America’s COVID-19 crisis has not ended, but we have begun to count the staggering size of the nation’s loss. Some of the cruelest pain has come to a group with the least capacity to understand and cope with it — children who have lost a parent or other in-home caregiver to the virus. The impact on these children, their families and their communities will be that much more profound if Americans do not rally to support them.
Our analysis of COVID-19 death counts and household surveys paints a disturbing picture. Among the more than 760,000 deaths from COVID-19 in the United States in the past 22 months are the parents, custodial grandparents, or other in-home caregivers to 167,000 children. Seventy percent of the loss affected those 13 and younger, who are at a stage of complete dependence on their parents and caregivers to grow and thrive.
More than 70,000 children have been deprived of a parent, and nearly the same number lost a grandparent who lived in their home. At the extreme of this loss, more than 13,000 children have lost their only in-home caregiver.
The SARS-CoV-2 virus can strike anyone but it concentrates its cruelty on groups facing histories of social and economic adversity. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander children lost caregivers at nearly four times the rate of white children; Black and Hispanic children at 2.5 times the rate; and Asian children at 1.6 times.
All states have children experiencing such loss, but five states — California, Florida, Georgia, New York and Texas — account for half of total caregiver loss from COVID-19.
Beyond the numbers of such unspeakable grief is the risk of further tragedy. Studies show parental loss is associated with higher rates of depression, anxiety, alcohol and substance abuse, and suicide; worse peer relationships; and lower rates of educational attainment and adult employment. Parental loss during early life, and the trauma associated with the suddenness of death from COVID-19, puts these children at even higher risk.
The grief and confusion of these young people is concealed by being scattered across the country. Unless we know one of them personally, empathy requires analogy. COVID’s hidden loss is the moral equivalent of children calling to us from the wreckage of a collapsed building. The nation must rally to do everything necessary to rescue and assist them.
This challenge is unprecedented, but we have a good idea of how this kind of grief can be confronted. Most of these children —likely between 90 and 95 percent — do not require treatment in a clinical setting, though they will require loving people in their communities who understand the depth of their loss and are dedicated to their well-being. A smaller group — perhaps 5 to 10 percent — will experience traumatic or prolonged grief that requires clinical intervention. In every case, we need to act quickly to provide these children with the tools of resilience, support and hope.
America, from communities to the White House, needs a comprehensive and coordinated response to identify children who have lost a parent or caregiver to COVID-19 through schools, community and faith-based groups, primary care settings, and administrative records. After decades of study, we know that quality mentoring relationships, peer support programs, grief camps, social and emotional learning in schools, and programs such as the Family Bereavement Program all have important roles to play.
In many cases these children lost not only a caregiver but a breadwinner, and addressing their economic challenges is critical to their resilience. Similar to efforts to help the families of 9/11 victims and HIV/AIDS orphans, a COVID-19 Bereaved Children’s Fund could provide support for essential needs such as housing, clothing, food, medical care, education and grief counseling.
Categorical eligibility for these children for a range of means-tested supports, such as Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), Medicaid, and the Child Tax Credit, together with good outreach and case management, will be essential. For children who need clinical intervention, America should expand access to mental health care, train counselors in schools to help identify and support them and reduce cost-sharing responsibilities of outpatient mental health care.
We call on the public and private sectors to engage in a national strategy that includes ideas offered here and more.
COVID has challenged us as a people as seldom before. Now we have a chance to show that America is a single moral community, dedicated to the welfare of children who carry a heavy burden of pain and loss. There can be no partisan division in caring for these children in need, and this is an effort we can undertake as a united country.
John M. Bridgeland is co-founder and CEO of the COVID Collaborative and former director of the White House Domestic Policy Council. Dan Treglia is associate professor of practice at the University of Pennsylvania and CEO of Social Policy Analytics. They are co-authors of the report and plan of action, “Hidden Pain: Children Who Lost a Parent or Caregiver to COVID-19 and What the Nation Can Do to Help Them.”