More than a million children around the world have lost a parent, grandparent or older caregiver as a result of the coronavirus pandemic, research suggests.
An early study found the infection is mild in four out of five cases, but it can trigger a disease called COVID-19. Treatment delays and postponed screenings amid lockdowns may have also caused non-COVID diseases to become advanced.
Children in particular rarely become seriously unwell with the coronavirus itself, but the stress of home schooling and ill relatives is said to have taken its toll on youngsters, with experts previously reporting a "steep rise" in depression among 7- to 11-year-olds.
To better understand how much grief has been caused by the pandemic, scientists from the US Centers for Disease Control and Prevention (CDC) estimated coronavirus death data from March 2020 to April 2021 in 21 countries.
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When extrapolated out on a global scale, more than 1.5 million children are thought to be grieving a deceased parent, "custodial" grandparent or "other secondary familial caregiver" as a direct or indirect result of the pandemic – with a guardian being lost every 12 seconds.
Writing in The Lancet, the scientists are calling for urgent investment into services that support these children, who may be at increased risk of disease, abuse, sexual assault and teenage pregnancy.
"For every two COVID-19 deaths worldwide, one child is left behind to face the death of a parent or caregiver," said co-lead author Dr Susan Hillis.
"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.
"Our findings highlight the urgent need to prioritise these children and invest in evidence-based programmes and services to protect and support them right now, and to continue to support them for many years into the future – because [bereavement] does not go away."
Co-author Professor Lucie Cluver – from the University of Oxford – agreed, adding: "We need to respond fast because every 12 seconds a child loses their caregiver to COVID-19".
Pre-pandemic, an estimated 140 million children worldwide were bereaved, with these youngsters known to be at greater risk of mental health problems, violence and poverty.
These children are also more likely to die due to suicide or a chronic disease, like cancer or heart disease.
To better understand the impact of the pandemic, the CDC scientists estimated coronavirus death rates against the national fertility data of 21 countries that account for more than three-quarters (77%) of coronavirus deaths worldwide.
Results suggest 1 million children have lost at least one parent, rising to 1.1 million youngsters grieving either a parent or custodial grandparent, who live with a grandchild in the absence of their mother or father.
Children who live in multigenerational households often rely on their grandparents for care and financial support. The CDC results suggest half a million children worldwide have lost a grandparent who lived in their home amid the pandemic.
In the US, two in five (40%) grandparents who live with their grandchildren are said to act as their primary caregiver. In the UK, 40% of grandparents "provide regular care for grandchildren".
Overall, more than 1.5 million children have lost a parent, custodial grandparent or secondary familial caregiver due to the pandemic.
More than 1 million children lost one or both parents in the first 14 months of the outbreak specifically, the results suggest.
Mexico is among the worst affected, with three in every 1,000 children – totalling 141,132 youngsters – having lost their primary caregiver, followed by Brazil – 130,363 children – and the US, where 113,708 youngsters are grieving a caregiver lost to the pandemic. UK data are unknown.
In India, the number of newly bereaved children is estimated to have increased by 8.5 times from March 2021 to April 2021 alone.
Being male has long been linked to a higher risk of coronavirus complications. The CDC results suggest up to five times more children have lost their father than their mother.
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"The hidden pandemic of loss is a global emergency and we can ill afford to wait until tomorrow to act," said co-lead author Dr Seth Flaxman, from Imperial College London.
"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 institutionalised 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 every child can be given the support they need to thrive."
The results are likely even underestimates due to muddled reporting of coronavirus cases in some countries, according to the scientists.
"Tragically, many demographic, epidemiological and healthcare factors suggest the true numbers affected could be orders of magnitude larger," said co-lead author Dr Juliette Unwin, from Imperial College London.
"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 [loss]."
The scientists have stressed limited data affects the accuracy of their results.
Nevertheless, Dr Rachel Kentor, from the Baylor College of Medicine in Houston, and Dr Amanda Thompson, from the Inova Schar Cancer Institute in Virginia, wrote in The Lancet: "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."
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