Most people find allergy information on food labels unclear

WILEY

Research News

When researchers evaluated consumers' understanding of allergy information on food labels, less than half of individuals found the information to be clear.

The study, which is published in Clinical & Experimental Allergy, involved two separate experiments with a total of 96 consumers with food allergies and 105 without. Investigators first randomly presented 18 different food products with labels suggesting peanut was, may be, or was not an ingredient, and then they presented three different formats of information: 'Produced in a Factory' and 'May contain' or 'Traces of'. Precautionary allergen labels (PALs) were especially problematic, with consumers attributing anything between 2% and 99% risk of a reaction and anything between 1% and 98% comprehensibility assessments. This suggests that precautionary statements such as 'may contain peanut' have little value for consumers and may lead to inappropriate dietary restrictions or risk-taking behavior.

"Also, many consumers interpret 'Produced in a factory' to reflect a weaker warning than 'May contain,'" said lead author Bregje Holleman, PhD, of Utrecht University, in The Netherlands. "From a communication perspective, it's logical for consumers to attribute different risk levels to warnings worded differently. But since producers probably mean to communicate the exact same level of risk with each of these different warnings, we advise to use only PAL wording."

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Three in ten Americans increased supplement use since onset of pandemic

Some U.S. adults seek enhanced immunity against COVID-19, but lack knowledge on safety

THE REIS GROUP

Research News

WASHINGTON (July 21, 2021) - Twenty-nine percent of Americans are taking more supplements today than they were before the COVID-19 pandemic, bringing the percentage of U.S. supplement-takers to 76%, according to a new survey conducted by The Harris Poll on behalf of Samueli Foundation. Nearly two-thirds of those who increased supplement use (65%) cited a desire to enhance their overall immunity (57%) or protection from COVID-19 (36%) as reasons for the increase. Other common reasons for increasing supplement use were to take their health into their own hands (42%), improve their sleep (41%), and improve their mental health (34%).

"The COVID-19 pandemic is a catalyst for increased supplement use," said Wayne Jonas, MD, executive director of Integrative Health Programs at Samueli Foundation. "Supplements--when used under the guidance of health care professionals--can be beneficial for one's health. Unfortunately, however, many people are unaware of the risks and safety issues associated with their use."

More than half of Americans taking supplements (52%) mistakenly believe that most dietary supplements available for purchase have been declared safe and effective by the Food and Drug Administration, according to the June 2021 online survey of more than 2,000 U.S. adults. Nearly one-third of supplement-takers (32%) believe that if a supplement could be dangerous, it would not be allowed to be sold in the U.S.

"Contrary to what many believe, the FDA does not regulate supplements. In fact, many supplements are not identified as dangerous until after people are negatively affected by them," said Jonas. "There are benefits to one's health from supplements, but also risks, so I encourage anyone who is taking a supplement or thinking of taking one to discuss it with your health care provider first."

Fewer than half of Americans who use supplements (47%) say they consulted with their health care provider before use, despite national guidelines that strongly recommend doing so. Further, 46% of Americans currently taking prescription medications say they have not discussed with their health provider the potential interactions that supplements could have with their prescriptions. But the desire to speak to their physicians is there.

Four in five Americans said they would feel comfortable sharing which supplements they take with their health care provider (81%) and say it is important to tell their health care provider whether or not they are taking supplements (80%). They also identified various barriers to discussing supplements with their health care providers:

-41% of those currently taking supplements said that it hasn't occurred to them to discuss their supplement use with their health care provider, including half of those ages 18-34 (49%).

-35% of all Americans said they don't think their health care provider is interested in whether or not they are taking supplements.

-32% of Americans don't think their health care provider knows enough about supplements to advise them properly.

-26% of those currently taking supplements are worried that their health care provider will judge them based on the supplements they are taking.

"As more people begin taking supplements, we need to be sure that they have the information needed to make informed and healthy decisions," said Jonas. "My obligation, as a physician, is to help patients understand which supplements can play a safe and effective part of their overall health and well-being goals. The good news is that patients are willing to discuss this topic, but it is up to providers to ask."

