Opinion | A Million Children Have Lost a Caregiver to Covid. Here’s How We Can Help Them.

From March 2020 to last April, over a million children worldwide lost a mother, father, grandparent or another adult they relied on as a primary caregiver to Covid-19. In South Africa, one in every 200 children lost his or her primary caregiver. In Peru, it was one in every 100.

Because of international gaps in coronavirus testing and reporting, these numbers are likely underestimates. But our team of researchers, including experts from public health organizations and universities around the world, used mathematical modeling and mortality and fertility data from 21 countries with 76 percent of global deaths from Covid-19 to estimate the number of children who lost a caregiver (some lost one or both parents, others lost grandparent caregivers). We created an online calculator that shows minimum estimates for every country in the world.

What we found was a scale of family loss that has not been seen since AIDS first rampaged through sub-Saharan Africa. “Do you remember Africa in 2002, when we realized that all the dying adults meant orphaned children?” asked the lead author of our study, Susan Hillis, a senior technical adviser for Covid-19 at the Centers for Disease Control and Prevention.

I did. I remembered the spread of a deadly virus at a time when lifesaving medicines were available in the United States and Europe, but still years away for other countries. I remembered that we were too slow to invest in caring for those children losing their mothers, fathers and grandparents. The global community made well-meaning but terrible errors in our response: sending hundreds of thousands of youngsters to orphanages, and so putting them at a higher risk for mental health problems, infectious diseases, physical abuse and sexual violence and poverty.

A similar situation is playing out now with Covid-19. Our estimates suggest that every 12 seconds, a child loses an important caregiver to the coronavirus. Even though there have been over half a billion Covid-19 vaccine doses administered worldwide, more than 75 percent of them have been used by the world’s richest countries.

This toll is unequal in many ways. In countries like the United States there are already robust social services for children who lose their caregiver. In other countries, like those that have already been hard hit by diseases like AIDS and Ebola, there are fewer safeguards.

Children in countries where multigenerational homes are the norm and older family members play important roles in caregiving may be at greater risk. In some places, children who lost parents to Ebola or AIDS are in the care of grandparents who are falling victim to Covid-19. These are the very countries, in Africa, South Asia and Latin America, experiencing new surges in infections.

Since widespread vaccination coverage may take years, the number of bereaved children worldwide could grow exponentially.

These children’s grief and their future are the global community’s responsibility. Other mass-fatality outbreaks, like H.I.V. and Ebola, offer guidance on a way forward.

In 2003, the United States made a groundbreaking commitment to children worldwide affected by the AIDS epidemic. It mandated that 10 percent of the President’s Emergency Plan for AIDS Relief, also known as PEPFAR, would support children whose primary caregivers had died or were infected. This program continues to support families caring for children who lost caregivers, which helps prevent children being placed in institutions.

It also provides funding to households to cover food and other basic needs for children. There are parenting programs to help prevent violence and improve relationships and mental health as well as subsidies so that children, especially girls, can go to school. Eighteen years later, the mandate has maintained cross-party support, and the program continues to invest hundreds of millions of dollars in safe, stable and nurturing family-based care. Evidence suggests that programs like these help children progress in school and improve physical and mental health.

The world needs a PEPFAR-like initiative that can offer the same kind of support for children affected by Covid-19.

Increasing vaccination around the world will prevent caregivers from dying. When children lose a parent to Covid-19, ideally they are supported by a social worker or community organization. Siblings should be kept together, and children should be asked whom they want to live with.

Investments are also needed to provide safe family-based care services and to offer parenting programs to new caregivers, as well as money for food and school.

Programs like these are feasible and can be affordable. Cellphone-based parenting support programs that help caregivers to manage stress, give them strategies for nonviolent discipline and teach ways to keep children safe from sexual violence can cost as little as about $8 a child. A child grant for families with orphaned or vulnerable children in Kenya costs about $18 a month, and research shows that the families that use them prioritize food and education.

The global community needs to consider options like these. Children losing their parents and caregivers to Covid-19 is a secondary pandemic.

Lucie Cluver is professor of child and family social work at the University of Oxford and University of Cape Town. She is a co-author of a recent paper on Covid-19 associated orphanhood with experts at Centers for Disease Control and Prevention, the World Health Organization, World Bank and the United States Agency for International Development.

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