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The countless orphans of COVID-19

During the COVID-19 pandemic, priority has been given to prevention, detection, and responses to infection. While it is mainly adults who are at risk of dying from SARS-CoV-2, one aspect of the situation has tended to be neglected: the loss of parents or grand-parents, which can have severe consequences for children. Numerous studies, carried out during other epidemics, show that these children are exposed to poverty, to late development, to problems of mental health, or to physical, emotional or sexual abuse (UNICEF). The risk of suicide is greater, as is pregnancy, premature marriage or various infections. However, there is no quantifiable data available on the subject.

In response to this situation, American researchers at the Center for Disease Control (CDC, Atlanta) carried out a co-ordinated study with several research centres worldwide, in order to estimate the number of children aged under 18 who have lost parents and grand-parents during the COVID-19 pandemic. They modelled data from 21 countries (mortality, fertility, family size and structure, cultural habits, gender, age, deceased member of the family, indirect mortality, and access to health care) using a method already proven in HIV research. The model included 76% of all COVID-19 deaths.

It has been estimated that between the 1st of March 2020 and the 30th of April 2021, 1 134 000 children lost a parent (with about 100 000 losing both), or a grand-parent with custody. If we add grand-parents or other relatives who lived in the family house and provided support, this figure rises to 1,5 million. The consequences are catastrophic, since about 23% of those children in the study come from single-parent families.

In addition, the grand-parents, who are more vulnerable to COVID-19, provide psychological, practical, educational and financial support to their grand-children. Orphans already in the position of being raised by their grandparents are therefore subjected to a second trauma. The most affected countries are Peru (1,2 children out of 100 have lost a parent or grand-parent responsible for raising the child), South Africa ((5,1 in 1000), Mexico (3,5 in 1000), Brazil (2,4 in 1000), Columbia (2,3 in 1000), Iran (1,7 in 1000), the United States (1,5 in 1000), Argentina (1,1 in 1000) and Russia (1 in 1000). In all of these countries, children lose their father 5 times more often than their mother, accentuating their economic vulnerability.

Designed to inform and to give pointers as to what actions should be taken, this study is the first to show that orphan children represent a hidden problem arising out of the COVID-19 pandemic. According to its authors, it is very important to avoid institutionalising the affected children, and to seek to ensure they are taken in charge by relatives or foster families, or adopted. The majority of children who have a surviving parent also need to be given priority support. The INSPIRE and DREAMS programmes (World Health Organization, CDC, UNICEF, and US Agency for International Development, along with other partners) have supported and saved millions of orphan children, particularly in the context of HIV, and may serve as a model for the current situation, bringing invaluable experience and logistical capacities.

The consequences risk getting worse with the arrival of new variants, or if access to vaccines is limited. The global vaccination effort needs to be bolstered, since some studies predict that herd immunity will not be achieved for 4 years in numerous countries. Since the number of deaths is continuing to evolve exponentially, the likelihood is that this social problem will get worse. 

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