Other findings from the survey showed further differences based on race and ethnicity:

-86% of White (non-Hispanic) Americans said they would be comfortable sharing which supplements they take with their health care provider, compared to only 67% of Hispanics and 75% of Blacks.

-Black (49%) and Hispanic (50%) supplement users were more likely than Whites (36%) to say that it hasn't occurred to them to discuss their supplement use with their health care provider.

-More than 1 in 3 Hispanic adults (35%) said they worry that their health care provider will judge them based on the supplements they take, and 46% said they don't think their health care provider is interested (compared to 31% of White (non-Hispanic) adults).

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More information on supplement use and survey findings can be found online at http://www.drwaynejonas.com.

About Samueli Foundation

Samueli Foundation's Integrative Health Programs are dedicated to the promotion of personal health and well-being with the support of health teams dedicated to all proven approaches, including conventional, complementary, and self-care. Dr. Wayne Jonas, the former director of the NIH Office of Alternative Medicine and the former director of a World Health Organization Center for Traditional Medicine, is clinical professor of Family Medicine at the Uniformed Services University and at Georgetown University School of Medicine.

Survey Method:

The survey was conducted online by The Harris Poll on behalf of Samueli Foundation among 2,053 U.S. adults ages 18+, including 1,531 who are currently taking supplements, surveyed from June 15-17, 2021. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. For complete research methods, including weighting variables and subgroup sample sizes, please contact Stacy Skelly at sskelly@TheReisGroup.com.

 

Innovative program entertains and teaches children about fish migration

WILEY

Research News

IMAGE: A PAGE FROM THE SHOUT TROUT WORKOUT COMIC WRITTEN BY MERRYN THOMAS AND ILLUSTRATED BY ETHAN KOCAK. view more 

CREDIT: WRITTEN BY MERRYN THOMAS AND ILLUSTRATED BY ETHAN KOCAK.

It's important to communicate about hard-to-see and complex environmental topics and issues with young people. In an article published in People and Nature, an international team reflects on the group's creation of the Shout Trout Workout, a lyric poem, comic, and music video for children aged 8-14 years old designed to entertain, engage, and enrich learning about migratory fishes and aquatic environments.

The authors hope that sharing their experiences and reflections will be useful and inspiring for those who aim to create learning enrichment and engagement materials about ecological processes and environmental issues for young people.

"We wanted to share about fish migration in an educational and informative way and think we achieved this through our interdisciplinary collaboration with passionate creatives and academics," said lead author Merryn Thomas, PhD, of the Freshwater Interdisciplinary Research and Engagement (FIRE) Lab at Swansea University, in the UK. "We also learned a lot about co-creation along the way, which we hope will be useful for others who are interested in collaborating across boundaries to design inspiring engagement materials for young people about our natural environments."

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Fully booked at the bottom of the sea: There seems no room for new bacteria on sand grains

Bacteria on the sand on the ocean floor do not change between the seasons. Presumably, there is simply no room for change.

MAX PLANCK INSTITUTE FOR MARINE MICROBIOLOGY

Research News

IMAGE: IN SUMMER, THE SUN NEVER SETS ON SPITSBERGEN; IN WINTER, IT NEVER MAKES IT ABOVE THE HORIZON. NEVERTHELESS, THE BACTERIAL COMMUNITY ON THE SANDY BOTTOM OF THE SEA DOES NOT... view more 

CREDIT: KATRIN KNITTEL

A relaxing vacation on the beach frees us from many of the worries of everyday life. But the sand not only cleans the head and soul of vacationers - it also cleans the seawater.

Coastal sands are so-called biocatalytic filters. Hundreds of thousands of bacteria live on each grain of sand, and they process, for example, nitrogen and carbon from the seawater that flows through the sands. In this way, the sands act like giant, purifying filters. Much of what the seawater washes into the ground does not come out again.

A study by researchers at the Max Planck Institute for Marine Microbiology in Bremen, Germany, published in the journal ISME Communications, now shows that the bacteria living on the sand are very different from the ones in seawater. And while the bacterial community in the water is constantly changing and adapting with the changing seasons, the sand bacteria are rather indifferent to spring, summer, fall and winter.

