COVID has killed millions across the world, but the suffering it has caused lingers on in those that survive. Nearly 40,000 children lost at least one parent to COVID in the United States, write researchers at Stony Brook University and Penn State. The trauma that these children face will last a lifetime, which is why urgent interventions are required to mitigate the long-term risks to mental health and other problems.

“Every day, I open up the newspaper and see a growing count of how many people have died. But it isn’t just about who dies, it is also about who is left behind. And we have seen little mention of the children who are being orphaned. Yet, we estimate tens of thousands of children have lost at least one parent,” Rachel Kidman, Associate Professor of Family, Population and Preventive Medicine at Stony Brook, told ZME Science.

The researchers performed a statistical model, showing that while nearly 80% of COVID-related deaths are among those ages 65 and older, 15% of deaths are among those in their 50s and early 60s and 3% are among those in their 40s. Within this younger age bracket, many among the deceased were parents of young children.

About three-quarters of the nearly 40,000 children who have been orphaned by COVID-19 are adolescents. About one-quarter are elementary-aged children, for whom the psychological toll of parental bereavement is even higher.

For comparison, the number of children that have been orphaned by the virus is nearly 13 times higher than the approximately 3,000 children who lost at least one parent in the 9/11 attacks.

Losing one or both parents puts children at risk of traumatic prolonged grief and depression, lower educational attainment, economic insecurity and accidental death or suicide, the researchers mentioned in their study published today in the journal JAMA Pediatrics.

“Right now, these children need schools to be open so they can socialize with friends and access support. They need interventions that can help them deal with their grief. Evidence shows that some brief, evidence-based interventions can prevent more severe mental health consequences. Ensuring wider access to such is a start. However, some children will likely need more intensive or sustained mental health support,” Kidman said.

The grief of losing one’s parents isn’t shared equally among demographics. The study found that Black families are disproportionately affected by pandemic-related parental bereavement. Nearly 20% of the orphaned children by COVId are Black, although just 14% of U.S. children are Black.

Unlike other situations of mass parental deaths, such as following a war, the pandemic presents unique challenges. Virtually all people still need to practice social isolation. Furthermore, the psychological toll befalling bereaved families is amplified by economic woes.

“From past studies, we know children who are orphaned face immense challenges – from depression to poor educational outcomes – and these reverberate throughout their lives. For many years, my research focused on children who had been orphaned or otherwise affected by the HIV/AIDS epidemic. I think the main lesson learned was that often the best way to support bereaved children was to strengthen their families’ ability to care for them. In the US, new federal policies – such as expanding the child tax credit – will help raise some families out of dire poverty, especially if combined with help accessing Social Security benefits. We also learned that we should be paying close attention to their social and emotional needs. That is one reason why schools are so important. Having in-person schooling means kids have a chance to socialize with their friends, be supported by caring adults, and access counselors,” Kidman added.

Previous research shows that certain interventions can help prevent some of the most severe psychological problems. However, there are many unknowns as this pandemic is a once-in-a-century event.

“I think it will be important to understand how these children experience loss and grief during such an acute national crisis – one that has been incredibly isolating. I don’t think we know what their needs will be a few years down the road. That’s why it will be important to find these children now, and to establish a cohort of kids who experience loss due to the Covid pandemic, as well as a group of children who could serve as a comparison so that we really do understand whether there are unique needs that emerge. Most importantly, we must be prepared to respond quickly and with flexibility to those needs,” Kidman concluded.