In a recent study published in JAMA Pediatricsresearchers conducted epidemiological modeling to update estimates of caregiver and parent losses associated with coronavirus disease 2019 (COVID-19).
Deaths associated with COVID-19 have left millions of children without caregivers and parents across the world. The loss of caregivers and parents can lead to devastating long-term outcomes, including abuse, institutionalization, traumatic grief, teenage pregnancy, poor school performance, chronic infectious diseases, and mental health issues.
While huge investments have been made to prevent the mortality associated with COVID-19, little has been done for the care of deprived children. Investments to support orphans who have lost their parents to Acquired Immune Deficiency Syndrome (HIV AIDS) illustrate successful solutions that can be replicated to improve the lives of children orphaned by COVID-19.
Inter- and intra-country comparisons have been hampered previously due to inconsistent testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), associated mortality reports and access to new mortality data excess associated with COVID-19 to update the minimum COVID -19 estimates of caregiver death and loss of parents.
About the study
In the current study, researchers provided an update on estimates of caregiver and kin losses associated with SARS-CoV-2 infection.
Derived estimates of excess COVID-19 deaths were calculated for deprived children in each country, based on data provided by The Economist, IHME (Institute for Health Measurement and Evaluation) and WHO (Organization World Health). Deaths associated with COVID-19 in previously used logistic models were replaced with excess deaths associated with COVID-19 (except cases with negative excess deaths), and composite deaths were calculated for periods between January 1, 2020 and December 31, 2021 and between January 1, 2020 and May 1, 2022.
A bootstrap was performed to calculate the uncertainty of death estimates derived from mortality and fertility data. National and regional estimates of deaths were calculated based on WHO methodology, as the WHO findings showed higher conservatism than those of The Economist and IHME. The study was conducted in accordance with GATHER guidelines (guidelines for precise and transparent health estimate reporting).
Using WHO-based methods for excess mortality associated with COVID-19, the team estimated that 10,500,000 children were deprived of their caregivers or parents, and 7,500,000 children were orphaned due to COVID-19. 19 as of May 1, 2022. Composite deaths reported by The Economist, IHME and WHO as of December 31, 2021 were 18, 18.3 and 15.6, respectively. The corresponding composite deaths through April 1, 2022 were 21.3, 20.5 and 17.5, respectively.
The estimated values for orphans and loss of primary caregiver provided by The Economist, IHME and WHO as of December 31, 2021 were 9.7, 10.3 and 7.2, respectively. The corresponding values for orphans and loss of primary caregiver as of April 1, 2022 were 11.6, 11.2 and 7.9. respectively. The estimated values for the number of orphans and the loss of primary and/or secondary caregivers reported by The Economist, IHME and WHO as of December 31, 2021 were 12.3, 12.9 and 9.5, respectively . The corresponding values for orphans and loss of primary and/or secondary caregiver as of April 1, 2022 were 14.8, 14.1, and 10.5, respectively.
Higher numbers of orphans associated with COVID-19 due to loss of primary and/or secondary caregivers were noted in the WHO regions of South-East Asia (41%) and Africa (24%), compared to compared to the Eastern Mediterranean regions (15%), in the United States. (14%), Western Pacific regions (1.8%) and European regions (4.7%) as of 1 May 2022. Similarly, country-level variations in death estimates have been observed, and countries like India, Egypt, Nigeria and Pakistan were the most affected up to May 1, 2022, whose death estimates were 3,490,000, 450,000, 430,000 and 410,000 respectively.
Among the most affected WHO regions in Southeast Asia, the highest numbers of orphaned children have been observed in countries such as India, Bangladesh, Indonesia, Nepal and Myanmar. The most affected regions on the African continent were the DRC (Democratic Republic of Congo), Kenya, Ethiopia, South Africa and Nigeria.
Overall, the study results showed that considerable loss of parents and caregivers associated with SARS-CoV-2 infection has occurred worldwide, warranting urgent care for children. orphans. Urgently needed global responses to the COVID-19 pandemic can combine equitable vaccinations with programs that transform the lives of orphaned children.
However, epidemiological modeling estimates cannot provide a true picture of orphanage associated with COVID-19, as modeling estimates are not accurate measures of the actual number of bereaved children, and other surveillance programs of the SARS-CoV-2 pandemic must include these pediatric populations to help mitigate the long-term adverse consequences of COVID-19-associated orphanage.
The development of effective vaccines and therapeutic drugs against SARS-CoV-2 must be accelerated, and enforcement of COVID-19 containment measures could help prevent parental and caregiver mortality associated with COVID-19. Bereaved children must be protected through economic support, violence prevention, parental support and increased accessibility to schools and education.