Stable in number and type

The team led by Katrin Knittel and Sebastian Miksch from the Max Planck Institute in Bremen studied the sand bacteria in the North Sea off Helgoland and in the Arctic near Spitsbergen, where there is no primary production at all during the polar night. "Both the number and the type of bacteria were surprisingly stable," reports Miksch, who conducted the study as part of his doctoral thesis. "Actinobacteria of the orders Actinomarinales and Microtrichales were particularly numerous and also particularly active. They probably play a prominent role in the turnover of organic material in these coastal areas." While the respective proportions of these two groups differ significantly between the studied sites in Helgoland and Svalbard, in themselves they hardly change.

All booked on the sand grain

"We were very surprised to see such a different pattern in the seafloor than in the water where microbial communities show a pronounced seasonality," Katrin Knittel explains. The spots on the sand grains that are well-protected from friction and predators are densely populated with bacteria while exposed spots show a low population density. The researchers therefore suspect that there is simply no habitable space for new, different inhabitants. "All the apartments are already occupied, so to speak. New tenants who could change the community simply can't find a sheltered place - or at least not in large numbers," Knittel adds.

But do bacteria really not care about the season as well as polar night and day? "We now want to go a step further, and look inside the bacteria. The bacteria remain the same, but over the seasons, perhaps the activity of different enzymes changes because different food arrives at the bottom."

CAPTION

There is plenty of sand on the North Sea island of Helgoland. And yet, on the sand-covered seabed, living space for new bacterial species is very limited.

CREDIT

Jan Bruewer

 

Tiny organisms shed big light on ocean nutrients

BIGELOW LABORATORY FOR OCEAN SCIENCES

Research News

IMAGE: A CONDUCTIVITY, TEMPERATURE, AND DEPTH SENSOR, OR CTD, LOWERS INTO THE SARGASSO SEA. RESEARCHERS USED THE INSTRUMENT TO COLLECT PHYTOPLANKTON, A FOUNDATION OF OCEAN HEALTH, WHICH THEY STUDIED TO DISCOVER... view more 

CREDIT: PHOTO BY DEBRA LOMAS

As the world warms, sweeping changes in marine nutrients seem like an expected consequence of increased ocean temperatures. However, the reality is more complicated. New research suggests that processes below the ocean surface may be controlling what is happening above.

Plankton are some of the most numerous and important organisms in the ocean. The balance of chemical elements inside them varies and is critical to shaping many marine processes, including the food web and the global carbon cycle. Temperature has been traditionally thought to control the ratio of these elements. However, a new study suggests this balance is largely dependent on activity in the subsurface ocean, from depths of over 300 feet. The work, led by scientists at Bigelow Laboratory for Ocean Sciences, was recently published in Communications Earth and Environment.

The team looked at samples from eight locations in oceans around the world. They found that the ratio of nitrogen and phosphorus introduced from the subsurface ocean controls the balance of those nutrients in the marine microorganisms that form the foundation of ocean health. This discovery could allow scientists to more accurately explore complex ocean processes.

"This is the first time that we've looked across a broad range of ocean regions and directly measured the balance of nutrients in ocean microorganisms, which is really exciting," said Mike Lomas, lead author on the paper. "Now we can apply more realistic parameters based on what is actually driving marine dynamics to the computer models used to forecast ocean change "

For decades, researchers have been using a fixed ratio to estimate the balance of carbon, nitrogen, and phosphorus in marine environments. Scientists and groups like the International Panel on Climate Change use this ratio in computer simulations to make predictions about the future of the planet.

However, it does not necessarily represent the wide diversity of chemical balances in the ocean or the significant role that organisms play in cycling nutrients.

"The problem is that the fixed ratios are safe estimates that do not actually represent how biology works," Lomas said. "More realistic, but risky and complicated, approaches are not yet widely utilized."

To develop a more accurate understanding of these ratios, Lomas directly measured them in phytoplankton - some of the most critical marine organisms worldwide. The elements in these organisms' cells reflect the available nutrients in their habitat and shine light on the role of biodiversity in how the nutrients cycle.

This is not the first time phytoplankton have been examined to understand nutrient levels in the ocean, but it is the most advanced and comprehensive. The team examined phytoplankton around the world to create a snapshot of three critical nutrient elements across broad environmental conditions. Traditionally, researchers have used physical filters to sort out plankton from seawater before examining them. However, this approach can also capture bacteria and tiny particles, leading to errors.

