Much of the focus of Covid-19 has been on the astronomical death toll and case numbers, yet this fixation neglects to consider the impact on those left behind by loved ones. A recent study in The Lancet estimates that globally 1,134 000 children experienced the death of primary caregivers, including at least one parent or custodial grandparent, and 1,562 000 children experienced the death of at least one primary or secondary caregiver. Between two and five times more children had deceased fathers than deceased mothers.
The study used mathematical modeling and mortality and fertility data from 21 countries with 76 percent of global deaths from Covid-19 to estimate the number of children who lost a caregiver. These countries included Argentina, Brazil, Colombia, England and Wales, France, Germany, India, Iran, Italy, Kenya, Malawi, Mexico, Nigeria, Peru, Philippines, Poland, Russian Federation, South Africa, Spain, United States, and Zimbabwe. The countries with the highest numbers of children who lost primary caregivers (parents or custodial grandparents) included South Africa, Peru, United States, India, Brazil, and Mexico. The scale of family loss from Covid-19 has not been seen since AIDS first rampaged through sub-Saharan Africa. As global vaccine disparities widen, lower-income and underresourced countries will begin to shoulder a greater burden of caregiver deaths associated with Covid-19.
In reality, the number of children who have lost parents is probably far greater than the study estimates due to international coronavirus testing and reporting gaps. In the US, the CDC only records deaths from Covid-19 and not the survivors left behind. We need to establish domestic and global institutions to collect this data and allocate resources to provide evidence-based psychosocial and economic support to children who have lost a caregiver.
After 9/11, the federal government orchestrated a significant effort to support the families who lost loved ones. Almost 20 years later, those families are still receiving support; why can we not orchestrate a similar effort for children who have lost a caregiver from Covid-19. With a study from JAMA Pediatrics, estimating more than 40,000 children in the United States have lost a parent to Covid-19, such a program should be a priority in our pandemic recovery. ADVERTISING
When a child loses a parent or caregiver, they are not just affected emotionally but also lose financial support and become at greater risk of dropping out of school, developing anxiety, depression, alcohol, and other substance abuse issues. These impacts could be compounded by the circumstances and stressors of the pandemic. The authors of the JAMA Pediatrics study highlight that “Covid-19 losses are occurring at a time of social isolation, institutional strain, and economic hardship, potentially leaving bereaved children without the supports they need.” There are also racial disparities involved in the loss of a parent or caregiver. By age 20, a Black child is twice as likely to experience the death of a mother and 50 percent more likely to experience the death of a father.
Support for a grieving child can take several forms, including individual counseling and camps or group programs. The National Alliance for Grieving Children provides resources and a regional directory for helping children deal with loss. But we must not overlook access to financial and material support either, less than 50 percent of children who experience the loss of a parent are estimated to receive Social Security survivors’ benefits which they may be entitled to. The timing of providing this aid is crucial, according to psychologist Dr. Kathryn Cullen who wrote in a 2018 editorial in The American Journal of Psychiatry that “the first two years after losing a parent is a period of critical risk for developing depression.” We must not continue to overlook this vulnerable population and beginning building programs to support them.