More than 167,000 kids in the U.S. have lost at least one parent or primary caregiver to COVID-19.

Dr. Charles Nelson coined the term COVID orphans to describe children who have lost one or both parents, or primary caregivers, to the disease. One in four adult deaths to COVID-19 leaves a child orphaned or left without a caregiver — something the Harvard University professor of pediatrics and psychiatry describes as a hidden cost of the pandemic.

“Grief manifests itself differently in young children than it does in adults,” he says.

Grieving children experience anxiety and depression if they’re old enough, he says, but also secondary effects like acting out in the classroom or stress caused by food insecurity or loss of health insurance. This stress can have both a psychological and biological impact on kids.

When someone experiences stress, the brain produces stress hormones. Chronically elevated stress hormones can harm the brain and heighten the risk of physical and psychological ailments, Nelson says.

“If children are grieving the loss of their parents and if that grief is not recognized and it’s not treated,” he says, “short term effects can become long term effects.”

After losing a parent, children feel like “the world has been turned upside down,” he says. Kids need support and a feeling of safety from an adult who is there for them at all times, ideally a family member but also perhaps a teacher, clergy member or neighbor.

“What we need is a safety net that gets put into place immediately so that that child is really being protected by adults,” Nelson says. “And that needs to continue until the child seems to have gotten on the other side and started to resolve this grief.”

Nelson wants municipalities to pay attention to the issue of COVID orphans. Governments need to recognize the problem and then figure out who should be responsible for promptly meeting kids’ needs like counseling or medication, for example, he says.

Friends, extended family and community members need to hold the child’s hand and reassure them that things will get better, he says. In addition to material support like food and shelter, kids need a community of caregivers who can be available for them 24/7.

“Any time that child cries out for help or shows any sign of needing help, the adult needs to be available,” he says, “because if too much time goes by and the child’s needs are not attended to, that feeling of abandonment is just going to get overwhelming for that child.”

‘This is bigger than us’

In Georgia, Cornelius and Melanie Daniel were already the parents of three young children when they adopted their two teenage cousins last summer.

Within 24 hours, 18-year-old Myles Daniel and 15-year-old Marina Daniel lost their parents to COVID-19. Martin Daniel was 53 when he died and Trina Daniel was 49.

Cornelius Daniel describes his uncle as a role model who inspired his love of science. A chemist, Martin Daniel would do experiments in the home.

“My uncle was a very inquisitive guy, very witty fella. He and I both, and Melanie, all graduated from Tuskegee [University],” Cornelius Daniel says. “He inspired us all.”

An old family photos of Trina and Martin Daniel, who died of COVID-19 within 24 hours of one another in July. (Courtesy of the Daniel family)

The family last got together in May for Myles Daniel’s high school graduation. Then on July 6, Melanie Daniel called her husband to tell him his uncle had died and that she thought it was from COVID-19. And Trina Daniel left a voicemail for Cornelius Daniel’s dad that day where they could hear her “labored breathing” and that she wasn’t doing well, he says.

Martin Daniel died at home, and shortly after, his wife was taken to the hospital where she collapsed and was resuscitated. Trina Daniel died after she collapsed again and couldn’t be resuscitated.

At the time, the kids were quarantined at home with COVID-19.

“Myles turned 18 the Sunday after his parents passed away. And so it’s been a long journey. Recently, they lost their grandmother as well. Within the same week of losing their grandmother, they had to celebrate their mother’s birthday,” Cornelius Daniel says. “But with God’s grace and a lot of family support, we’ve been able to sustain ourselves.”

Now, the family takes it a day at a time, Melanie Daniel says.

“I’ve even said to Marina, some days when we can’t take it a day at a time, we take it an hour at a time,” Melanie Daniel says. “And ensuring that there’s positive reinforcement throughout the days, the months and hopefully the years to come.”

The family wrote a letter to Georgia Sens. Jon Ossoff and Raphael Warnock asking about legislation to support families who have taken in the children of COVID-19 victims, education benefits and mental health care, Cornelius Daniel says. He hasn’t heard back about the letter yet but plans to follow up.

His family has the resources to support their cousins emotionally and financially, he says, but many people don’t. And he’s concerned about what could happen to grieving kids who aren’t offered the same help.

“This is bigger than us,” Cornelius Daniel says. “God has given us a bigger purpose, and we’ve stepped into that moment and walked into it with that focus, making sure these young people have the opportunities they need to move forward in life.”

Martin and Trina Daniel were not vaccinated at the time of their deaths. The couple was hesitant about the vaccine but had finally scheduled their first doses when they got sick.

Melanie Daniel says people need to take the precautions available to protect themselves.

“I know that everything happens for a reason. I have a strong spiritual belief,” she says, “but it does make me a stronger advocate for being vaccinated because without putting in the work, then our faith means nothing.”

Karyn Miller-Medzon produced and edited this interview for broadcast with Chris Bentley. Allison Hagan adapted it for the web. 

This article was originally published on WBUR.org.

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