There are two very simple ways to think about it that almost everyone can wrap their heads around. One is simply for every two reported COVID deaths, there is one child left behind. By a little over 3 million deaths, there have been 1.5 million children who have been affected. So it’s basically a 2-to-1 ratio in almost any country. Every two COVID deaths leaves behind one child who is affected by the death of a mother or father or grandmother or grandfather who lives in their home and helps provide their care, which is really heartbreaking and has serious long-term consequences.
Another easy way to think about it is every 12 seconds, one child is either orphaned or loses a caregiver due to COVID-19. So by the time you basically count to 12, another child has had a parent die in the world.
Those were the numbers by the end of April. That rate has continued relatively stable in April, May and June and even into July. We had hoped as the vaccine uptake increases, those numbers would go down. I think eventually they will, but right now, we don’t have adequate vaccine coverage globally to really make those numbers quickly go down.
Not only is this heartbreaking, as you said, but what kind of risks does this pose to these children?
There are both immediate, short-term, serious threats to children’s health and wellbeing and there are lifelong threats to children’s health and wellbeing because orphanhood doesn’t go away. You can get COVID, and most people actually do recover from it and heal from it — we know some don’t, and that’s really what brought this whole study about — but once a child has experienced the death of their mother and is a maternal orphan, that status does not change for all of their childhood.
Short term, there are increased risks of mental health problems, including anxiety, depression, post traumatic stress disorder, as well as serious economic problems and serious threats to being able to stay in school that are often linked to the economic problems. Often, there are additional threats of domestic violence and physical, sexual and emotional abuse.
That constellation of short-term risks together comprises what we call at CDC and as scientists “adverse childhood experiences,” and multiple combinations of those increase your lifelong risk of chronic diseases, including heart disease and specific kinds of cardiovascular diseases, including heart attack, diabetes, cancer and serious chronic lung problems. In fact, they increase every major cause of death in the world.
We have a three-fold strategy for solutions called “prevent, prepare, protect.” The very first thing we need to actively do is aggressively promote equitable distribution of vaccines around the world. Because if, in fact, we can achieve widespread herd immunity in every country that’s having COVID-associated orphanhood consequences, we can actually prevent that before it even happens, which is what we would most want to do.
While we wait — because in many countries, there isn’t the vaccine access we would like — we know what works for mitigation. We can all say it: distancing, masking and making sure we maintain proper hand hygiene. Particularly for people in faith environments, it’s being careful to avoid mass gatherings and congregating in large groups when the numbers of transmissions in a community or in a state or in a nation are high. So that’s what we need to do on the “prevent” side.
The report stresses that institutions such as orphanages are not the best way to care for these children. Can you talk about why that is and what some better solutions for children and their families might be?