On 3 July, the European Centre for Disease Prevention and Control (ECDC) published a technical report providing guidance on the provision of support for medically and socially vulnerable populations during the COVID-19 pandemic. Medically vulnerable groups are defined as those who are at higher risk of severe complications from COVID-19, including older adults and people with underlying health conditions such as hypertension and diabetes, while the socially vulnerable category includes groups such as people with chronic physical, intellectual or sensory impairments; ethnic minorities; and homeless people.
Based on an exploratory literature review and a public survey, the ECDC report identifies specific challenges faced by the groups listed above, and describes the ways in which organisations have addressed these challenges. In particular, the report highlights issues with access to healthcare services, crowded living conditions, poor health literacy, stigmatization, discrimination and lack of inclusion. As a result, medically and socially vulnerable populations are at greater risk of mortality due to COVID-19; for example, people with intellectual and developmental disabilities have double the case fatality rate, while several COVID-19 outbreaks have been reported in shelters for homeless people. Organisations that support medically and socially vulnerable groups have experienced unprecedented levels of demand for their services, and have made substantial efforts to adapt their systems to meet this demand whilst respecting the physical distancing measures. Indeed, the ECDC report emphasizes that civil society and charitable organisations have made remarkable efforts to maintain their provision of services during the pandemic, despite the financial and logistical challenges.
To address these challenges the ECDC report suggests good practices for action during the COVID-19 pandemic. These include universal and equitable inclusion in national public health systems, by prioritizing health over immigration or social status; counteracting stigma by spreading factual messages around COVID-19 in an accessible way; using online consultations with healthcare providers to ensure continuity of care; and promoting meaningful social connections with others despite physical distancing. The report also highlights the need for greater financial and political support from national and regional authorities, to ensure the rights of vulnerable populations are upheld.
