Pandemic left many children without parents. Can nations boost support?

Charlee Roos loved the “buddyship days” she shared with her father when she was a kid. He would take her out for Mickey Mouse pancakes, attend all her soccer games, and go to her dance recitals, “even though he didn’t really get dance competitions.”

He was her best friend, Ms. Roos says. 

Two days before Christmas, Kyle Roos died of COVID-19. In the last days, when he couldn’t speak and asked family to be his voice, she peppered nurses and doctors with terminology most high school sophomores barely grasp – knowledge her father, a well-loved pharmacist in their hometown in Minnesota, imparted to her growing up. 

Now, she continues to be his voice – to her little sister, Layla. That means showing up at the hockey rink, where Ms. Roos’ father and sister shared a love of the ice. “I’ve tried to go to every single one of her hockey games and support her that way,” she says.

And she aims to be his steady presence, in all the ways her 10-year-old sister needs.

“My mom and I have really tried to encourage her to talk about my dad. We’ll go through pictures of him and show her pictures when he was younger and tell her stories about him,” she says. “I think she feels a little alone in all of this.”

The girls are among an estimated 40,000 children in the United States who have lost a parent or caregiver to COVID-19, according to modeling published in April in JAMA Pediatrics. In a preliminary study published as a pre-print by The Lancet ahead of peer review, researchers estimate that over 1 million children lost caregivers through December, with the U.S., Mexico, and Brazil among the worst affected.

Globally, children’s needs are mounting – and government support that is hard to access in the best of times barely matches the magnitude of the problem. “Kids have been made invisible in this pandemic,” says Dora Giusti, head of child protection at UNICEF Mexico. 

But children’s rights have come to the fore, too, with the overwhelming need prompting systems to rethink how they deliver care. In the U.S., JAMA Pediatrics’ estimate generated calls for more support for children, including benefits they are entitled to but often don’t receive. And in India and Mexico, the pandemic has forced governments to continue reforming their child welfare systems away from institutionalization, in line with best practices that children’s advocates have been recommending for years.

“Without a doubt, this is a crisis that’s also an opportunity,” says Matilde Luna, director of the Latin America Foster Care Network (RELAF).

Coming forward for kids

In the small Indian town of Pilani, in the western state of Rajasthan, Nikhil Bansal’s aunt and uncle died within days of each other in April – leaving his cousins, twin boys aged 16 and a 22-year-old woman, alone. Mr. Bansal’s family (not their real name, to protect their privacy) lives next door, and immediately rallied around the children.

“One of our aunts spends the night at their place. During the day, they come and study alongside me. We try to make sure they aren’t alone,” says Mr. Bansal. Every morning, he hears the oldest sibling replaying videos of her father that he had posted on Facebook.

Since March 2020, more than 3,600 Indian children have been orphaned, and 26,000 have lost one parent, according to government figures. At the height of India’s second wave, social media was flooded with adoption requests, prompting officials to step in to prevent child trafficking and create awareness about the legal process for adoption. Prime Minister Narendra Modi’s government has offered financial and educational assistance to children who have been orphaned, and some state governments have offered help as well. 

Prabhat Kumar, head of child protection at Save the Children India, says subsidies are tied up in red tape and too many children fall through the cracks. (Mr. Bansal’s cousins, for example, don’t qualify for government programs because their mother’s death certificate does not list COVID-19 as the cause of death.) But he’s encouraged by efforts to keep children in their homes and communities, rather than sending them to institutions.

Nearly half of such institutions do not have adequate measures in place to prevent sexual and physical abuse, according to the country’s first-ever national audit last year, and their adoption rates are paltry. “The silver lining is that we are seeing many community members come forward,” Mr. Kumar says. 

One of them is Vidhya Kamble, a community health worker in a tiny village in Sangli district in Maharashtra – about 1,000 miles south of Mr. Bansal’s home. She’s been caring for two boys next door, aged 7 and 10, sent to their ancestral village by their overwhelmed father after his wife died of COVID-19. For three weeks the children had lived alone while their father cared for their mother in the hospital.

No stranger to the siblings thanks to their previous visits, Ms. Kamble often video-called the boys – who had both tested positive for COVID-19 – to keep their spirits up. Now that they’re next door, her own children keep them company. But much of the village did not take kindly to the brothers’ presence, fearful of infection. “I kept telling them what the facts were and that there was nothing to worry. Now they understand,” she says.

