More than 1,000 members of the Traveller Community living in Galway have been infected with Covid-19, since the start of the pandemic.
A conference in the city has heard that at one stage during the third wave of the virus, over a third of people in ICUs locally were from the Traveller Community.
The webinar, organised by the Galway Traveller Movement, has heard of the "huge burden of infection and hospitalisation" experienced, particularly in recent months.
The Alpha variant spread rapidly through large extended Traveller family networks, especially where people had sub-standard living conditions or were experiencing overcrowding.
A total of 942 cases were confirmed among Travellers in Galway city and county, between the end of November and mid-April. Case numbers surged during January and February.
The vast majority were linked to outbreaks on halting sites and Traveller group housing schemes.
A Public Health specialist, working to co-ordinate the local response to outbreaks, said Covid-19 had shone a spotlight onto adverse living and working conditions.
Dr Aileen Kitching told the webinar that a collective effort was needed to change the social determinants to healthcare.
She detailed the manner in which the Health Service Executive had worked to limit the spread of the virus and encourage vaccine take up.
Dr Kitching said a legacy of discrimination had led to some mistrust of the healthcare system. Problems were also identified around the sharing of personal information about others, for contact tracing purposes.
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The Executive Director of the World Health Organization's Health Emergencies Programme told attendees that marginalised communities around the world had suffered more in terms of the spread of Covid-19.
Dr Mike Ryan said those already vulnerable because of limited access to healthcare had been impacted disproportionately and that even in a developed country like Ireland, there were "real barriers" in this regard.
He said equality did not come about from sayings or catchphrases, but from an actual commitment to change.
While the pandemic had caused its own wounds, it had also "ripped away bandages" on old wounds too. Dr Ryan said the world was paying a heavy price for leaving so many people outside of the health system.
With regard to the problems experienced by the Traveller Community, he said there had to be a dialogue about how to improve housing, reduce overcrowding and address social determinants to healthcare.
He said it was important to "move beyond the tokenism of saying there's a problem" and instead focus on how communities could come together to bring about fundamental change.
Key to this was the involvement of those who feel marginalised in having a voice to say what is wrong and to offer suggestions on how it could be fixed.
Dr Ryan said the vast majority of reasons why people in certain ethnic groups had poor health outcomes was to do with the social circumstances in which they lived, their access to healthcare and the way in which their society treated them as equal to others.
Speaking on RTE's Morning Ireland, Joanna Corcoran from the Galway Traveller Movement said inadequate living conditions, overcrowding and lack of sanitation made infection more widespread in their community.
Ms Corcoran said that existing inequalities in housing, including access to water, electricity and a clean home environment also made the community particularly vulnerable.
She said that hidden homelessness and the failure to provide enough culturally appropriate accommodation resulted in many families living together.
This made self-isolation impossible and "that helped to make issues worse".
She said the HSE had responded well to the needs of the Traveller community during the pandemic, but local authorities had not responded adequately.
Reports compiled since April 2020 show many members of the Traveller community living in substandard and overcrowded conditions found it nearly impossible to self-isolate or follow public health advice when necessary to help prevent the spread of the virus.
Younger people and children were also disadvantaged.
An education survey, carried out during the first lockdown (in May 2020) showed that only 41% of Traveller families in Galway had the digital equipment and internet required for children and young people to do their schoolwork during lockdown.
Many families had access to a phone only, with up to seven children in some families having to use the one device.