An estimated 1.5 million children worldwide have lost a parent, custodial grandparent, or other relative who cared for them, due to COVID-19.

New research, published in The Lancet and led by Imperial academics, offers the first global estimates of the cost of the pandemic on children based on COVID-19 mortality data from March 2020 through April 2021.

Of those, more than 1 million children experienced the death of one or both parents during the first 14 months of the pandemic, and another half a million experienced the death of a grandparent caregiver living in their own home, the study estimates.

Children who have lost a parent or caregiver are at risk of profound short- and long-term adverse effects on their health, safety, and wellbeing, such as increasing the risk of disease, physical abuse, sexual violence, and adolescent pregnancy.

The researchers call for urgent action to address the impact of caregiver deaths on children into COVID-19 response plans.

Orphaned children worldwide

Before the pandemic, there were an estimated 140 million orphaned children worldwide. These children have greater risks of mental health problems, family poverty, and physical, emotional, and sexual violence. They are also more likely to die by suicide or develop a chronic disease, such as heart disease, diabetes, cancer, or stroke.

The COVID-19 pandemic has resulted in more children facing the loss of a parent or caregiver.

In addition, as older adults are the most vulnerable to COVID-19, many children living in multigenerational families will have experienced the death of a grandparent.

Evidence shows that grandparents are increasingly playing key roles in providing care and financial support for their grandchildren worldwide. 

First global figures

Before this report, there were no global figures to quantify how many children have been affected by the loss of a caregiver during the COVID-19 pandemic, either directly (due to the virus) or indirectly (due to another condition that was exacerbated due to the pandemic).

The study’s researchers developed mathematical models using the best available data as an initial attempt to estimate the magnitude of this hidden impact of the pandemic on children.

The findings suggest that at least 1,134,000 children experienced the death of their mother, father, or custodial grandparents, as a consequence of COVID-19. Of these, an estimated 1,042,000 lost their mother or father, or both. Overall, 1,562,000 children are estimated to have experienced the death of at least one parent or a custodial or other co-residing grandparent (or other older relative).

Countries with highest rates of children losing primary caregiver

Countries with the highest rates of children losing their primary caregiver (parent or custodial grandparent) included:

• Peru (1 child per 100, totalling 98,975 children),
• South Africa (5 children per 1,000, totalling 94,625 children),
• Mexico (3 children per 1000, totalling 141,132 children)
• Brazil (2 children per 1,000, totalling 130,363 children)
• Colombia (2 children per 1,000, totalling 33,293 children)
• Iran (>1 child per 1,000, totalling 40,996 children)
• USA (>1 child per 1,000, totalling 113,708 children)
• Russian Federation (1 child per 1,000, totalling 29,724 children).

In April 2021, in India, the researchers estimate an 8.5-fold increase in the numbers of children newly orphaned (43,139) compared to March 2021 (5,091).

"The hidden pandemic of orphanhood is a global emergency, and we can ill afford to wait until tomorrow to act." Dr Seth Flaxman Study lead author

In England and Wales, 8,886 children lost a primary caregiver, including 8,495 children who lost a parent.

For almost every country, deaths were greater in men than women, particularly in middle and older ages. Overall, up to five times more children lost their fathers than lost their mothers.

The researchers note that children experiencing COVID-19-associated deaths of parents or caregivers are at greater risk of family separation and institutionalisation, such as being placed in orphanages or care homes. They argue this should be avoided because it has negative effects on social, physical, and mental development.

Dr Seth Flaxman, one of the study’s lead authors, from the Department of Mathematics, says: “The hidden pandemic of orphanhood is a global emergency, and we can ill afford to wait until tomorrow to act. Out of control COVID-19 epidemics abruptly and permanently alter the lives of the children who are left behind.

"Tomorrow is too late for the child institutionalised in an orphanage, who will grow up profoundly damaged by the experience. We urgently need to identify the children behind these numbers and strengthen monitoring systems, so that every child can be given the support they need to thrive.” 

'Millions more children could experience orphanhood'

"Tragically, many demographic, epidemiological, and healthcare factors suggest that the true numbers affected could be orders of magnitude larger." Dr Juliette Unwin Study lead author

The researchers say their findings are likely underestimates because figures for a number of countries included in the study were based on COVID-19 mortality only and excess death data were unavailable. 

Dr Juliette Unwin, another lead author, the School of Public Health, adds: “Our study establishes minimum estimates — lower bounds — for the numbers of children who lost parents and /or grandparents.

"Tragically, many demographic, epidemiological, and healthcare factors suggest that the true numbers affected could be orders of magnitude larger.

"In the months ahead variants and the slow pace of vaccination globally threaten to accelerate the pandemic, even in already incredibly hard-hit countries, resulting in millions more children experiencing orphanhood.”

Real-time COVID-19 calculator

As part of this work, the researchers developed a real-time COVID-19 calculator, providing ongoing updated estimates of COVID-19-associated orphanhood and death of caregivers for every country in the world.

Every 12 seconds a child loses their caregiver due to COVID-19

Dr Susan Hillis, one of the lead authors on the study, from the U.S. Centers for Disease Control and Prevention COVID-19 Response Team says: “For every two COVID-19 deaths worldwide, one child is left behind to face the death of a parent or caregiver.” 

Study author Professor Lucie Cluver, Oxford University, UK, and the University of Cape Town, South Africa, says: “We need to respond fast because every 12 seconds a child loses their caregiver to COVID-19."

Access the orphanhood trends tool

Access the orphanhood COVID-19 caculator