Hundreds of thousands of children orphaned by COVID-19 globally, study finds
An estimated 1.5 million children globally have seen a parent or caregiver die from COVID-19. File photo by Eco Clement/UPI | License Photo
July 20 (UPI) -- More than 1.5 million children worldwide saw a parent, custodial grandparent or other relative who cared for them die from COVID-19, according to a study published Tuesday by the Lancet.
Of these children, more than 1 million children had one or both parents die during the first 14 months of the pandemic, and another 500,000 experienced the death of a grandparent caregiver living in their own home, the data showed.
"By April 30, 2021, these 1.5 million children had become the tragic overlooked consequence of the 3 million COVID-19 deaths worldwide, and this number will only increase as the pandemic progresses," study co-author Susan Hillis said in a press release.
"Our findings highlight the urgent need to prioritize these children and invest in evidence-based programs and services to protect and support them right now and to continue to support them for many years into the future," said Hillis, an epidemiologist with the CDC in Atlanta.
Before the start of the pandemic in March 2020, there were an estimated 140 million orphaned children worldwide, World Without Orphans estimates.
These children are at increased risk for mental health problems, family poverty and physical, emotional, and sexual violence, and they are also more likely to die by suicide or develop a chronic disease, including heart disease and diabetes, according to the organization.
For this study, the researchers developed mathematical models using the best available data to estimate the number of children impacted by the death of a parent or guardian during the pandemic.
They based their COVID-19 orphanhood estimates on mortality data for 21 countries that collectively account for 77% of global COVID-19 deaths, they said.
The analysis included both reported COVID-19 deaths between March 1, 2020 and April 30, 2021 and the number of excess deaths during the same period.
COVID-19 death rates were linked with fertility data for males and females from the 21 countries to estimate the number of children who had lost a parent to the virus, and the death of both parents was accounted for so that children were not counted twice.
The analysis also included deaths of grandparents or other older adults age 60 to 84 who were living in the same household as the children to account for custodial grandparents who have primary responsibility for their grandchildren's care.
At least 1.134 million children experienced the death of their mother, father or custodial grandparents due to COVID-19, the data showed.
Of these, an estimated 1.042 million lost their mother or father or both.
More than 1.5 million children are estimated to have experienced the death of at least one parent or a custodial or other co-residing grandparent or other older relative, they said.
The United States was amongst the countries with the most children -- nearly 114,000 -- who saw the death of a primary caregiver and a per capita rate of one child per 1,000 people in the general population.
These are likely underestimates, the researchers said, because figures for a number of countries included in the study were based on COVID-19 mortality only and excess death data were unavailable.
For almost every country, deaths were greater in men than women, particularly in middle and older ages, and up to five times more children lost their fathers than lost their mothers.
"Our study establishes minimum estimates -- lower bounds -- for the numbers of children who lost parents or grandparents," study co-author Dr. Juliette Unwin said in a press release.
"In the months ahead variants and the slow pace of vaccination globally threaten to accelerate the pandemic, even in already incredibly hard-hit countries, resulting in millions more children experiencing orphanhood," said Unwin, a research fellow in medicine at Imperial College London in England.
More than 1.5M children lost a primary or secondary caregiver due to the COVID-19 pandemic
Addressing the impact of caregiver deaths critical for pediatric mental health, authors note
More than 1.5 million children around the world are estimated to have lost at least one parent, custodial grandparent, or grandparent who lived with them due to death related to COVID-19 during the first 14 months of the pandemic, according to a study published today in The Lancet. The study highlights orphanhood as an urgent and overlooked consequence of the pandemic and emphasizes that providing evidence-based psychosocial and economic support to children who have lost a caregiver must be a key part of responding to the pandemic.
The analysis used mortality and fertility data to model rates of COVID-19-associated orphanhood (death of one or both parents) and deaths of custodial and co-residing grandparents (ages 60-84) from March 1, 2020 to April 30, 2021, across 21 countries. This study was funded in part by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.
In the paper, "COVID-19-associated deaths" referred to the combination of deaths caused directly by COVID-19 and those caused indirectly by other associated causes, such as lockdowns, restrictions on gatherings and movement, decreased access or acceptability of health care and of treatment for chronic diseases.
Traumatic experiences, such as the loss of a parent or caregiver, are associated with increases in substance use, mental health conditions, and other behavioral and chronic health conditions. NIDA supports research aimed at understanding the impact of trauma on young people, preventing substance use after experiencing hardship, and treating substance use in populations that experience trauma.
