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ince January, the current pandemic has infected nearly 1.3 million persons worldwide with a death toll of nearly 70,000 as of Tuesday. The situation may be worsening by the day as many countries struggle to respond to the growing crisis. Several measures would work for the general public but do little to help particularly vulnerable groups.

Vulnerability, according to the World Health Organization, is defined as the degree to which a population, individual or organization is unable to anticipate, cope with, resist and recover from the impacts of disasters.

Such groups include the elderly, pregnant women and the immunocompromised — the malnourished, HIV patients or patients having chronic terminal diseases like cancer. With low immunity, they are highly prone not only to exposure to the virus, but also to contract even more severe diseases when infectious disease manifests.

The susceptibility to infection remains high among this vulnerable population, and COVID-19 is no exception. The susceptibility of the population to infectious diseases depends on underlying conditions.

The elderly, for example, develop frailty or physiological decline due to aging, in which cells are degenerated more quickly, including the immune system cells. People infected with the human immunodeficiency virus, for example, are prone to parallel infection (or coinfection) since HIV destroys the immune system.

Unfortunately, social arrangements potentially exacerbate this issue. For instance, one in four elderly people in Indonesia has a preexisting health condition and/or health complaint, according to Statistics Indonesia.

Special attention is needed for the poorest among the elderly, as many cannot seek health services either because of financial or physical difficulties in reaching health facilities. Moreover, many are uninformed or even unable to understand health promotion messages.

Following the declaration of a national emergency response period, the government implemented massive public health measures through physical distancing, promoting personal hygiene and preparing healthcare facilities to test and treat patients.

However, our country is already burdened with a high prevalence of HIV, chronic diseases and malnourished children. With millions of pregnant women, elderly and people living with chronic diseases like HIV/AIDS and diabetes, many more lives are at risk if we fail to protect these vulnerable groups through some urgent measures.

First, we need specific education materials covering hygiene practices and self-protection methods for each of these groups, using clear and simple language. The national COVID-19 task force has published guidelines on its website, which could be translated into local languages by local governments. Involving the local community, to the neighborhood or hamlet level, to ensure important messages reach these groups. Certain communication platforms should be also identified to engage with marginalized groups, such as people living with HIV.

Second, establish community teams providing direct support for these groups, without neglecting physical distancing. An excellent example is in the neighborhood of Kauman, Yogyakarta, in which a local response team has built a communal washtub, distributed health flyers and helps the elderly buy groceries or first aid drugs to reduce their exposure from to crowds.

Such teams can contact the nearest healthcare facility if they find any in their community falling sick or developing COVID-19 symptoms. Furthermore, this community team could promote and monitor physical distancing in their area, by reminding people not to conduct any gathering and pray at home. This is particularly crucial nearing the Ramadan fasting month in late April, when people gather for breaking the fast and prayers.

Third, strengthen the primary health care services to conduct active health response at the community level, by prioritizing these vulnerable groups. The health workforce could collaborate with the local community to monitor their health status.

When more test kits to detect infections are available, massive and free testing are imperative. Rapid transmission of the virus is expected to worsen when it reaches Jakarta’s many crowded slums; thus, we recommend free testing in such dense areas, especially as several patients had not shown prior recognizable symptoms.

Lastly, as the current estimates suggest the epidemic peak will peak be during the Ramadan fasting month, while the government has decided against banning the seasonal massive exodus of urbanites migrants to their hometowns and villages ahead of the post-Ramadan and Idul Fitri celebrations. Local leaders are only told to discourage people against returning home, and monitor them closely, as the travelers would put their families and communities at great risk, particularly the elderly.

Last year, some 15 million people from Greater Jakarta joined the exodus to other provinces ahead of Idul Fitri.

Banning the exodus is vital, as even now hospitals and health workers are already overwhelmed.

Despite the existing public health measures, vulnerable groups, still need specific assistance. More contextualized approaches are needed to protect these groups from suffering in this ravaging pandemic.