Under the radar: global minimum estimates for COVID-19-associated orphanhood and deaths among caregivers

<p><strong>Background:</strong> The COVID-19 pandemic priorities have focused on prevention, detection, and response. Beyond morbidity and mortality, pandemics carry secondary impacts, such as children orphaned or bereft of their caregivers. Such children often face adverse consequ...

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主要な著者: Hillis, S, Unwin, HJT, Chen, Y, Cluver, L, Sherr, L, Goldman, PY, Ratmann, O, Donnelly, C, Bhatt, S, Villaveces, A, Butchart, A, Bachman, G, Rawlings, L, Green, P, Nelson, CA, Flaxman, S
フォーマット: Journal article
言語:English
出版事項: Elsevier 2021
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author Hillis, S
Unwin, HJT
Chen, Y
Cluver, L
Sherr, L
Goldman, PY
Ratmann, O
Donnelly, C
Bhatt, S
Villaveces, A
Butchart, A
Bachman, G
Rawlings, L
Green, P
Nelson, CA
Flaxman, S
author_facet Hillis, S
Unwin, HJT
Chen, Y
Cluver, L
Sherr, L
Goldman, PY
Ratmann, O
Donnelly, C
Bhatt, S
Villaveces, A
Butchart, A
Bachman, G
Rawlings, L
Green, P
Nelson, CA
Flaxman, S
author_sort Hillis, S
collection OXFORD
description <p><strong>Background:</strong> The COVID-19 pandemic priorities have focused on prevention, detection, and response. Beyond morbidity and mortality, pandemics carry secondary impacts, such as children orphaned or bereft of their caregivers. Such children often face adverse consequences, including poverty, abuse, and institutionalisation. We provide estimates for the magnitude of this problem resulting from COVID-19 and describe the need for resource allocation.</p> <p><strong>Methods:</strong> We used mortality and fertility data to model minimum estimates and rates of COVID-19-associated deaths of primary or secondary caregivers for children younger than 18 years in 21 countries. We considered parents and custodial grandparents as primary caregivers, and co-residing grandparents or older kin (aged 60–84 years) as secondary caregivers. To avoid overcounting, we adjusted for possible clustering of deaths using an estimated secondary attack rate and age-specific infection–fatality ratios for SARS-CoV-2. We used these estimates to model global extrapolations for the number of children who have experienced COVID-19-associated deaths of primary and secondary caregivers.</p> <p><strong>Findings:</strong> Globally, from March 1, 2020, to April 30, 2021, we estimate 1 134 000 children (95% credible interval 884 000–1 185 000) experienced the death of primary caregivers, including at least one parent or custodial grandparent. 1 562 000 children (1 299 000–1 683 000) experienced the death of at least one primary or secondary caregiver. Countries in our study set with primary caregiver death rates of at least one per 1000 children included Peru (10·2 per 1000 children), South Africa (5·1), Mexico (3·5), Brazil (2·4), Colombia (2·3), Iran (1·7), the USA (1·5), Argentina (1·1), and Russia (1·0). Numbers of children orphaned exceeded numbers of deaths among those aged 15–50 years. Between two and five times more children had deceased fathers than deceased mothers.</p> <p><strong>Interpretation:</strong> Orphanhood and caregiver deaths are a hidden pandemic resulting from COVID-19-associated deaths. Accelerating equitable vaccine delivery is key to prevention. Psychosocial and economic support can help families to nurture children bereft of caregivers and help to ensure that institutionalisation is avoided. These data show the need for an additional pillar of our response: prevent, detect, respond, and care for children.</p> <p><strong>Funding:</strong> UK Research and Innovation (Global Challenges Research Fund, Engineering and Physical Sciences Research Council, Medical Research Council), UK National Institute for Health Research, US National Institutes of Health, and Imperial College London.</p>
