiency of the COVIDSafe app, a contact tracing app designed to be downloaded to individual smartphones. The app was released in April 2020 by Prime Minister Scott Morrison with the promise that it would enable earlier opening of borders, lifting of the then-quite severe national lockdown restrictions and allow us to "get back to business and do the things we love" (Prime Minister, 2020). Morrison heavily implied that if enough people downloaded the app, restrictions would be lifted.

The app was developed based on the open access code made available from the Singaporean TraceTogether app and used Bluetooth communications technology to identify close contact between people through their smartphones (Lee & Lee, 2020). This would then allow the app to track people who had been in close contact with someone who was later found to have the virus. The COVIDSafe app, like its Singaporean parent, had a number of significant failures, namely, "it wasn't compatible with an iPhone, which is the single most popular mobile device" (Patton, 2020). Furthermore, the app struggled to facilitate communication between iPhone and Android phones, making live contact tracing unfeasible. While iPhones held a significant 40% of the Australian smartphone market in 2019 (Corbett, et. al. 2020), our survey found that in the blind and low vision community its use was significantly higher, at 74% (Locke et. al. 2020). This made the operational flaw, already significant, even more so for the blind and low vision community. The impact of this was reflected in our interviews.

I didn't download the app because, of the adverse reports on it's tracking capability, particularly on iPhones. If I had felt confident it would do what was intended, I would have been more than likely to have installed it.

The other significant issue in relation to the app's adoption by the public at large and people with disabilities in particular are related to issues of privacy. Downloading the app and inputting data is voluntary. Consent is required to send the information onward to relevant authorities. The digital handshake between phones measures potential contact and any data collected is stored on individual phones. However, in the Singaporean example, the government failed to guarantee that information could not be sent to other organizations such as the police. While in Australia, legislation was enacted to ensure that the app data could only be used for its stated purpose, there are concerns around how long the data would be stored, and that the data would be stored overseas in the United States and who would be able to access the data (Kang & Haskell-Dowland 2020).

Another major concern for many citizens is 'control creep' whereby "history is full of examples of 'temporary' but invasive measures being introduced in response to a crisis, and then becoming permanent" (Kitchin, 2020, p. 8). There is significant concern that once people give away their privacy, they may not be able to get it back and that such app-based tracking under the guise of a public health emergency could become normalised.

Most interview participants expressed some skepticism about the app, both its effectiveness and the way their privacy/data would be used.

I did [download it]. I felt it was socially responsible. Not many people I know have it. They don't trust the government, the Amazon cloud, whatever.

I didn't get it. I wasn't sure where my information would end up.

I downloaded the app, but then I took it off, my wife was concerned about privacy.

This lack of uptake and skepticism of the role of the government-led COVIDSafe app mirrors findings on the perspective of the broader community (Simko et. al., 2020), but may also be influenced by the increased privacy concerns and management for people with disabilities we have noted in previous research (McRae et. al., 2020).

While some participants were concerned about their privacy, others found the app inaccessible.

When it was first downloaded onto my phone there was only one button that was unidentifiable.

I tried but it was quite difficult.

I did download it, but my son had to do it for me.

These responses highlighted the complexity of access; where multiple actors, app interfaces, and perceptions of access and value intersect with social and cultural knowledges and discourses around digital technology.

Other apps related to the COVID-19 pandemic have also been launched by state governments, such as the SafeWA app in Western Australia. These apps are used to scan a QR code to register at different public venues, for instance shops, cafes and gymnasiums, and note the time of a visit so that people and their contacts can be more easily traced in the event of an outbreak of the virus. While there are no currently documented accessibility problems with these apps, they rely on individual venues providing accessible signage for the QR code to be scanned with appropriate braille instructions on where to scan the code, and appropriate signage placement to be accessible to all people visiting a venue. While these accessibility requirements are not always made clear to the venues by government, or widely adhered to, a manual signing-in sheet provides a work around for those without a smartphone or unable to use the app.

Conclusion

The impact of the COVID-19 pandemic on the blind and low vision community in Australia, and their use of smartphone technology, has been significant. The limitations and inaccessibility of the device for different individuals is magnified when alternative support structures are removed, exacerbating isolation and disconnection. Blind and low vision users employ creative and adaptive techniques, combining technology and human support, to remove accessibility barriers and limitations imposed in a health emergency setting. This exemplifies a disability paradox – of both providing a solution to the restrictions brought about by the health emergency, and a source of exclusion, frustration, and inaccessibility.

The response to COVID-19 in Australia brought forward a raft of newly accessible practices and technologies for people with, and without, disabilities, including long-campaigned for flexible and digital working arrangements (Ellis, 2020). While some of these practices, such as online learning for school students, were intended as temporary measures, others such as standard government-supported access to telehealth services and remote working are set to continue after the current crisis passes, providing an enduring improved level of access for people with disabilities.

While people with disabilities are using their phones in new and innovative ways, the Australian government's attempt to intervene in the digital space through the COVIDSafe app have been more problematic, with issues of reliability, accessibility and privacy preventing its take-up in the blind and low vision community.

Australia has been fortunate in its interaction with the COVID-19 virus relative to many other nations. At the time of writing, 909 COVID-related deaths had been recorded in the country. This is still a long way from the conditions in other countries such as the United States and the United Kingdom, yet it is still a tragic outcome. Similarly, as many other countries have shown, early success in managing the pandemic is no guarantee that it will not re-emerge in significant numbers. People with disabilities are one of the most vulnerable groups and this must still be a significant concern. As this article was in final review Australia had started its COVID-19 vaccination program. The program is accessed through a website that informs a user of their eligibility, and closest clinic location. This website is not compatible with accessibility software, including screen readers, making it unusable by the blind and low vision community and leaving them unable to access the vaccination program through the site.