Preventing Spread of COVID-19 Among the Most Vulnerable to Complications

April 2, 2020 - (8 min read)

Supporting Seniors, People with Disabilities and People with Underlying Medical Conditions during COVID-19

Older adults and people with chronic health conditions, such as diabetes, heart disease and lung ailments, are more likely than younger, healthier people to experience serious symptoms from the illness caused by the coronavirus (COVID-19).  The immune system grows weaker as one ages, which makes it more challenging for older adults to fight off infectious diseases. Chronic diseases are more common with age, can compromise the immune system, and make people more vulnerable to serious complications. In addition, many individuals with disabilities and chronic health conditions and many seniors, rely on in-home care, making physical distancing challenging for them, their loved ones and their caregivers. Individuals in nursing homes and longterm care facilities are at a particularly heightened level of risk for severe illness as a result of COVID-19. 

The pandemic presents unique challenges for people who: 

  • Lack access to testing and health services 
  • Lack access to prescription drugs and routine services  
  • Lose income from furloughs or termination of employment 
  • Experience mental health stressors and social isolation 
  • Lack access to online communication 
  • Lack access to needed personal assistance 
  • Confront adverse impact to long term care and nursing facilities, disability service provider agencies and other senior living and congregate living facilities 

Intersections with Racial Equity 

Seniors, people with disabilities and those with pre-existing medical conditions who are people of color are disproportionately burdened by this pandemic in ways including health outcomes, access to resources and the cumulative impacts of racial stressOn average, older adults of color suffer from a greater incidence of acute and chronic health issues and underlying medical conditionswhich make the risks of contracting COVID-19 more serious. Three in 10 American Indian/Alaskan Native people and one in four Black people have a disability, compared to one in five Whites, one in six Hispanic/Latinx peopleand one in 10 Asian peopleAny COVID-19related need for people with disabilities will disproportionately affect people of color, specifically Black people, American Indian/Alaskan Native peopleand people with disabilities. 


Isolation is a critical risk for many people with disabilities, people with underlying health conditions and elderly people remaining at home or in facilities where family visits or caregiver support may be limitedWith the need to keep physical distance to prevent the spread of COVID-19, the term “social distancing” has entered everyday conversations nationwide. However, john a. powellof the University of California at Berkeley Haas Institute, and others have called for the distinction we must make between physical distancing and social isolation. We can maintain physical separation and find new ways to stay socially connected with friends, family, colleagues and loved ones. This is especially important for older adults, people with disabilities, and people with underlying health conditions, whose need to remain separated from any potential source of COVID-19 will place them in socially isolated conditions.  

Seniors and People with Underlying Medical Conditions 

Given the disproportionate mortality rate caused by the virus and related complications faced by people 65 or older, seniors are uniquely vulnerable to complications from COVID-19According to the CDC, individuals living with medical conditions like diabetes, serious heart conditions, renal or liver disease, respiratory issues like asthma and those who are pregnant or with compromised immune systems are at higher risk for complications of the disease. There are unique recommendations for people with particular conditions, but these populations are advised to take extra precautions to keep space from others, stock up on supplies, stay home and make plans for acquiring supplies and receiving care if they or a caregiver are to get sick.  

People with Disabilities 

People with physical disabilities who require help but do not have a live-in caregiver face a greater risk of exposure to COVID-19 because of travel for appointments and the need to bring an outside caregiver into the home. Parents and families with children with disabilities rely on the resources and structure a typical school day provides. Because COVID-19 has closed many schools, these families now need to provide constant care to their children at home. Parents may not be able to take off from work to provide this care, which then means that they must find friends, family, or other caregivers instead. Adults with developmental disabilities who cannot go to work, therapy, and other activities may suffer physically and mentally. 

Supporting these populations presents a critical focus for cities to ensure that those at increased risk receive the supports they need to stay nourished, receive medication and medical supplies, address isolation and remain out of the hospital when possible. Measures like developing tailored food distribution channels, monitoring fraudulent information, tailoring unemployment and small business resources and supportive educational environment for these populations are also addressed elsewhere on this microsite. 

City leaders CAN take the following steps to protect the high burdened populations described above: 

Priority Testing 

Expand safe COVID-19 testing for the coronavirus with a focus on screening seniors.  

Expand In-Home Support  

Many older adults depend on services and support provided in their homes to maintain their health and independence. Without the opportunity to congregate in community spaces, cities can play a critical role in developing new systems for the delivery of food/meals, medication, medical supplies, cleaning/disinfecting, etc.  

Be a Trusted Source of Information  

  • During times of crisis, the elderly are prime targets of scammers and fraudulent information. Local governments can strengthen their sources of official information-sharing regarding COVID-19 testing/treatment, social security payments, income tax preparation, etc.  
  • Local, community-based organizations play an important role in sharing trusted information with older adults. Senior centers, adult day centers, and non-profit service providers should partner with local health departments to provide seniors with the latest guidance. Consider partnering with the local Agency on Aging to provide information and guidance.  
  • Minnesota Guidance 
  • Northeast Ohio Area Agency on Aging 

Provide Guidance for Home Care Workers, Caregivers and Congregate Living

Ensure that nursing homes, long term care facilities, home care workers and caregivers in your communities have adequate guidance to keep residents and caregivers be safe and avoid spreading COVID-19. Consider sending trained teams to ensure adequate infection control, physical distancing and hygiene measures are being followed. 

Decrease social isolation 

As social distancing is a recommendation to help combat COVID-19, local governments should prioritize ways to decrease social isolation for older people and other individuals who must remain at home by themselves. Develop resources like the Institute on Aging’s friendship line to provide a crisis line of support by phone for older adults and those living with disabilities.  

For additional information and resources, visit the Vulnerable Populations page on our COVID-19 website. 

About the Authors:

Katherine_Carter_SmallKatherine Carter is a Senior Specialist with NLC’s Race, Equity, And Leadership (REAL) Initiative.



Ian_SnyderIan Snyder is a Heinz Policy Fellow with NLC’s Race, Equity, And Leadership (REAL) Initiative




Aliza R. Wasserman is the Senior Program Specialist with NLC’s Race, Equity, And Leadership (REAL) Initiative.