"Studies like this play a crucial role in illuminating the COVID-19 pandemic's long-lasting consequences for families and the future mental health and wellbeing of children across the globe," said NIDA Director Nora D. Volkow, M.D. "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."
To estimate pandemic-associated orphanhood and caregiver deaths, the study used excess mortality and COVID-19 mortality data for 21 countries that accounted for 77% of global COVID-19 deaths during 2020 and early 2021. These include Argentina, Brazil, Colombia, England and Wales, France, Germany, India, Iran, Italy, Kenya, Malawi, Mexico, Nigeria, Peru, Philippines, Poland, Russian Federation, South Africa, Spain, United States, and Zimbabwe.
The authors estimate that 1,134,000 children lost a parent or custodial grandparent due to COVID-19-associated death. Of these, 1,042,000 children were orphaned of a mother, father, or both - most lost one, not both parents. Overall, 1,562,000 children are estimated to have experienced the death of at least one parent or a custodial or other co-residing grandparent (or other older relative).
The countries with the highest numbers of children who lost primary caregivers (parents or custodial grandparents) included South Africa, Peru, United States, India, Brazil, and Mexico. The countries with rates of COVID-19-associated deaths among primary caregivers (>1/1000 children) included Peru, South Africa, Mexico, Brazil, Colombia, Iran, United States, Argentina, and Russia.
The study found that for every country, COVID-19 associated deaths were greater in men than women, particularly in middle- and older-ages. Overall, there were up to five times more children who lost a father than who lost a mother.
"We know from our research that loss of a parent or caregiver can upend children's lives and potentially affect their development if they are not in a stable home setting. If we take into consideration variants of concern or possible severity of illness among youth, we must not forget that the pandemic continues to pose a threat to parents and caregivers - and their children," said Chuck A. Nelson, III, Ph.D., study author, Boston Children's Hospital.
While research on the science of substance use and addiction remains the primary focus of NIDA's work, NIDA is supporting COVID-19 research, and has issued over $15 million in funding for COVID-19-related projects since the start of the pandemic that could leverage current infrastructure, projects, or scientific knowledge and resources.
###
Reference: S Hillis, et al. Global Minimum Estimates of Children Affected by COVID-19-associated Orphanhood and Death of Caregivers. The Lancet. DOI: 10.1016/S0140-6736(21)01253-8 (2021).
About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit http://www.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.
NIH...Turning Discovery Into Health®
The Lancet: 1.5 million children worldwide have lost parent, grandparent, caregiver due to COVID-19
- Study offers first global estimates of the number of children who experienced the death of a parent, grandparent, or primary caregiver from COVID-19.
- Researchers estimated figures based on COVID-19 mortality data from March 2020 through April 2021, and national fertility statistics for 21 countries, and extrapolated findings to produce global estimates.
- Findings suggest 1 million children have lost a parent, 1.1 million have lost a parent or custodial grandparent, and more than 1.5 million have lost a parent, custodial grandparent, or other secondary familial caregiver from COVID-19.
- Authors call for urgent investments in services to support children who have lost their parents and caregivers.
An estimated 1.5 million children worldwide have experienced the death of a parent, custodial grandparent, or other relative who cared for them, as a result of COVID-19, according to a new study published in The Lancet.
Of those, more than 1 million children experienced the death of one or both parents during the first 14 months of the pandemic, and another half a million experienced the death of a grandparent caregiver living in their own home, the study estimates.
Children who have lost a parent or caregiver are at risk of profound short- and long-term adverse effects on their health, safety, and wellbeing, such as increasing the risk of disease, physical abuse, sexual violence, and adolescent pregnancy. The researchers call for urgent action to address the impact of caregiver deaths on children into COVID-19 response plans.
Dr Susan Hillis, one of the lead authors on the study, from the U.S. Centers for Disease Control and Prevention COVID-19 Response Team says: "For every two COVID-19 deaths worldwide, one child is left behind to face the death of a parent or caregiver. By April 30, 2021, these 1.5 million children had become the tragic overlooked consequence of the 3 million COVID-19 deaths worldwide, and this number will only increase as the pandemic progresses [1]. Our findings highlight the urgent need to prioritize these children and invest in evidence-based programs and services to protect and support them right now and to continue to support them for many years into the future - because orphanhood does not go away." [2]
Before the pandemic, there were an estimated 140 million orphaned children worldwide. These children have greater risks of mental health problems, family poverty, and physical, emotional, and sexual violence. They are also more likely to die by suicide or develop a chronic disease, such as heart disease, diabetes, cancer, or stroke.
