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Forgotten in the calls for a “new normal” and the shuffle toward it are the millions of children around the world whose parent or guardian has died from Covid-19. Their post-pandemic lives will be anything but normal.

In a study published recently in the journal Lancet Child and Adolescent Health, we and several co-authors estimated that, in the first 20 months of the pandemic, more than 5 million children have lost a parent or other caregiver living in the home, such as a grandmother or grandfather. By the two-year anniversary of the pandemic in March 2022, the Covid-19 orphanhood calculator shows this number has grown to more than 7 million children.


Consider the story of 2 1/2-year-old Diana (not her real name), who lives in rural Zambia. Her mother died before the pandemic, shortly after Diana’s birth, and her grandmother stepped in to become her sole caregiver. Three months ago, Diana’s grandmother became sick with Covid, with no one else at home to help care for the two of them. After nine days, she died, leaving boiling water on the stove for Diana’s morning tea. The toddler, seeing that no one was making tea, tried to do it herself. But she spilled the scalding water on her scalp and shoulders.

Her screams reached her grandmother’s neighbors, Rev. Billiance Chondwe and his wife, Catherine, who rushed to find a car to get Diana to the nearest hospital, about a 45-minute drive. When Diana was released from the hospital, the Chondwes cared for Diana in their home.

In our study, we were able to identify the groups of children most affected by caregivers’ deaths. More than half of the children affected are like Diana, mourning a recent loss, because the Delta variant accelerated Covid-19 deaths in 2021. In just six months, the worldwide total of children affected doubled from 2.7 million as of May 2021 to 5.2 million children by the end of October 2021. The toll has kept rising.


For various demographic and epidemiological reasons, three-quarters of children worldwide who experienced the death of a parent during the pandemic lost their fathers who, in many cultures, are the principal breadwinners. Studies show that paternally orphaned children who do not get the help they need are at increased risk of exploitation, abuse, teen pregnancy, poverty, and vulnerability to violent extremism.

As global health researchers and experts in child and family welfare who also study the prevention of violence toward and vulnerability of children, we hear stories from around the world about what the death of parents and grandparent caregivers is doing to children and families. We also hear about those who step in to make a difference for the children left behind.

Individuals like us, readers like you, organizations, and countries must acknowledge the responsibility to help children left behind through concrete actions.

One place to start is by building on the success of U.S. governmental programs like the President’s Emergency Plan for HIV/AIDS Relief (PEPFAR) that have provided support for 20 years to the millions of children orphaned by AIDS. PEPFAR has used best practices and evidence-based models for protecting orphans and vulnerable children, and collaborated with national and local governmental, non-governmental, and faith- and community-based organizations to support basic needs like food and education, and to invest in family-based support services to keep children in loving families and out of orphanages. Such efforts need to be expanded and sustained in countries around the globe for children orphaned by Covid-19.

That, however, starts with accepting that we do not get to simply turn the page on the pandemic, saying “How sad,” and moving on. Instead, we should be asking “How can I help?”

Although the numbers that we and our colleagues revealed in our research are large, for a child whose parent or caregiver has suddenly died the only number that matters is one. In Diana’s case, that “one” was the Chondwes. Like them, each of us can be “the one” by offering practical and compassionate support.

Each of us can also be the voice for many. It’s a simple thing to reach out to members of Congress to urge them to include children who have lost a parent or primary caregiver in Covid response plans — and emphasize that the U.S. can lead by example through ensuring Covid-related orphanhood is on the agenda for President Biden’s second Global Covid-19 Leaders Summit in April.

The U.S. led the world with its exemplary generosity in responding to the extreme threats for 7 million orphaned and vulnerable children during the past 20 years of the AIDS pandemic. Americans invested in the ongoing health, educational, psychosocial, and economic support of these children and, in so doing, ensured their recovery and resilience. The U.S. can once again can show that the American people are dedicated to the welfare of the millions of bereaved children carrying a heavy burden of pain and loss in just the first two years of the Covid pandemic.

As Nelson Mandela once said, “There can be no keener revelation of a society’s soul than the way in which it treats its children.”

The Chondwes continued helping Diana by searching for a relative who could become her caregiver. They found her great-aunt, a widow in a nearby village, who agreed to adopt her. The pastor’s wife in that village has been visiting Diana weekly to provide psychosocial and spiritual support. But the new family still needs food, as well as transport to get Diana to the medical check-ups she requires. Investments are needed now to support these essential aspects of Diana’s care and growth.

The world has surpassed 6 million Covid-related deaths, and what was once shocking has become for many people merely a statistic. Many accept the daily death toll — unless it personally affects them — because they feel powerless to do otherwise. We look away, explain away, rationalize. But we cannot do that with the children left behind by this terrible scourge.

Seth Flaxman is an associate professor in the Department of Computer Science at the University of Oxford. Susan Hillis is the coordinator of the Global Reference Group on Children Affected by Covid-19 and the former senior technical advisor for the U.S. Centers for Disease Control and Prevention’s Covid-19 Response Team. They are grateful to Rev. Billiance Chondwe, project chairman for the PEPFAR Faith and Community Initiative Partnership in Kapiri Mposhi, Zambia, for Diana’s story.

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