This study used a technique called flow cytometry, which allows researchers to examine and sort hundreds to thousands of cells per second. This enabled the researchers to isolate and examine only the cells they were interested in. It not only gave them a more accurate understanding of the diverse ratios of elements in the ocean, but also what processes are controlling them.

The team found that, contrary to the most common hypothesis, the ratio of carbon, nitrogen and phosphorus in cells was primarily dependent on the ratio of nitrogen and phosphorus supplied from the subsurface ocean to the sunlit waters where phytoplankton are active. This was true across all locations, regardless of the kind of phytoplankton or their environmental conditions.

Lomas hopes that this improved understanding of nutrients can be used to better picture how oceans will respond to climate change.

"We can't examine the nutrients in every single cell in every ocean, but we need to be sure all the controlling factors are included in computer models," Lomas said. "As we blend these results with other advanced disciplines, we will really advance our understanding of ocean dynamics and ability to forecast future conditions."

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Bigelow Laboratory for Ocean Sciences is an independent, nonprofit research institute located in East Boothbay, Maine. From the Arctic to the Antarctic, Bigelow Laboratory scientists use innovative approaches to study the foundation of global ocean health and unlock its potential to improve the future for all life on the planet. Learn more at bigelow.org, and join the conversation on Facebook, Instagram, and Twitter.

ECO-CSI

Crime scene tape set to revolutionize microplastics research

Forensic scientists have developed a new method to help monitor plastic pollution across the world.

STAFFORDSHIRE UNIVERSITY

Research News

IMAGE: EASYLIFT® TAPE BEING USED ONBOARD THE AMERICAN PROMISE DURING THE HUDSON RIVER EXPEDITION view more 

CREDIT: STAFFORDSHIRE UNIVERSITY

An adhesive tape patented by Staffordshire University researchers to recover trace evidence from crimes scenes is being adopted to analyse microplastics more efficiently.

Man-made polymer particles or ‘microplastics’ are proven to be present in land, air and water environments. However, despite extensive global studies, there is no standardised approach for their collection and analysis.

Currently, studies regularly involve retrieving microplastic samples from water using a filtration method. Samples are commonly analysed in situ on the filter or after removal from it by hand, which is time consuming and risks accidental loss of the particles and cross contamination.

Claire Gwinnett, Professor of Forensic and Environmental Science, is part of the team that created Easylift® tape more than a decade ago and has more recently applied her expertise in fibre analysis to microplastics.

She explained: “Easylift® tape was developed for the forensic market. However, what we have found is that the same benefits are true when looking at particulates from any environment.

“We realised that it holds great potential for microplastics work particularly when you are out in the field, for example on a boat or on a beach, where the risk of losing or contaminating your microplastic samples is huge.”

A new paper, published in Environmental Advances, addresses the shortcomings of current research methods and sets out a new workflow using Easylift® tape. The technique uses the self-adhesive tape to ‘lift’ microplastic particles from a filter then safely preserves them between the tape and a sheet of suitable material – in this case glass.

This method was trialled by Professor Gwinnett during an expedition to collect microplastic samples along the Hudson River in New York with the Rozalia Project where it proved highly effective, with a mean fibre recovery rate of 96.4%. It also enables multiple analytical techniques to be applied to the samples afterwards and preserves them for future study.

Professor Gwinnett said: “The ultimate goal is that this will become the standardised workflow for microplastics research across the world. At the moment, scientists are extrapolating data and it is only through constant monitoring that we will we truly know how much microplastic pollution is out there. If there is a standardised method to globally track microplastics then we can much better understand the risks and where we should be targeting our efforts for mitigation.

“We know plastic pollution is widespread, but we need to understand how much is in different locations, where it has come from and where it is going. What we need is a global collaborative effort to gather that large-scale data.”

CAPTION

Professor Claire Gwinnett collecting microplastic samples from the Hudson River in New York

CREDIT

Annie Tuthill

Easylift® tape is already being employed more widely and was used to collect microplastic samples during a transatlantic sailing expedition on former racing vessel the SV Jolokia last year. The Marine Education Centre based in New York State is also training ‘citizen scientists’ to take samples from the Hudson River and other locations using the tape.

