key: cord-0689252-krdt2g38
authors: Maykrantz, Sherry A.; Weiss, Erica H.; Baker, Francine
title: COVID-19 and the Vulnerable
date: 2020-08-13
journal: Dela J Public Health
DOI: 10.32481/djph.2020.08.014
sha: 25c4038681812e5e6b4499e5835d375393cdf139
doc_id: 689252
cord_uid: krdt2g38

nan

consider the reasons why COVID-19 is infecting these groups at higher rates and communicate action plans to help.

While public health is built on three pillars: to prevent, protect, and promote health for all, addressing a pandemic is a slippery-slope. 8 Throughout this pandemic, local governments and vulnerable populations have been detached from the resources they need to respond with robust testing and tracing programs. However, since public health principles consider many layers of protection, even limited resources can be activated to protect the vulnerable, including simple, evidence-based steps to prevent the spread of disease.

When considering a public health plan of action, a balance must be struck between individual rights vs. societal rights (delivering the most good for the most people). 8 The White House offers general guidelines to manage this pandemic but suggests that each state should do what is best for their own. The Constitution provides the general framework that guides state "powers," 9 but state governors hold the authority to regulate the health and safety of their residents. 8, 9 Within state guidelines, locally run agencies are allowed to determine additional guidelines if they have more vulnerable people, based on their resources to actively administer public health services at the local level. Additionally, media and social media services play a major role in generating truthful information and dispersing clear public health guidelines among the disinformation that may persist. With all of these layers, delivering carefully considered public health guidelines can be difficult, especially as the COVID-19 virus knows no boundaries.

Even with these complicating factors, all individuals should find trust in the CDC's guidelines, which remains our most reliable resource. When Federal, State, and local information conflicts, you can find trust in a few basic evidence-based principles that the CDC promotes to prevent the spread of disease: clean your hands often, do not touch your face, wear a mask, and stay at least six feet -if not more -from others, stay home if you can, and avoid crowds. 2, 8 

Consistent communication and modeling safe behaviors by local community leaders are essential practices for infectious disease management. Local authorities and leaders should do everything they can to communicate the importance of wearing a mask while in public spaces to protect the mask wearer, and more importantly, protect others. Cloth masks have been found to help reduce the spread of coronavirus by people who have COVID-19 but don't know it. 10 Countries that have required facemasks, testing, isolation, and social distancing early in the pandemic have had more success slowing the spread of this coronavirus than we have so far in the United States. 11, 12 It is critical for local officials to collaborate with trusted local nonprofit service providers, business leaders, faith leaders, and local public health professionals to reach vulnerable populations and offer them accurate information to prevent the spread of COVID-19.

When resources are low, local governments and businesses can put greater emphasis on gainframed communication messages (what can the community gain?) 8 to explain the benefits of wearing a mask, cleaning hands, or keeping proper social distance. This strategy is used to explain how the community can play a role in preventing the spread of this virus, or how preventing the spread of the virus can help the economy and jobs. This is an essential component in public health, with much to be gained. 2, 4, 8 As more local officials and their constituents understand the value of upstream public health interventions, 8 the more we can do both individually and together to prevent a potentially disastrous second wave of COVID-19, especially within the vulnerable communities impacted the most during these initial months.

In ideal cases, localities could rely on a coordinated government response with Federal and State investment in testing and contact tracing. In the absence of that, local authorities should be encouraged and supported in using trust-worthy information from the CDC to create powerful local public health messages based on prevention and self-care. Being prepared and informed is the best approach to help protect vulnerable populations. 13 The Maryland Public Health Association (MdPHA) stepped-in to help local authorities in Maryland with the Public Health Action Alliance (PHAA). This newly created volunteer force coordinates highly skilled public health professionals and students residing in Maryland to aid local community leaders, faith communities, school leaders, and nonprofit organizations. Volunteer public health professionals can help reach vulnerable populations with accurate, culturally appropriate, targeted information and resources; teach local leaders and service providers how to offer evidence-based prevention strategies; support contact tracing efforts; aid in employee training and risk communications. They can offer a wide range of public health services, as needed.

As we face a likely "second wave" of this virus, local authorities must communicate, frequently, that seemingly simple public health measures outlined by the CDC help protect the economy and the vulnerable. 13 Local authorities can continue to create a network of resources to help their constituents practice preventive measures and limit the spread of COVID-19 or even stop it, even in the face of disinformation and forgetfulness.

COVID-19 Map

Cases in the U

One-third of all U.S. coronavirus deaths are nursing home residents or workers. The New York Times

Social distancing and incarceration: Policy and management strategies to reduce COVID-19 transmission and promote health equity through decarceration

COVID-19 deaths analyzed by race and ethnicity

The essential workers filling New York's coronavirus wards

Why we're tracking every US health worker who dies from coronavirus. The Guardian

States with the most vulnerable populations to coronavirus

The new public health law: a transdisciplinary approach to practice and advocacy

Use cloth face coverings to help slow spread

Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China

The coronavirus pandemic: Can we handle such epidemics better

Identifying and protecting vulnerable populations in public health emergencies: Addressing gaps in education and training

Delaware Academy of Medicine / Delaware Public Health Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License