COMMENTARY

Children Are Losing Parents to COVID-19, and We Need to Help

F. Perry Wilson, MD, MSCE

Disclosures

April 07, 2021

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This transcript has been edited for clarity.

Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I'm Dr F. Perry Wilson of the Yale School of Medicine.

We have passed through a year of bereavement, a year of grief. The latest numbers, published in a research letter in JAMA, found that the excess mortality in the United States from March 1, 2020, to January 2, 2021, totaled 522,368 individuals. Deaths were 22% higher than expected over that period; the typical yearly variance is about 2% in either direction.

Each of those deaths ripple through the lives of those left behind. A simulation study in the Proceedings of the National Academy of Sciences found that each COVID-19 death left nine close family members bereaved.

I think the most succinct way I've heard the effect of the death of a loved one described comes from C.S. Lewis, who wrote, "The death of a beloved is an amputation."

It's an apt metaphor. Not just because of the profound loss, but because of how it changes your life forever — how, though normalcy may return to some extent, the loss is ever-present, shaping how you interact with the world.

For children who lose a parent, the loss is life-altering and can be life-defining. Kids who lose parents at a young age are substantially more likely to have depression, poor educational outcomes, death from suicide, and even unintentional death.

According to this research letter published in JAMA Pediatrics, from February 2020 to February 2021, 37,337 children in the US lost a parent to confirmed COVID-19 disease. If we look at excess mortality during the pandemic, that number rises to 43,027.

Some children, of course, have lost both parents.

There are 43,027 kids growing up without a parent. The authors calculate that's about 20% higher than the number of kids who lose a parent during a typical year.

Like many things in this pandemic, the grief is not distributed evenly. Black children [make up] 14% of children in the US but 20% of those who have lost a parent to COVID-19.

As providers of healthcare, we have a responsibility to those left behind. How will we care for these kids who in the past year have faced a fractured education system, social isolation, and the worst loss any of them could imagine? The authors call for the creation of a national child bereavement cohort to support these kids as they grow and develop.

Let's also remember that the pandemic is far from over. With highly transmissible variants in a race against highly effective vaccines, it's hard to predict where the case counts may go in the future. But one prediction is certain: There are children out there right now who will lose a parent to COVID-19. Preventing new infections — and new deaths — may save more lives than we appreciate.

F. Perry Wilson, MD, MSCE, is an associate professor of medicine and director of Yale's Clinical and Translational Research Accelerator. His science communication work can be found in the Huffington Post, on NPR, and here on Medscape. He tweets @fperrywilson and hosts a repository of his communication work at www.methodsman.com.

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