An interesting article published in The Lancet July 20th 2021 by Susan Hillis and others summarises this.

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.  

This article has helped to provide estimates for the magnitude of this problem resulting from COVID-19 and describes the need for resource allocation.  

The article 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.  

They considered parents and custodial grandparents as primary caregivers, and co-residing grandparents or older kin (age 60-84 years) as secondary caregivers.  

To avoid over counting, they adjusted for possible clustering of deaths using an estimated secondary attack rate and age specific infection – fatality ratios for SARS-CoV-2, they used these estimates to model global extrapolations for the number of children who have experienced COVID-19 associated deaths of primary and secondary caregivers.

They found globally from March 1st 2020 to April 30th 2021 an estimated 1134000 children experienced the death of primary caregivers, including at least one parent or custodial grandparent.  1562000 children experienced the death of at least one primary or secondary caregiver. 

The countries in their study set with primary caregiver death rates of at least 1 per 1000 children included Peru 10.2 per 1000 children, South Africa 5.1 per 1000 children, Mexico 3.5 per 1000 children, Brazil 2.4 per 1000 children, Colombia 2.3 per 1000 children, Iran 1.7 per 1000 children and the USA 1.5 per 1000 children and Argentina 1.1 per 1000 children and Russia 1 per 1000 children.

Numbers of children orphaned exceeded numbers of deaths amongst those aged 15 to 50 years.  Between two and five times more children had deceased fathers than deceased mothers.  

They interpreted the results as showing that orphan hood and caregiver deaths are a hidden pandemic resulting from COVID-19 associated deaths.  

They argued that accelerating the vaccine delivery was key to prevention. 

Psychosocial and economic support should be offered to help families to nurture children bereft of caregivers and help to ensure that institutionalisation is avoided. 

Their data showed the need for an additional pillar of the response, prevent, detect, respond and care for children.  

The London General Practice, the leading London doctors’ clinic in Harley Street commends the Government on its vaccination programme and encourages all those who are able to be vaccinated.

Dr Paul Ettlinger

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