The COVID-19 pandemic has resulted in more children facing the loss of a parent or caregiver. In addition, as older adults are the most vulnerable to COVID-19, many children living in multigenerational families will have experienced the death of a grandparent. Evidence shows that grandparents are increasingly playing key roles in providing care and financial support for their grandchildren worldwide. [3]
Study author Professor Lucie Cluver, Oxford University, UK, and the University of Cape Town, South Africa, says: "We have strong evidence from HIV and Ebola to guide solutions. We need to support extended families or foster families to care for children, with cost-effective economic strengthening, parenting programs, and school access. We need to vaccinate caregivers of children - especially grandparent caregivers. And we need to respond fast because every 12 seconds a child loses their caregiver to COVID-19." [2].
Before this report, there were no global figures to quantify how many children have been affected by the loss of a caregiver during the COVID-19 pandemic, either directly (due to the virus) or indirectly (due to another condition that was exacerbated due to the pandemic). The study's researchers developed mathematical models using the best available data as an initial attempt to estimate the magnitude of this hidden impact of the pandemic on children.
Implementing methods similar to those used by the UNAIDS Reference Group on Estimates, Modelling and Projections for estimating the number of children orphaned by AIDS [4], the authors based the COVID-19 orphanhood estimates on mortality data for 21 countries that account for 77% of global COVID-19 deaths [5]. The analysis included both reported COVID-19 deaths between 1 March 2020 and 30 April 2021 and the number of excess deaths (when such data were available), during the same time-period, to account for variations in country-specific reporting systems.
The researchers linked COVID-19 death rates to fertility data for males and females from those 21 countries [6] to estimate the number of children who had lost a parent as a consequence of COVID-19. Loss of both parents was accounted for so that children were not counted twice.
The researchers extended their analysis to include deaths of grandparents or other older adults aged 60 to 84 years who were living in the same household as the children, based on United Nations Population Division's statistics on household composition. These figures take into account custodial grandparents (living with grandchildren in absence of parents), who have primary responsibility for their grandchildren's care, as well as co-residing grandparents and other older family members, who live in the same household (with grandchildren and parents) and have secondary, but not primary caring responsibilities.
Mathematical modelling was used to extrapolate the findings from these 21 countries to the rest of the world, using country-level data on COVID-19 deaths and fertility rates. The model showed a high correlation between female fertility rate and the ratio of orphans to deaths.
The findings suggest that at least 1,134,000 children experienced the death of their mother, father, or custodial grandparents, as a consequence of COVID-19. Of these, an estimated 1,042,000 lost their mother or father, or both. Overall, 1,562,000 children are estimated to have experienced the death of at least one parent or a custodial or other co-residing grandparent (or other older relative).
Countries with the highest rates of children losing their primary caregiver (parent or custodial grandparent) included: Peru (1 child per 100, totalling 98,975 children), South Africa (5 children per 1,000, totalling 94,625 children), Mexico (3 children per 1000, totalling 141,132 children), Brazil (2 children per 1,000, totalling 130,363 children), Colombia (2 children per 1,000, totalling 33,293 children), Iran (>1 child per 1,000, totalling 40,996 children), USA (>1 child per 1,000, totalling 113,708 children), and Russian Federation (1 child per 1,000, totalling 29,724 children).
In April 2021, in India, the researchers estimate an 8.5-fold increase in the numbers of children newly orphaned (43,139) compared to March 2021 (5,091).
For almost every country, deaths were greater in men than women, particularly in middle and older ages. Overall, up to five times more children lost their fathers than lost their mothers.
The authors note that children experiencing COVID-19-associated deaths of parents or caregivers are at greater risk of family separation and institutionalization, such as being placed in orphanages or care homes. They argue this should be avoided because it has negative effects on social, physical, and mental development.
Dr Seth Flaxman, one of the study's lead authors, from Imperial College London, UK, says: "The hidden pandemic of orphanhood is a global emergency, and we can ill afford to wait until tomorrow to act. Out of control COVID-19 epidemics abruptly and permanently alter the lives of the children who are left behind. Tomorrow is too late for the child institutionalized in an orphanage, who will grow up profoundly damaged by the experience. We urgently need to identify the children behind these numbers and strengthen monitoring systems, so that every child can be given the support they need to thrive." [2]
The researchers say their findings are likely underestimates because figures for a number of countries included in the study were based on COVID-19 mortality only and excess death data were unavailable. COVID-19 deaths may be underreported because of variability in SARS-CoV-2 testing and reporting systems.
