Table 3.

Themes and examples of further affirming quotes.

Health and access to care	That I cannot see a Dr. is the absolute worst!!! All my adaptive sports were canceled. Being grounded like a child has been taxing on my emotional wellbeing!!!! I want out … (Participant #8, LOI: Thoracic) My physical therapy can no longer treat out patients. I have not been able to find another who does. As a result, I have increased weight, spasticity, pain and weakness, depression, frustration, and unsure of future … For me, exercise is huge. I thrive with intense physical exercise 4 or 5 days a week. To accomplish this I need help from PT and friends. They are now not available due to COVID. (Participant #11; LOI: Cervical) Since the pandemic, I have noticed that the availability of home health caregivers has decreased. This has a direct impact on choosing a good aide, and I have lowered my criteria in hiring them – often settling on lower quality aides. (Participant #15; LOI: Cervical) Loss of caregivers, loss of experience in caregivers, caregiver apathy about Covid, loss of function due to lack of care and problems with access to help with necessary rehab exercise support on VA provided equipment … falls on equipment due to maintenance delays … (Participant #26; LOI: Cervical)
Making sense of the pandemic	Also, the fear of getting Covid because I'm not sure how well I would recover from it so there was/is a slight hesitation to go out in public more due to others’ lack of being considerate/safe than our own. (Participant #7; LOI: Thoracic) For me the biggest challenge has been how to navigate all the restrictions and regulations being put in place. Having my freedoms taken away is extremely difficult to deal with. There has been strain on relationships because people think I’m careless for things like not wearing a mask or even giving someone a hug. It’s insanity. (Participant #20; LOI: Thoracic) It had been hard to realize how alone we are in this world. I don’t feel comfortable going anywhere outside my property, even to a clinic. (Participant #21; LOI: Thoracic) It’s my belief that it affects us pretty much all the same. Sure there are some things I’m on able to do like social gatherings and lunches/diners out but everyone is Experiencing the same things as I am. It may affect me a little bit more because of the fewer things available to me but this type of life is challenging anyways so I’m used to it. (Participant #29; LOI: Cervical)
Daily life during the pandemic	I currently work from home, for my company decided to close our offices until further notice. My work has laid people off, but my role isn’t at a high risk for being let go. I’ve enjoyed being home more, and having time to do things that I typically didn’t have time for pre-COVID. (Participant #1; LOI: Thoracic) I suppose the most positive things are that family and friends are tending to reach out and check with one another as to how everybody is getting along and if anybody needs anything. It brings out a lot of good in people, not always but you see the good come out and people in most cases. (Participant #29; LOI: Cervical) Our social interaction with family and friends has been severely impacted since COVID. We were having get together a few times a month and that has almost come to a stop. Both my wife (my primary caregiver) and myself need that social interaction and really miss it. (Participant #18; LOI: Thoracic) There has been strain on relationships because people think I’m careless for things like not wearing a mask or even giving someone a hug. It’s insanity. (Participant #20; LOI: Thoracic)