Throughout the pandemic, media outlets and online dashboards have provided constant updates on the number of people who have died from COVID-19. Far less prominent—but just as striking—are the tallies of those left behind.
According to an estimate published recently in the journal Pediatrics, at least 140,000 American children had lost a parent or caregiver because of the coronavirus by the end of June—meaning that one of roughly every 500 children lost one of the most important adults in their life. Susan Hillis, a co-author of the study and an epidemiologist at the CDC, told me that as of earlier this month, the total had reached at least 170,000.
Fully grasping this complicates some of the standard narratives about the tragedy of the pandemic. It is not only the number of lives cut short by COVID-19 that should mark the scope of our losses, but also the millions of people who had a loved one die. And it is not just older Americans who suffer—even if kids are less vulnerable to the virus itself, they are no less vulnerable to the loss it causes.
In a typical, non-pandemic year, many children lose a parent, but globally, an additional 1.5 million children were estimated to have lost a parent or caregiver from March 2020 to April 2021. And in the U.S. alone, the number of people who have lost a close relative—whether a child, sibling, spouse, parent, or grandparent—to COVID-19 is thought to be about 6.5 million.
For children in particular, the death of a caregiver is tremendously destabilizing. “It essentially shatters kids’ assumptions about the world when their parents—these figures who are supposed to provide a sense of security and safety and meet basic needs—die,” Tashel Bordere, a professor of human development and family science at the University of Missouri, told me. Many kids who lost a parent during the pandemic will continue living in the same home, but some will move in with another family member or close friend. Others will enter the foster-care system or become homeless.
The racial disparities among this group are stark. According to the Pediatrics study, Hispanic children have been almost twice as likely as white children to lose a caregiver because of the pandemic, Black children have been more than twice as likely, and American Indian and Alaska Native children have been more than four times as likely. Hillis told me that these inequities reflect the facts that Americans of different races have died of COVID-19 at different rates and have different fertility rates.
Bordere said that the way children respond to a death can vary based on their developmental stage, gender, and personality, among other factors. But in general, children who lose a parent tend to be at higher risk of experiencing physical- and mental-health problems, housing instability, academic and behavioral issues, and sexual abuse. They are also more likely to enter poverty—for many, a parent’s death means a loss of income.
The passing of a sole caregiver who’s a grandparent can be especially hard, because it represents a “double loss,” after the earlier death of or separation from a parent. (Approximately 10 percent of American children live with a grandparent in their household; that rate is higher for Black, Hispanic, and Asian children.)
A caregiver’s death during a pandemic presents unique challenges for grieving kids. Job instability and general stress may have depleted the abilities of other adults in their lives to support them. And they have to live with constant reminders, in the media and daily life, of why their parent is gone. “[The] replaying of an event can retraumatize children,” Bordere said. “The masks, the numbers that we’re updated on—anything related to COVID will be a trigger for a child who has dealt with a loss.”
Not every child even gets room to process their emotions. Bordere told me that Black children are frequently penalized in school for perfectly normal reactions to a death, such as crying, distractedness, and fatigue. This punishment can impede their grieving process. In a study from before the pandemic, Black Americans were found to be more likely than white Americans to have experienced a death in their family during childhood.
And children in general may struggle more than adults with how inexplicably the virus arose and with not getting to be present for the end of their parent’s life. “Children are imaginative, particularly younger children,” Bordere said. “They’re left with [mental] images that may be far worse” than what actually happened in their parent’s final days.
What would help these children? “We’ve learned that programs that target one type of vulnerable child (e.g., an ‘AIDS orphan’ or ‘COVID orphan’) can be highly stigmatizing and inefficient,” Rachel Kidman, a social epidemiologist at Stony Brook University, wrote to me in an email. Instead, she suggested anti-poverty initiatives and additional resources for counseling in schools—“programming that is more universal, but still sensitive to the needs of these children.”
These children don’t match the oversimplified portrait of a typical COVID-19 victim: an old person near the end of their life. But the coronavirus can also have awful effects on people at the very start of their lives, even when they themselves don’t get sick. “For every surge in COVID cases, until we have widespread, adequate vaccination, there will be a surge in COVID deaths,” Hillis told me. “And for every surge in COVID deaths, there will be a surge in COVID orphanhood.”