Speeding up reform

In Mexico, children’s welfare has long been considered a family matter, with even relatives sometimes hesitant to get involved, says Lizzeth Navarro, until recently the executive director of the Office of the Attorney for the Protection of the Rights of Girls, Boys, and Adolescents (DIF) in Mexico City. But when the pandemic forced shelters to reduce their services, the office tapped its network of child care workers to become temporary foster parents – fortifying existing efforts to build a foster system. 

“The pandemic is speeding up this plan to help kids, to eradicate institutionalization, and have more kids live their right to be with their families,” she says.

Government goals to shutter homes for children in favor of foster care or keeping children within the nuclear family, where appropriate, hadn’t seen notable progress until the pandemic arrived, says Ms. Luna of RELAF. Since then, a handful of states and Mexico City have closed government-backed children’s homes, or significantly decreased their populations.

“A central consequence of COVID-19 is that families are more fragile,” she says. But she also sees the pandemic accelerating changes that experts have long known are needed. Internationally, there’s a growing recognition that children taken from their families and placed in orphanages or children’s homes risk long-term consequences, from developmental delays to an increased likelihood of falling victim to violence.

In Mexico, the pandemic’s effects on many families have increased the need for financial support. Globally it’s been far more common for children to lose one parent, not two. In Mexico, over 80,000 children are estimated to have lost a parent – mostly fathers, who are often the breadwinner.

Last winter, as Mexico tallied among the highest death tolls in the world, Alejandra Haydee Cardenas Olmos and her husband, José Ángel Sánchez Cabrera, hunkered down at home in Guanajuato, taking precious time off as a taxi dispatcher and driver. As debts began to pile up, Mr. Sánchez Cabrera returned to work to keep the family afloat, and died soon after.

Colleagues pooled money to help pay funeral costs, and relatives knocked on the door with a few thousand pesos or food. Even so, economic challenges overshadow much of their family’s life. Ms. Cardenas Olmos shudders to imagine a scenario where she and her three children might have lost their home or even been separated. “I need my children more than ever,” she says. “I can’t do [this] alone.”

The federal government has made children whose parents died of COVID-19 eligible for small cash grants, to help keep them in school, and local authorities have also provided a little help. But the couple’s eldest, Fernanda Lisabet Sánchez Cardenas, who is in her early 20s, was overwhelmed by the bureaucracy. “The government supposedly has these programs to help, but they put up so many obstacles; it’s like the [policies] are designed so that no one can access the help,” she says.

“She’s not the only one”

Rachel Kidman, a social epidemiologist at Stony Brook University in New York who co-authored the JAMA Pediatrics report, has done most of her research on orphans of the AIDS and HIV epidemic. She says the best outcomes result from “cash plus care” programs that offer both financial and emotional assistance, and often when they focus on the entire family.

“Even though you’re trying to help the child, the best focus may not be the child but the family. Because if the family can be that rock for the child, the child has better outcomes,” she says. “I do think a lesson for the U.S., for Mexico, for India is this idea of strengthening the family.”

She and co-authors have called on the U.S. government to task an institution – like the Department of Health and Human Services – to collect names of children who have lost caregivers to COVID-19 and make sure they receive benefits, such as Social Security, to which they are entitled. They also believe a federal point person for bereaved children could help lobby for financial and psychological support.

So far, for many American families, coping has been ad hoc. 

Diana Ordoñez, in New Jersey, is one young widow who has relied on support from her church and found her way to the “Young Widows and Widowers of Covid-19” support page on Facebook. A year after her husband’s death, her 6-year-old daughter, Mia, relies on a collection of keepsakes – a tear bottle, a dream catcher, and the wedding photos of her parents she put on her dresser – to help her find the courage to fall asleep each night. “She’s just afraid that things will happen that she has no control over, that her whole world could change overnight,” Ms. Ordoñez says.

Recently the grief has felt heavier as life returns to normal in the U.S. – without Juan at their side.

“It’s been really lonely, this feeling like, ‘This wasn’t supposed to happen to us,’” she says. “I think for Mia, it will be helpful to her one day, hopefully, to know she’s not the only one, that she can talk to another kid that loved their dad and lost their dad too. I think that feeling that you’re less alone makes a big difference.”