Who Else is Vulnerable to COVID-19?
While there are certain populations that are more at-risk or vulnerable to contracting the disease and experiencing severe symptoms, there are also populations more vulnerable to the secondary effects of the pandemic, including its harmful social and economic effects.
Community-based health workers counsel a variety of different populations that face different risks and challenges that make them more or less vulnerable to contracting the disease and experiencing its harmful secondary effects.
People Living in Poverty
Displaced people who live in crowded camps and individuals living in informal settlements and slums may be unable to practice physical distancing, making them more susceptible to contracting the disease and spreading it. Additionally, lack of adequate shelter, food, clean water, protective supplies, healthcare, family or community support, internet connectivity, and reliance on the informal market to make a living, can make it harder for these populations to practice safe behaviors to prevent getting or transmitting COVID-19.
Individuals who are homeless may not have access to clean water for hand washing or finances for necessary health and social services, or places for safe physical distancing. Lack of connectivity may prevent them from receiving helpful information to protect themselves and others in their communities.
For displaced populations, a combination of legal status, discrimination, and language barriers may also limit access to otherwise publicly available information and health and social services.
Persons with Disabilities
Access to information is often a barrier for people with disabilities who have specific communication needs. For example, people who depend on lip-reading will be additionally disadvantaged, given that wearing face masks is a recommended practice for preventing the spread of COVID-19, which will make it difficult for them to communicate.
Persons with disabilities are often excluded from decision-making spaces and have unequal access to information on outbreaks and availability of services.
Children and Adolescents
Most children and adolescents may only get mild cases of COVID-19 or be asymptomatic, and they can unknowingly transmit it to caregivers who may be more vulnerable to infection and severe illness.
Though rare, new evidence has emerged suggesting that some children may have different symptoms of COVID-19 that can be just as severe as adults, such as developing a multi-system inflammatory disease.
Prolonged periods of school closure and movement restrictions may also lead to emotional unrest and anxieties.
Caregivers might not be able to take effective care of the children who depend on them. If parents have to go out for work and children have to stay at home due to schools being shut, it may impact their safety and security. Heightened parental anxieties and frustrations might also lead to an increase in violence against children at home.
If caregivers are infected, quarantined, or pass away, it could lead to protection and psychosocial issues for children. They may also risk passing the disease onto their children.
Unaccompanied and separated children may be particularly challenged in accessing timely and relevant information on how to prevent themselves from getting and spreading COVID-19, and how to access health services for potential treatment.
Women are often the primary caregivers both at home and in their communities, making up to about 80% of the health workforce and serving on the frontlines in their communities and health facilities. Thus, they are frequently placed in situations where they are more at risk of contracting the disease.
Women are more likely to be engaged in the informal sector and be hardest hit economically by COVID-19, and thus may experience high rates of financial stress.
Women experience increased risks of gender-based violence, including sexual exploitation and intimate partner violence. The rates of domestic violence are especially likely to go up with movement restrictions, self-quarantine behaviors, physical distancing measures, and financial stress. The stress of the pandemic, like other conflict and emergency situations, has exacerbated the rates of violence against women and children as men may feel unstable and powerless. Additionally, the pressure to respond to COVID-19 cases may disrupt care and support for gender-based violence survivors.
Women are experiencing interrupted access to sexual and reproductive health services, including to family planning services and supplies. If a woman’s preferred method of contraception is not available, women may need to try out other contraceptive options that are more available, which may require counseling and essential health services.
There is no evidence at this time that there is an increased risk of complications or miscarriage for those who are pregnant, however, pregnant women can be at a greater risk of developing serious respiratory infections due to changes in their immune systems, and evidence continues to emerge about optimal management.
While antenatal care services should be prioritized as an essential service, pregnant women may not be able to access regular services as resources may be diverted to COVID-19 patients when health services are overburdened, or may be inaccessible due to lockdowns. There will likely be interrupted pre- and post-natal care, which could potentially result in increased rates of maternal and child mortality, as pregnant women may not be able to get the professional health support they need.
It is important to note that even if pregnant women are able to attend their facility for their usual check-ups, frequent and sometimes unnecessary contact with health facilities can increase their risk of infection, especially in health facilities with inadequate infection control measures. Therefore, the role CHWs play in supporting pregnant women who cannot or should not go to health facilities at this high-risk time is especially important, and they can refer women to health facilities if and when things escalate beyond what they can provide.
Men are at risk where gender norms mean they do not promptly access health services – with delays in detection and treatment.
More research must be conducted to determine the reasoning, but thus far, more men have contracted the disease than women, and men are more likely to die from it than women. In fact, from a study of COVID-19 in Shenzhen, China, men were about 2.5 times more likely to contract the disease than women.