The Kids Orphaned by COVID Won’t Return to ‘Normal’

Losing a parent may be one of the most destabilizing events of the human experience. Orphans are at increased risk of substance abuse, dropping out of school, and poverty. They are almost twice as likely as non-orphans to die by suicide, and they remain more susceptible to almost every major cause of death for the rest of their life.

Because of the pandemic, some 200,000 American children now face these stark odds. Even after two years that have inured the country to the carnage of the coronavirus, the scope of the loss is so staggering that it can be hard to comprehend: Caregiver loss during the pandemic is now responsible for one out of every 12 orphans under the age of 18, and in every public school in the United States, on average two children have lost a caregiver to the pandemic. COVID-19 case counts rise and fall, but “orphanhood doesn’t come and go. It is a steadily rising slope, and the summit is still out of sight,” Susan Hillis, the co-chair of the Global Reference Group on Children Affected by COVID-19, told me. “It’s not like you’re an orphan today and then you’re recovered in two weeks.”

Even if orphans face an immense set of challenges, their fate isn’t sealed: For decades, researchers have known that programs that tap into children’s extraordinary resilience can help orphans overcome the unthinkable, especially if kids get help in the immediate aftermath of a death. And yet, so far, the plight of pandemic orphans has not proved to be much of a pressing issue in the United States. No law or executive order has provided any resources specifically for pandemic orphans, even as Congress and the White House have spent trillions of dollars to help Americans get through this crisis. And while a memorandum issued by President Joe Biden yesterday promises that the administration will develop a plan for orphans, it’s poised to be too little, too late. “It really doesn’t outline any plan or commitment,” Rachel Kidman, a social epidemiologist at Stony Brook University, told me.

And the inaction goes deeper than that: With a few exceptions, even the parts of the country most inclined toward action don’t seem to be doing much to help these kids. “No one has even established a system for figuring out who these children are,” Hillis said. The pandemic’s orphanhood crisis matters most for orphans, but it also matters for the rest of us. If America can’t do anything to help the children most profoundly affected by COVID, what hope is there to make any sort of long-lasting changes as we try to leave the pandemic behind?

A 10-year-old in New York City who lost her father in the first wave of early 2020. Four children in Boynton Beach, Florida, left behind by a single mother who died 48 hours after being taken to the hospital. A 6-year-old boy and an 8-year-old girl from McAlester, Oklahoma, who lost their mother to COVID just two and a half years after losing their father to liver failure. With COVID deaths now nearing 1 million, all types of American children have been orphaned by the pandemic. But the well-documented racial and ethnic disparities in the virus’s toll are further compounded in caregiver loss. For example, the COVID death rate for Hispanic Americans is just slightly higher than that for white Americans, but Hispanic caregiver loss is more than double that of white Americans. Similar trends hold for other groups, according to an analysis by Dan Treglia, a social-policy researcher at the University of Pennsylvania and an expert contributor at the COVID Collaborative, a coalition of experts in health, education, and economics.

Because of how easily COVID can spread within a household, some kids have lost both parents; others may have lost a grandparent who was a primary caregiver. Almost a quarter of American children live with one parent and no other adults, meaning it can take only a single death for catastrophic loss to occur. Because these children are disproportionately low-income and nonwhite, they already face systemic barriers that amplify the fallout of orphanhood—and many families are unprepared from the start. Unlike some other diseases that leave children orphaned, COVID strikes quickly. It’s more like a car crash than cancer. With COVID, “somebody drops dead in weeks,” Hillis said. It’s so sudden that no one has even thought about, “Oh my goodness, who’s gonna take care of the kids?”

Despite the urgency, the national response is not meeting the moment. The federal government has set aside funds to help pay for the funerals of Americans who died from COVID. While that’s a laudable effort that helps offset costs at a crucial moment, the money is hardly the kind of investment needed to support the long-term needs of orphaned children. Yesterday, as part of the presidential memorandum addressing the long-term effects of COVID, the Biden administration made a vague promise that federal agencies would draw up a report within several months outlining how they’ll support “individuals and families experiencing a loss due to COVID-19.” But Mary C. Wall, a senior policy adviser on the White House’s COVID-19 Response Team who will serve as the “bereavement lead,” told me that the effort won’t have a dedicated team and will be focused on raising awareness about existing resources for families rather than implementing initiatives that would require new funds. At some point, Wall said, the program might request additional funding, but that ask could run into problems, given that Congress struggled to reach a deal for even basic COVID-fighting supplies such as treatments, tests, and vaccines.

