We often measure the toll of the pandemic by the number of lives claimed by Covid-19, but recently published studies show that it’s just as important to measure the impact on those who are left behind. According to studies published in The Lancet and Pediatrics, it’s estimated that over 1.5 million children around the world have lost at least one of their caregivers during the pandemic. 140,000 children have been orphaned by Covid-19 in the United States alone. This means that one child loses a caregiver who provided their home and basic needs including love, security, and daily care, for every four Covid-19-related deaths.
The United Nations Children’s Fund (UNICEF) defines an orphan as a child who has lost one or more of their primary caregivers. Orphanhood does not affect demographic groups equally. The Lancet and Pediatrics studies revealed wide racial disparities, with children of color losing caregivers at far higher rates than white children. In the US, for example, Latinx, Black, and Native American children accounted for 65% of those who lost a primary caregiver due to the pandemic. In these same groups, it’s also more likely that children reside with a grandparent rather than a parent. In the US, there are 4.5 million children who live with a grandparent instead of a parent, and as Covid-19 affected the elderly most severely, those children faced orphanhood a second time.
The emotional and developmental impact of losing a caregiver is severe. Grief in children causes stress that can have both psychological and biological impact on them. Children can suffer from lower educational attainment, slower brain development, and higher risk of mental health disorders and substance abuse. Studies have shown that adverse childhood experiences—traumatic events like the loss of a caregiver—affect a child’s mental health in the same way underlying conditions affect physical health. When someone experiences stress, the brain produces stress hormones, and chronically elevated stress hormones can harm the brain and heighten the risk of physical and psychological ailments. In other words, if a child’s grief is not recognized and treated, short-term effects can become long-term effects. Prolonged grief can lead to depression, anxiety, post-traumatic stress disorder, substance abuse, and suicide. Many child development experts have studied the epigenetics of childhood trauma—the process by which gene expression is switched on or off depending on life experiences. While a genome is fixed at birth, its activity can be profoundly affected by adverse childhood experiences, meaning for the rest of their lives, a child who suffered the loss of a caregiver is at an increased risk of every major cause of death in adulthood including cardiovascular disease, diabetes, cancer, or pulmonary disease.
There are a few possible scenarios for a child when they lose a caregiver; they may rely on a remaining caregiver, be taken in by relatives, placed in foster care, or sent to an institution. But often parents who are left to take care of children alone, or relatives who take in orphaned children, suffer financial hardship and stress. The foster care system is strained, and institutions are short on the resources they need to provide care. This means that all of us—society at large and especially our children—will feel the immediate and long-term impact of this for generations to come. Maintaining orphaned children in families must be a priority, and families bereaved by the pandemic must be supported. This may look like financial support, trauma-informed education, or policies that promote stable, nurturing relationships and address childhood adversity.
In December, the Covid Collaborative, a bipartisan group of child advocates, published Hidden Pain, a report that details how the loss of a caregiver can hinder a child’s development for the rest of their life. Hidden Pain calls for a coordinated effort to use schools, health care settings, and other community-based organizations, to identify and support children and families who have lost a caregiver due to the pandemic. It also calls for the creation of a Covid-Bereaved Children’s Fund, like those created to support the victims and families of 9/11 or children orphaned by HIV/AIDS, with priority given to those children who lost their only in-home caregiver.
When a child’s world has been turned upside down, they need to be supported at all times, ideally by a family member but also by the community. When a child has lost a caregiver, adults around them need to build them a safety net that protects them until they can heal from their trauma and resolve their grief. Kids need to be reassured that it will get better, and that they are loved, heard, and safe. Any time a child who has lost a caregiver cries out for help, someone should be there to answer that call. This trauma-informed approach to orphan care must be a priority as the pandemic subsides and orphaned children around the world feel the effects of the loss of a caregiver. Policy makers, caregivers, and families must have the tools they need so that children can heal from their trauma and be gifted the chance to thrive.
The studies referenced in this post represent collaborations between the CDC, USAID, the World Bank, Imperial College London, Harvard University, Oxford University, the University of Cape Town, South Africa, and others. They represent research across 21 countries, including the United States.
This piece was written for All God's Children International and originally appeared on their blog.