Dr Juliette Unwin, another lead author from Imperial College London, UK, adds, "Our study establishes minimum estimates--lower bounds--for the numbers of children who lost parents and /or grandparents. Tragically, many demographic, epidemiological, and healthcare factors suggest that the true numbers affected could be orders of magnitude larger. In the months ahead variants and the slow pace of vaccination globally threaten to accelerate the pandemic, even in already incredibly hard-hit countries, resulting in millions more children experiencing orphanhood." [2]
The authors note some limitations to their results. Their study is based on the best available data, but many countries do not have robust reporting systems for deaths or fertility. Additionally, data on country-specific prevalence of orphans before the pandemic was lacking, so their estimates of double orphans are limited to deaths of both parents during the pandemic.
Writing in a linked Comment, Assistant Professor Rachel Kentor of Baylor College of Medicine, USA and Amanda Thompson of Inova Schar Cancer Institute, USA, (who were not involved in the study), say: "By answering the authors' call to expand our worldwide pandemic response to include caring for children, the global community can capitalise on this momentum; we can harness the current global attention on children bereaved by the pandemic to mobilise resources and implement systemic, sustainable supports for bereaved youth around the world."
As part of this work, the authors developed a real-time COVID-19 calculator [7], providing ongoing updated estimates of COVID-19-associated orphanhood and death of caregivers for every country in the world. These estimates as of the end of April 2021, along with an evidence-based strategy for action as described in the paper, can also be found in a policy report authored by the Global Reference Group for Children Affected by COVID: "Children: The Hidden Pandemic 2021 - A joint report of COVID-19-associated mortality and a strategy for action." [8]
###
Peer-reviewed / Modelling
NOTES TO EDITORS
This study was funded by UK Research and Innovation (UKRI) Global Challenges Research Fund Accelerator Hub, UKRI Medical Research Council, UKRI Engineering and Physical Sciences Research Council, UK National Institute for Health Research, Imperial College COVID-19 Research Fund and the US National Institutes of Health. It was conducted by researchers from the Centers for Disease Control COVID-19 Response Team (USA), Imperial College London (UK), the University of Oxford (UK), University of Copenhagen (Denmark), University of Cape Town (South Africa), the World Health Organization, University College London (UK), Maestral International, US Agency for International Development, World Without Orphans, World Bank Group and Harvard Medical School.
[1] Johns Hopkins University Coronavirus Resource Center. https:/
[2] Quote direct from author and cannot be found in the text of the Article.
[3] Chamie J. Increasingly Indispensable Grandparents. 2018. https:/
[4] UNAIDS, UNICEF, USAID. Children on the Brink 2004. A Joint Report of New Orphan Estimates and a Framework for Action: UNICEF, 2004.
[5] The 21 countries are: Argentina, Brazil, Colombia, England and Wales, France, Germany, India, Islamic Republic of Iran, Italy, Kenya, Malawi, Mexico, Nigeria, Peru, Philippines, Poland, Russian Federation, South Africa, Spain, USA and Zimbabwe.
[6] Fertility rates were calculated from country-specific data for male and female and fertility (UK), figures reported in the Demographic and Health Survey, or figures from the UN World Prospects and UN Statistics Division, alongside population estimates.
[7] For Imperial College's Calculator giving up-to-date minimum estimates by country of minimum estimates of children affected by COVID-19 orphanhood and death of caregivers: https:/
For Imperial College's Interactive Visualization enabling comparisons between countries and over time of minimum estimates of children affected by COVID-19 orphanhood and death of caregivers: https:/
[8] Children: The Hidden Pandemic 2021 - A joint report of COVID-19-associated orphanhood and a strategy for action (CDC, USAID, World Bank, WHO, University College London, University of Oxford, Imperial College, University of Cape Town) For embargoed access, please see: https:/
Post-embargo it will be available via: https:/
The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: http://www.
IF YOU WISH TO PROVIDE A LINK FOR YOUR READERS, PLEASE USE THE FOLLOWING, WHICH WILL GO LIVE AT THE TIME THE EMBARGO LIFTS: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01253-8/fulltext
No comments:
Post a Comment