It’s not just the Biden administration that’s been slow to confront the greatest mass-orphanhood event in a generation. Only in the past few months has there been any political movement anywhere in the country. Representatives Bonnie Watson Coleman of New Jersey and Haley Stevens of Michigan, both Democrats, introduced a resolution in March to “raise awareness” of COVID’s impact on bereaved children, but it’s little more than a hopeful call to arms. At the state level, targeted efforts seem to be the exception, not the rule. California State Senator Nancy Skinner introduced a bill to set up trust funds of $4,000 to $8,000 for each of the state’s more than 20,000 pandemic orphans. It is working its way through the legislature, and a spokesperson for the senator said he was not aware of any resistance. At the local level, some counties are moving forward on their own as well. Santa Clara County, California, set aside $30 million in federal relief funds, a portion of which will be used to identify and support children who lost caregivers to COVID (the details of the program haven’t been announced).

This patchwork of efforts is better than nothing, but without a stronger centralized national strategy, tens of thousands of children are likely to fall through the cracks. The irony is that the U.S. already has the know-how to piece together that strategy. During the HIV epidemic, the U.S. helped orchestrate an impressive response to the world’s orphanhood needs. The President’s Emergency Plan for AIDS Relief, established in 2003, earmarks 10 percent of its annual $7 billion budget specifically for orphans. “If we wanted to focus on children at home, we could absolutely do that,” Kidman said. “The expertise is there if the will is there.”

What America needs to be doing right now, Kidman said, is providing help—financially and psychologically—to both orphans and their families. Experts I spoke with applauded promoting mental-health services for children, but warned that counseling isn’t sufficient. And if yesterday’s memorandum is any clue, the White House has no clear plan for the unique psychological challenges of orphanhood, and could even end up simply rebranding existing mental-health services as a bereavement program. Regular cash transfers can reduce trauma and anxiety symptoms among orphans and boost school completion by 22 percent. It’s unlikely that the White House’s plan to reimburse funeral costs will have the same effect. “The cost of a funeral is a drop in the bucket. These families need sustained financial support,” Joyal Mulheron, the founder of Evermore, a bereavement nonprofit, told me. One promising approach is “cash plus care” programs, which stabilize families with regular cash infusions coupled with interventions that help enhance caregivers’ parenting skills.

That said, some funds may already be available—just untapped. Bereaved children have long been eligible for Social Security benefits, yet the best available data suggest that less than half of all orphans are receiving the financial resources already allocated for them. The Biden administration is sensibly trying to connect children with existing benefits, but Wall offered few details about how the administration will actually achieve that. Popular legislation such as the expanded child tax credit, which temporarily slashed poverty, could be a lifeline for the disproportionately low-income children orphaned by COVID—but Congress allowed that temporary benefit hike to expire at the end of last year.

Solving the orphanhood crisis might not feel as urgent as, say, developing a vaccine did. But time is of the essence. A toddler who lost his father in March 2020 is getting ready to enter kindergarten this fall. A junior-high kid who lost her mother is now a sophomore in high school learning to drive. Children change with breathtaking speed, and several experts I spoke with told me that early intervention may be crucial for reducing trauma and improving overall health. “If we miss this critical period with children, then they are going to have this burden carried forward,” Kidman said. “We can’t come back in five years and mitigate their pain. This has to happen now.”

At every stage of the pandemic, there’s been a glimmer of hope that some of the trauma would finally lead to lasting change. Perhaps the country would realize that our health-care system is nowhere near good enough. That paid sick leave is necessary to keep illness out of the workplace and protect society’s most vulnerable members. That the nation’s indoor air is long overdue for an upgrade.

But as the pandemic enters year three, it’s becoming clear that America is adamant about changing as little as possible. Yes, we’re in a relative lull of case counts and deaths. But just because people aren’t dying at the same rate they were at the pandemic’s peaks doesn’t mean the crisis is over for the 200,000 children set adrift in one of the most unimaginable ways possible. “Pretending that these kids can just go back to normal is going to be a mistake,” Kidman said. “There isn’t a normal for them to go back to.”

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