Staffordshire University is now collaborating with the University of Oxford and Nekton Mission to analyse microplastic samples from an expedition to the Antarctic where these particulates will be retrieved from ice cores using Easylift® tape.

Professor Gwinnett added: “We need the ability for people to constantly monitor plastic pollution without massive expertise and the beauty of Easylift® is that it can be used by anyone – volunteers, sailing crews, people working in waste-water management can all use this in a robust way.

“It will allow us to share microplastic samples with partner institutions across the world for further analysis and to validate research methods. As with evidence recovered from crime scenes, we will also be able to store microplastic samples to be re-examined in a decade’s time or longer. Being able to collaborate and share research in this way is an exciting step forward.”

Read the full paper The application of tape lifting for microplastic pollution monitoring in Environmental Advances.

DO IT

Tokyo 2020 Olympics may be called off amid rising COVID-19 cases


A Japanese woman wearing an N95 mask passes a Tokyo 2020 banner on Tuesday. Photo by Richard Ellis/UPI.

July 20 (UPI) -- The head of the Tokyo Olympics organizing committee has not ruled out last-minute cancellation of the Games over COVID-19 cases.

"We cannot speculate," how infections will spread, Tokyo 2020 chief Toshiro Muto said through a translator at a news conference, adding that if cases spread, "we have to fully consult," leaving open potential for cancellation of the Games, which are slated to open on Friday.

Muto added that at five-party talks held recently, officials said they will continue to monitor the situation and will host another meeting if required. The five-party talks include the International Olympic Committee, the International Paralympic Committee, the Tokyo Metropolitan Governments, the Tokyo 2020 organizing committee, and government of Japan.

"The infection may spread, or the infection may be brought under better control," Muto said. "When we see a concrete situation going forward, then we will consider the matter."

As of Tuesday, officials have listed nearly 70 people in Tokyo associated with the Summer Olympics who have tested positive for COVID-19 since July 1, including contractors, personnel, media and athletes.

The Olympics have already been postponed from last year because of the COVID-19 pandemic.

 

'Rare' tropical fish washes up on Oregon coast

July 20 (UPI) -- An Oregon aquarium said a colorful, 100-pound fish that washed up in the state is known as an opah fish and is "rare to the Oregon coast."

The Seaside Aquarium said the 3.5-foot fish, which is also known as a moonfish, washed up on Sunset Beach in Seaside, far from its usual home in the more temperate waters of the tropics.

The fish has a round, flat body that made for an unusual sight on the beach, experts said.

"They're pretty cool fish, and we don't normally see them on the shore," Seaside Aquarium General Manager Keith Chandler told CNN. "It was pretty exciting for locals."

The National Oceanic and Atmospheric Administration said researchers still don't know much about opah fish, because they are normally found deep in the ocean.

Chandler said the fish appears to have been on the beach for less than an hour before it was reported to the aquarium.

"Unfortunately, it washed up not living, but we got to it before the birds," he said.

He said the fish is being kept frozen until it can be dissected by researchers in partnership with the Columbia River Maritime Museum.

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

NIH/NATIONAL INSTITUTE ON DRUG ABUSE

Research NewsL

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.

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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.nida.nih.gov.

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.gov.

NIH...Turning Discovery Into Health®

The Lancet: 1.5 million children worldwide have lost parent, grandparent, caregiver due to COVID-19

THE LANCET

Research News

• 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]

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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://coronavirus.jhu.edu/

[2] Quote direct from author and cannot be found in the text of the Article.

[3] Chamie J. Increasingly Indispensable Grandparents. 2018. https://archive-yaleglobal.yale.edu/content/increasingly-indispensable-grandparents

[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://imperialcollegelondon.github.io/orphanhood_calculator

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://imperialcollegelondon.github.io/orphanhood_trends

[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://drive.google.com/file/d/1_wJnjGCtLFYC4LIGoT7L24xIr4vvmkpa/view?usp=sharing

Post-embargo it will be available via: https://www.cdc.gov/coronavirus/2019-ncov/downloads/community/orphanhood-report.pdf

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