COVID orphans: The pandemic’s hidden toll on children who lose parents, caregivers

Even with vaccines, masks and contact tracing, COVID-19 has likely caused an outsized impact on some of Montana’s youngest residents. In a recent publication in the journal “Pediatrics,” early estimates show that nearly 500 children have experienced the loss of a primary caregiver or parent in the state.

While the number and calculations are based on a complex set of variables and circumstances, the researchers also demonstrated that those losses have affected Native American children at a much higher rate than their White counterparts.

The article, which was originally published in October, estimated that even prior to publication, an estimated 461 Montana children were left without at least one caregiver because of the pandemic. Those losses were estimated to continue unless COVID could be stopped through vaccination or isolation. Now, more than four months later, that number has likely surpassed 500.

However, it’s impossible to know the exact numbers because neither the state nor federal government track how many children lose a parent or caregiver to COVID.

Jon Ebelt, spokesman for the Montana Department of Public Health and Human Services, noted that during COVID, the number of kids in foster care has actually decreased slightly, one of the only quantifiable indicators that may demonstrate children may be especially hard hit by the long-term effects of the pandemic.

The journal article reported that 23 percent of American children live in single-parent households, leaving them at risk for being orphaned or traumatized if the caregiver gets ill or dies.

“During 15 months of COVID-19 pandemic, 120,630 children in the U.S. experienced the death of a primary caregiver … because of COVID-19-associated death,” the article states.

It also pointed out that children of color experienced loss at almost twice the rate of White children.

“Affected children who were American Indian/Alaska Native were more frequently represented in Arizona (18%), New Mexico (39%), Oklahoma (23%), Montana (28%) and South Dakota (55%),” the journal article said.

Montana’s rate mirrors that of some of its neighbor states, including Idaho, which had an estimated 497 children affected by the loss of a parent due to COVID.

For example, nationally, COVID-19 affected the caregiver of 1 in every 753 White children, while that rate increased dramatically for other groups. COVID-related death affected 1-out-of-310 Black Children, and 1 of 168 Native American children.

The pediatricians recommend, in addition to vaccination and masking, that more could be done to support children after such a large loss in their life.

They recommend “strengthening economic supports to families; quality childcare and educational support and evidence-based programs to strengthen parenting skills and family relationships.”

Three pediatricians interviewed about the article in “Pediatrics” said they’ve seen families, caregivers and children stressed by a number of COVID-related conditions, and all said they’d wager that the true number of Montana children being affected by COVID through their caregivers is likely much higher.

Dr. Heather Zaluski is the chief medical officer of Shodair Children’s Hospital in Helena and a board certified child and adolescent psychiatrist. Shodair treats psychiatric issues, and Zaluski said the number of youth who report suicidal thoughts doubled in 2021.

“There is abundant data to support the idea that children are really struggling,” she said.

That has led the American Psychiatric Association and the American Academy of Pediatrics to declare a “state of emergency.”

She said the loss of a parent or caregiver can have profound long-term impacts that may be hard to quantify with dashboards and daily numbers, but can be seen during the course of months or years. Loss of a parent leads to a loss of structure and increased anxiety about any number of activities that used to be normal.

Oftentimes, when parents or caregivers are stressed, the children feel it.

“Maybe it is a parent who is so tired or sick that they just don’t have the emotional capacity to give attention to a child,” Zaluski said. “A child’s very survival depends on adults’ stability and they pick up on those other stressors. We call it a ‘parental buffer’ – how the parents respond in a traumatic situation.”

She said that while many of the studies and research looks at the impacts on smaller children, which often require more parental support, Zaluski stressed that the trauma of having a caregiver or parent die of COVID can be equally disastrous on older children and teenagers.

“I would argue against the idea that teenagers will be OK. I have worked with teens most of my life and it’s a very challenging time because they have the developmental task of becoming their own person, and that’s complex,” Zaluski said. “Even if you come from an intact family, any curveball can make it become more tricky and fragile.”

Moreover, when a young child loses a caregiver, often families worry about the youngest, believing falsely that because teenagers are closer to adulthood, they will be better off, which means teens can be overlooked.

For parents who have experienced loss in the family, it’s an additional burden, Zaluski said. For example, many parents may find themselves being single parents, a new and unfamiliar territory.

“So now, not only is it a loss for the kids, but it’s also a loss for adults. The support they can give to their family often drops dramatically,” Zaluski said. “And it has tragic consequences for the kids.”

There is one positive to the COVID pandemic, Zaluski said – it hastened the rise of more mental health providers and telemedicine.

“Therapy has become so much more accessible,” Zaluski said.

Having more therapy and more options available isn’t just a good thing, she said, it’s going to be a necessary thing.

“COVID is also a mental health crisis, and we’re going to have to deal with it for a long, long time,” Zaluski said.