More than 1.5 million children worldwide had at least one caregiver die from a COVID-19-related cause during the first 14 months of the pandemic, researchers estimate in a new study.
These children lost a parent, custodial grandparent or a grandparent who lived with them to the respiratory illness, according to the study published Tuesday in the medical journal The Lancet.
The researchers hail from different institutions including the Centers for Disease Control and Prevention, Harvard Medical School, Imperial College and the University of Cape Town.
They counted deaths in multiple countries directly caused by COVID-19 and those caused by indirect, related matters such as lockdowns, decreased access to health care and treatment for chronic conditions and social and travel restrictions.
“Because most COVID-19 deaths occur among adults, not children, attention has been focused, understandably, on adults. However, a tragic consequence of high numbers of adult deaths is that high numbers of children might lose their parents and caregivers to COVID-19, as occurred during the HIV/AIDS, Ebola, and 1918 influenza epidemics,” the researchers wrote in their study.
“Because COVID-19 can lead to death within weeks, families have little time to prepare children for the trauma they experience when a parent or caregiver dies. Evidence shows institutionalisation — a common response even when there is a surviving parent — can result in developmental delays and elevated abuse.”
The study pulled mortality and fertility data from 21 countries to model rates of COVID-19 related orphanhood, or the death of one or both parents, and the deaths of custodial and co-residing grandparents ages 60 to 84 from March 1, 2020, to April 30, 2021.
The deaths accounted for 77% of the worldwide COVID-19 deaths that occurred last year and early 2021.
An estimated 1,134,000 children lost a parent or custodial grandparent who died directly or indirectly from COVID-19. The majority of children, 1,042,000 of them, lost a mother, father or both, with most losing one parent rather than both.
The study authors estimate that a total of 1,562,000 children lost at least one parent or custodial or co-residing grandparent or other older relative.
“The study illustrates the indelible mark that a pandemic makes. It is not just that millions of people are dead around the globe but the cascading impact of their absence,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security who was not involved in the study.
“The study underscores how important it is to get pandemic preparedness correct to prevent all of these horrendous consequences. To prevent future orphans from COVID-19 it is critical to get vaccines into the arms of the high risk around the world,” Dr Adalja said.
For the analysis, researchers collected data from Argentina, Brazil, Colombia, England and Wales, France, Germany, India, Iran, Italy, Kenya, Malawi, Mexico, Nigeria, Peru, Philippines, Poland, the Russian Federation, South Africa, Spain, the United States and Zimbabwe.
South Africa, Peru, the United States, India, Brazil and Mexico had the highest numbers of children who lost their parents or custodial grandparents.
Countries where at least one caregiver per 1,000 children died a COVID-19 related death included Russia, Argentina, the U.S., Iran, Colombia, Brazil, Mexico, South Africa and Peru, according to the study.
In every country, COVID-19 linked deaths were greater among men than in women, especially those who were middle-aged or older, the study also found. Between two and five times more children lost a father compared to the number of children who lost a mother.
Losing a parent or caregiver could be linked to increases in substance abuse, mental health problems and other chronic health and behavioral conditions, said the National Institute on Drug Abuse, which helped fund the study.
Dr. Nora Volkow, NIDA director, said the study highlights the COVID-19 pandemic’s lasting effects on families and the future mental health and wellbeing of children globally.
“Though the trauma a child experiences after the loss of a parent or caregiver can be devastating, there are evidence-based interventions that can prevent further adverse consequences, such as substance use, and we must ensure that children have access to these interventions,” Dr. Volkow said.