The hidden toll of the Covid-19 pandemic: 10 million children orphaned by the pandemic

• In Event: Intervention for young children with a history of deprivation: International perspectives on an ongoing problem

Abstract

In March 2020, the World Health Organization characterized COVID-19 a global pandemic. Between March 2020 and the end of April 2021, based on real-time mortality data, it was estimated that a minimum of over 1.5 million children lost a primary caregiver due to Covid-19. More recently, we (Hillis et al., 2022) have used sophisticated real-time modeling, in which excess deaths were defined as the difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods. Such estimates of excess deaths can provide information about the burden of mortality potentially related to the COVID-19 pandemic, including deaths that are directly or indirectly attributed to COVID-19.
Based on these data it is now estimated that between the start of the pandemic and May 2022, approximately 10.5 million are thought to have suffered the death of a parent or grandparent caregiver responsible for their needs and nurture (Figure 1). Of these, 7.9 million children lost a primary caregiver, and 7.5 million faced orphanhood. Importantly, there is enormous regional variability in Covid-related orphanhood (see Figure 2).
In my presentation I will present how our group has successful created a real-time calculator that permits one to examine continuous updates on Covid-related orphanhood; for example, by consulting this calculator https://imperialcollegelondon.github.io/orphanhood_calculator/#/country/United%20States%20of%20America so that one can see that, for example, as of July 2022, over 200,000 children in the United States have been orphaned (both single and double orphan) by Covid-19.
In August 2022, The Lancet Public Health published an editorial that acknowledged the urgency of recognizing and addressing orphanhood as a monumental public health problem “The death of a parent is one of the last taboos in public health.” The editor cites sobering evidence on consequences and encouraging research on solutions. She concludes that “After 2 years of the pandemic, with millions of preventable deaths worldwide, the consequences of losing a parent for the children and caregivers left behind have only multiplied. Enabling open conversations about grief among young people afflicted by a parental death and offering proven multidisciplinary support services to affected families is now its own public health emergency of international concern.”12
To state the obvious, parental or caregiver death is permanent, and the consequences for children can be devastating and enduring. Of particular relevance to this symposium, in many parts of the world orphanhood increases the risks of institutionalization, family economic hardship, separations, disruptions, physical, emotional, and sexual violence; it also increases the risks of mental ill health, suicide, infectious diseases such as HIV/AIDS, chronic diseases, adolescent pregnancy, and poor educational outcomes. Evidence from previous epidemics shows that ineffective responses to parental or caregiver death can lead to deleterious psychosocial, neurocognitive, socioeconomic educational, and biomedical outcomes for children. For these reasons it is imperative that governments throughout the world mount a concerted effort to identify and track children who have been orphaned by Covid-19 and to ensure that all such affected children receive the services they need.

Author

• Charles A. Nelson, Harvard Medical School
  Presenting Author