As the COVID-19 pandemic continues to wreak havoc globally, more than 1.5 million children have lost their parent(s), custodial grandparent(s), or grandparent(s) or kin who lived with them, according study findings published in The Lancet.

Researchers noted that the priorities during the pandemic have focused primarily on detection, prevention, and response. However, pandemics carry secondary impacts beyond morbidity and mortality, including children who are left orphaned.

“Because most COVID-19 deaths occur among adults, not children, attention has been focused, understandably, on adults. However, a tragic consequence of high numbers of adult deaths is that high numbers of children might lose their parents and caregivers to COVID-19, as occurred during the HIV/AIDS, Ebola, and 1918 influenza epidemics,” the researchers noted.

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The loss of a parent or caregiver places children at higher risk of mental health disorders, in addition to physical, emotional, and sexual violence and family poverty. “These adverse experiences raise risks of suicide, adolescent pregnancy, infectious diseases including HIV/AIDS, and chronic diseases,” the researchers noted in the study.

The study focused broadly on family members who serve as caregivers and not only parents, including both parents and grandparents. Commonly, children around the world live in multigenerational households and grandparents play a large role in the upbringing of young children. The percentage of children living in extended households that include grandparents is 38% worldwide, the researchers wrote.

The study used mortality and fertility data to model the rates of children orphaned as a result of the coronavirus pandemic from March 1, 2020 to April 30, 2021, across 21 countries.

The term “COVID-19 associated deaths” referred to the combination of deaths directly caused by the pandemic as well as those caused indirectly by other causes such as “lockdown, restrictions on gatherings and movement, and decreased access or acceptability of health care and of treatment for chronic diseases.”

Nearly 800,000 Children Orphaned of a Parent

By April 2021, 1,560,000 children were orphaned or lost a caregiver because of the pandemic. “Of these, 788,704 children lost a mother, father, or both, with most losing 1 parent; 73,661 children lost at least 1 custodial grandparent; and 355,283 lost at least 1 residing grandparent or older kin,” the researcher reported.

The countries with the highest number of children who lost a caregiver due to the pandemic were South Africa, Peru, the US, India, Brazil, and Mexico. Among the 21 countries, 1,217,648 children were left orphaned from the death of their custodial grandparents or other residing grandparents. “Rates of children losing primary or secondary caregivers were highest in Peru [14.1 per 1000 children], South Africa [6.4 per 1000 children], and Mexico [5.1 per 1000 children],” reported the researchers.

With the exception of South Africa, more children were affected by the death of a paternal figure, as opposed to the death of a maternal figure as death rates were greater in men than women.

The global response to the impact of caregiver deaths on children must be as rapid as that for COVID-19 disease control. “Multilateral organizations, national and local governments, non-governmental and faith-based organizations, voluntary organizations, and donors need to incorporate evidence-based programs into their COVID-19 response plans to address the impact of caregiver COVID-19-associated deaths on children,” they concluded.


Hillis S, Unwin H, Chen Y, et al. Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: a modelling study. The Lancet. 2021 July 20.  doi:10.1016/S0140-6736(21)01253-8.