Policymakers should focus on vulnerable minority groups in view of their unique characteristics, needs, culture and behaviours, which can hinder the implementation of physical distancing (such as, for example, the density of the communities they live in), and therefore accelerate the spread of the virus to a faster rate than among the mainstream population. Furthermore, since minorities usually have low SES, live in remote areas, and have language barriers, they have less access to healthcare services, including testing, particularly in times of crisis, even in countries with universal coverage due to lack of ability to pay and lower availability of services as well as cultural differences. If countries fail to take this into account in their policymaking, vulnerable minority groups will provide particularly fertile ground for the spread of COVID-19 to other sectors and they will be blamed for exacerbating the crisis. Therefore, it is imperative to formulate a comprehensive national intervention plan that is sensitive to the needs and lifestyle of these groups while at the same time fostering their trust in the government and its institutions.
In Israel, the ultra-Orthodox Jewish community and the Arab population are the most prominent and well-defined minority groups, representing 12%  and 20%  of the total population, respectively. During March 2020, cities predominantly inhabited by ultra-Orthodox Jews became foci of the COVID-19 outbreak. After some delay, the government implemented special measures adapted to this population. By mid-April, higher rates of COVID-19 infection were also reported in Arab cities, and there is a concern that these will also become the source for an acceleration of the outbreak and will require specifically tailored measures.
Ultra-Orthodox Jews are characterized by large families (in 2017, their fertility rate was 7.1 children per woman), a low SES, crowded living conditions, an intense social and community life, and higher dependency on public transportation – factors that provide an ideal environment for COVID-19. Furthermore, this population is characterized by low rates of formal labor force participation  and therefore are not always entitled to the economic assistance from the state related to the pandemic, such as unemployment benefits. Despite Israel’s universal National Health Insurance, the ultra-Orthodox community’s access to healthcare was lower than that of the general population even before the pandemic, due to the distances from healthcare providers, language and cultural barriers, and sometimes also the inability to pay copayments , and this situation did not improve during the pandemic.
Apart from socioeconomic characteristics, the ultra-Orthodox also have different behavioural norms that limit their ability to comply with mitigation measures. For example, some groups within the ultra-orthodox community do not use the conventional media nor social media, which the MoH has used to disseminate information and directives. Therefore, they are less informed about measures such as physical distancing while the information they did receive was not tailored to the community in terms of language and content. In addition, many members of this community, and in particular women, do not use smartphones and did not receive SMS messages alerting them of contact with an infected individual or they suffered from language barriers in order to understand the messages. Thus, this community did not self-quarantine to the extent that other populations did. Finally, ultra-Orthodox Jews live in tight-knit communities that tend to follow the instructions of their own leadership over complying with government directives.
As a result, the rate of the COVID-19 morbidity in cities primarily inhabited by ultra-Orthodox Jews is higher than that of the general population . Thus, the government came to the realization that measures were needed in these locations that are tailored to this community.
The first measure taken by the government was to build trust among the leadership of the ultra-Orthodox community and to gain their cooperation in, for example, communicating the importance of good hygiene and physical distancing. In addition, existing civic society networks and structures, such as aid and charity institutions, were recruited in order to provide essential services and goods such as food and prescription drugs during the lockdown, in cooperation with the health and welfare services and local municipalities.
Nonetheless, a great deal of effort was expended and precious time lost until the MoH, police and local authorities were able to create effective communication channels and to convince the ultra-Orthodox leadership to mandate physical distancing in their communities. For example, the education system in Israel was shut down on March 12, but some ultra-orthodox educational institutions continued operating for a full week after that. Although physical distancing measures were put in place in early March, synagogues were instructed to shut down only 2 weeks later, on April 19. Even then, a few ultra-Orthodox religious leaders permitted their followers to continue praying in synagogues for another 10 days (until April 31), even after it became evident that ultra-Orthodox cities and neighbourhoods were becoming foci of the virus’ spread. It is also worth mentioning that once the leadership instructed the community to follow the directives, the community complied almost without exception.
The second measure implemented by the government in ultra-Orthodox areas was increased diagnostic testing, isolation of positive individuals, and the evacuation of the elderly to now-empty hotels rented by the government.
The third measure was the quarantine of cities and towns with high infection rates. Thus, on April 1st, the government approved special emergency regulations to implement stricter physical distancing measures in these cities, the majority of which were ultra-Orthodox, and to quarantine them from the rest of the country. On April 12th, the measures were extended to neighbourhoods in the large cities with high infection rates. For example, Jerusalem was divided into four quarters and residents were restricted to their quarter. The army was called in to collaborate with the police in evacuating the elderly and families that agreed to do so, enforcing the quarantine of cities and neighborhoods, and distributing food and essential provisions to residents, particularly those in disadvantaged neighborhoods.
Measures during the Passover holiday
Holidays are critical occasions characterized by family get-togethers, increased travel, and greater attendance of religious services, all of which can potentially accelerate the spread of COVID-19. In order to curtail these activities, the government declared special measures during the Passover period (April 8 to April 15), including tighter restrictions on mobility and public gatherings. Thus, movement between Jewish cities was forbidden for 3 days starting from April 7. On April 8th and 9th people were prohibited from leaving home, even to buy food. In order to enforce these measures, the police set up roadblocks on major routes between cities. At the same time, the government approved a special one-time children allowance for Passover in the amount of 500 NIS (~USD125) per child and up to 2000 NIS per family, without any means tests and a 500 NIS grant for the elderly (for which the criteria have yet to be publicized).