Comment More than 10.5 million children have lost one or both parents during the coronavirus pandemic — nearly double previous estimates — according to figures released Tuesday. Southeast Asia and Africa suffered the highest rate of loss, with one in 50 children affected compared to one in 150 children in the Americas, according to the research letter published in JAMA Pediatrics. Among the countries with the highest rates of death of parents and caregivers are Bolivia, Peru, Namibia, Egypt, Bulgaria, South Africa, Ecuador, Eswatini, Botswana and Guyana, according to the analysis. Before the pandemic, there were an estimated 140 million orphaned children worldwide. Children in countries with lower vaccination rates and higher fertility rates were more likely to be affected, according to the modeling analysis, which is based on deaths that exceeded what would normally be expected in a year. The numbers take into account deaths that occurred from January 2020 to May 2022 and were produced through a collaboration between modelers at the World Health Organization, the World Bank, the Centers for Disease Control and Prevention and Imperial College London, among others. Lead author Susan Hillis, a former CDC epidemiologist now at the University of Oxford, called the findings “depressing” and urged world leaders to prioritize orphaned children by providing financial, educational and emotional support. Tens of thousands of children are affected by pandemic-related deaths of parents “When you have deaths of this magnitude, you can certainly unaided weaken the fabric of a society in the future if you don’t take care of children today,” Hillis said. In their letter, she and her colleagues wrote that “while billions of dollars are being invested to prevent deaths related to COVID-19, little is being done to care for the children who are left behind.” The consequences for children can be “devastating,” including institutionalization, abuse, traumatic grief, mental health problems, teenage pregnancy, poor educational outcomes, and chronic and infectious diseases, they wrote. The 10.5 million children who experienced the loss of one or both parents include 4.2 million in Southeast Asia, 2.5 million in Africa, 1.5 million in the Americas, 1.5 million in the Eastern Mediterranean region, and 500,000 in Europe. In the United States, grouped with other American nations, about 250,000 children have lost one or both parents. Advocates for children and families said the humanitarian crisis has parallels to the situation created by the AIDS epidemic. A 2020 report by the US Agency for International Development estimated that up to 17 million children had lost one or both parents to HIV/AIDS. John Hecklinger, president and chief executive of the Global Fund for Children, which works with 250 organizations in 46 countries, called the number of caregivers who died “explosive.” Aid workers in developing areas, he said, report that issues such as child trafficking, early marriage and exploitative child labor practices are increasing as the pandemic continues. “The orphan crisis is underneath many other issues,” he said. Carolyn Taverner, co-founder of Emma’s Place, which provides grief counseling in Staten Island, has been working throughout the pandemic with children and families who have experienced the loss of a parent due to Covid-19. He said public health policymakers should think about providing support not just for the short term but for the long term. Many resources are available in the immediate aftermath of a tragedy, he said, but those tend to wane over time. Meanwhile, it can take years for children to come to terms with the death, and the adults around them may not recognize that academic, cognitive, or behavioral issues are often related to the loss of a parent. “The problem,” she said, “is that often it takes children a little longer to understand grief and loss emotionally.” Only a small number of countries, including the United States, have made national commitments to address the impact of Covid-related orphanhood. President Biden’s White House released a memo promising that affected families will be able to access support programs and “connect with resources they may need to help with their healing, health and well-being.”