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spelling oxford-uuid:05e8b8c6-97ed-42c7-8cdd-8337a85f4b082022-03-26T08:59:52ZUnder the radar: global minimum estimates for COVID-19-associated orphanhood and deaths among caregiversJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:05e8b8c6-97ed-42c7-8cdd-8337a85f4b08EnglishSymplectic ElementsElsevier2021Hillis, SUnwin, HJTChen, YCluver, LSherr, LGoldman, PYRatmann, ODonnelly, CBhatt, SVillaveces, AButchart, ABachman, GRawlings, LGreen, PNelson, CAFlaxman, S<p><strong>Background:</strong> The COVID-19 pandemic priorities have focused on prevention, detection, and response. Beyond morbidity and mortality, pandemics carry secondary impacts, such as children orphaned or bereft of their caregivers. Such children often face adverse consequences, including poverty, abuse, and institutionalisation. We provide estimates for the magnitude of this problem resulting from COVID-19 and describe the need for resource allocation.</p> <p><strong>Methods:</strong> We used mortality and fertility data to model minimum estimates and rates of COVID-19-associated deaths of primary or secondary caregivers for children younger than 18 years in 21 countries. We considered parents and custodial grandparents as primary caregivers, and co-residing grandparents or older kin (aged 60–84 years) as secondary caregivers. To avoid overcounting, we adjusted for possible clustering of deaths using an estimated secondary attack rate and age-specific infection–fatality ratios for SARS-CoV-2. We used these estimates to model global extrapolations for the number of children who have experienced COVID-19-associated deaths of primary and secondary caregivers.</p> <p><strong>Findings:</strong> Globally, from March 1, 2020, to April 30, 2021, we estimate 1 134 000 children (95% credible interval 884 000–1 185 000) experienced the death of primary caregivers, including at least one parent or custodial grandparent. 1 562 000 children (1 299 000–1 683 000) experienced the death of at least one primary or secondary caregiver. Countries in our study set with primary caregiver death rates of at least one per 1000 children included Peru (10·2 per 1000 children), South Africa (5·1), Mexico (3·5), Brazil (2·4), Colombia (2·3), Iran (1·7), the USA (1·5), Argentina (1·1), and Russia (1·0). Numbers of children orphaned exceeded numbers of deaths among those aged 15–50 years. Between two and five times more children had deceased fathers than deceased mothers.</p> <p><strong>Interpretation:</strong> Orphanhood and caregiver deaths are a hidden pandemic resulting from COVID-19-associated deaths. Accelerating equitable vaccine delivery is key to prevention. Psychosocial and economic support can help families to nurture children bereft of caregivers and help to ensure that institutionalisation is avoided. These data show the need for an additional pillar of our response: prevent, detect, respond, and care for children.</p> <p><strong>Funding:</strong> UK Research and Innovation (Global Challenges Research Fund, Engineering and Physical Sciences Research Council, Medical Research Council), UK National Institute for Health Research, US National Institutes of Health, and Imperial College London.</p>
spellingShingle Hillis, S
Unwin, HJT
Chen, Y
Cluver, L
Sherr, L
Goldman, PY
Ratmann, O
Donnelly, C
Bhatt, S
Villaveces, A
Butchart, A
Bachman, G
Rawlings, L
Green, P
Nelson, CA
Flaxman, S
Under the radar: global minimum estimates for COVID-19-associated orphanhood and deaths among caregivers
title Under the radar: global minimum estimates for COVID-19-associated orphanhood and deaths among caregivers
title_full Under the radar: global minimum estimates for COVID-19-associated orphanhood and deaths among caregivers
title_fullStr Under the radar: global minimum estimates for COVID-19-associated orphanhood and deaths among caregivers
title_full_unstemmed Under the radar: global minimum estimates for COVID-19-associated orphanhood and deaths among caregivers
title_short Under the radar: global minimum estimates for COVID-19-associated orphanhood and deaths among caregivers
title_sort under the radar global minimum estimates for covid 19 associated orphanhood and deaths among caregivers
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