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The shadow orphan crisis of Covid-19

More than 40,000 children likely lost parents to Covid-19. Who will help them?

Luminarias lined up at the Reading Hospital in West Reading, where the hospital held a memorial ceremony for the 938 Berks County residents who have died from Covid-19.
Ben Hasty/MediaNews Group/Reading Eagle
Brian Resnick is Vox’s science and health editor, and is the co-creator of Unexplainable, Vox's podcast about unanswered questions in science. Previously, Brian was a reporter at Vox and at National Journal.

The Covid-19 pandemic is multiple crises in one, and our fixation with deaths and case numbers can obscure some of the pandemic’s collateral damage. But more of the related fallout is now coming into view, particularly when it comes to children.

Researchers now estimate that more than 40,000 children in the United States have lost a parent to Covid-19. Per the estimates, published recently in JAMA Pediatrics, for every 13 people who die of Covid-19 in the US, one person under the age of 18 loses a parent.

It’s part of a broader grief crisis that’s likely to leave a lasting toll on society. The death of a loved one at any age is hard. But for young people, it can be particularly destabilizing, altering the course of their lives.

When a young person loses a parent, they don’t just lose someone they love, they lose financial support. They become at greater risk of dropping out of school (at any level); for anxiety, depression, alcohol and other substance misuse issues; and for feeling like they have lost control over their lives.

“Moreover,” the authors of the JAMA Pediatrics estimate write, “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.”

Compared to white children, a greater proportion of Black children have likely lost parents

Researchers don’t precisely know the number of children in the United States who have lost a parent to Covid-19. The Centers for Disease Control and Prevention (CDC) collects data on who has died of Covid-19, but not the survivors they leave behind. (And though these estimates aren’t international, we can assume that with more than 3 million confirmed Covid-19 deaths around the world — certainly an undercount — many tens of thousands of children outside the US have lost parents, too.)

But they do estimate there are some racial disparities among the orphaned children in the US. We know Covid-19 has been taking minorities at younger ages than white people. And in the JAMA Pediatrics paper, the authors estimate that while Black children make up 14 percent of the total population of children in the US, they account for 20 percent of the kids who have lost a parent to Covid-19. (This particular analysis only estimated the burden on Black and non-Hispanic white children.)

“Those consequences could play out in the long term,” says Ashton Verdery, a co-author of the paper and a Penn State sociologist who studies the societal costs of bereavement. Research on bereavement in childhood, he says, points to “schoolchildren who were otherwise going to attend college but won’t because they experienced the death of a parent from Covid-19.”

The impact of these deaths is so powerful that bereavement is thought to be a source of racial disparities in health and education in America. 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. The pandemic is likely to make this trend worse.

There’s been a narrative throughout the pandemic that the deaths are mostly of the oldest and the frailest, and that’s broadly true in terms of who is most at risk of dying from Covid-19. But it obscures that middle-aged people and slightly older individuals have died, and they might have left kids under the age of 18 behind.

According to the CDC, more than 104,000 people ages 30 to 64 have died of Covid-19 in the US (out of a total of more than half a million deaths). “The numbers are just staggering,” Verdery says.

There’s no one in charge of helping grieving kids

The researchers say there needs to be a better tracking system for those who have lost parents to Covid-19. “To help these children, we need to know who they are,” Verdery and his co-authors write in the Washington Post. “After 9/11, the federal government orchestrated a large effort to support the families who lost loved ones. We don’t yet have an institution whose job it is to collect the names of children who have lost a parent or primary caregiver and to connect them to services.”

The timing of aid could be crucial. “The first two years after losing a parent is a period of critical risk for developing depression,” Kathryn Cullen, a psychiatrist at the University of Minnesota Medical School, wrote in a 2018 editorial in The American Journal of Psychiatry.

She was commenting on a study that tracked 216 young people for seven years after the death of a parent, and compared them to a similar cohort who didn’t lose a parent. It found bereaved children were more likely to experience depression than non-bereaved children 21 months after the death. And those who experienced that prolonged grief were then at greater risk for “functional impairment” (meaning disruptions to their daily lives) and depression at 33 months.

Support to a grieving child could include individual counseling, workbooks, and camps or group programs. The National Alliance for Grieving Children has resources and a regional directory for helping children deal with loss. There are also some online therapy sessions geared toward kids who need help combating depression and anxiety in general.

American society doesn’t do enough to protect these grieving kids in material ways, either. The death of a parent also often means the loss of financial stability. It’s estimated that less than 50 percent of children who experience the loss of a parent receive Social Security survivors’ benefits (which they may be entitled to). “This is one of the most staggering statistics that I found,” Verdery says. “The kids are already dealing with so much. And we’re not even getting them in touch with the benefits they’re entitled to.”

All of this is just another reason for all of us to work to end the pandemic as soon as possible. More deaths of parents can be avoided.