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Pediatric Psychologist On The High Rates Of Children Orphaned By COVID-19

MICHEL MARTIN, HOST:

We're going to move from the story of one child with a complicated beginning to the story of the many children who are facing an uncertain future because of COVID-19. More than a million and a half children around the world have lost at least one parent, grandparent or another caregiver to COVID-19. That's according to a study published in the science journal The Lancet this summer. It said that nearly 114,000 of those children are in the United States. Only Mexico, Brazil and India are countries with more kids orphaned by COVID-19 deaths.

Rachel Kentor is a pediatric psychologist at Texas Children's Hospital and an assistant professor in the department of pediatrics at Baylor College of Medicine. She wrote a commentary in response to The Lancet study titled "Answering The Call To Support Youth Orphaned By COVID-19," and professor Kentor is with us now. Welcome. Thank you so much for joining us.

RACHEL KENTOR: Absolutely. Happy to be here.

MARTIN: Briefly, could you just tell us a bit more about what's in the Lancet study or what the Lancet study said about kids who've lost caregivers to the virus, which prompted your commentary?

KENTOR: Certainly. So what that study looked at - they used different population statistics and extrapolated global estimates about the rates of orphanhood from COVID-19, and one of the things that was really unique is looking at not just parents but also caregivers that were in the home. And that's something that is such a crucial piece to include, particularly because we know that in different cultures around the world, there are different extended family members who might be living in the home and taking a primary caregiver role. And so it really took this global aspect of looking at how many kids were orphaned and to what extent so whether that was one parent, both parents, other caregivers in the home.

MARTIN: Well, you know, one of the points you make in your commentary, which was also published in The Lancet, notes that a lot of media attention has focused on COVID-19 mortality of adults but less on what happens to their kids when these adults die. So what are some of the urgent needs for children left without caregivers? Maybe this is intuitively obvious to some people, but I think we should still talk about it.

KENTOR: So if these children are left without a caregiver, whether that is only one parent, whether that's both parents or caregivers that are in the home, we need to look at what are basic needs? How is that child being taken care of after that death? Do they have access to other family members? Can they get supports, things like that? And especially in other countries, we see pretty high rates of adverse outcomes in terms of interpersonal violence, institutionalization, things like that, where children - their day-to-day life can change drastically.

MARTIN: I'm trying to think of a precedent for something like this that people might remember. I don't know any other way to describe this as an incidence of kind of mass illness and death, and the closest thing that I can think of might be HIV and AIDS. But in the United States, I'm not sure that as many people who were affected by that were at the parenting stage of their lives. And I'm just wondering, is there any precedent that you can look to to describe what this experience might be like for people who are going through it now?

KENTOR: I think that's a great question, and if we're thinking about in the United States, the closest analogy that I can think of is, honestly, September 11 - so this being kind of a national crisis that marked a generation of kids who grew up only knowing TSA requirements of taking off your shoes at the airport, things like that, with a generation really being marked by that event. And I think it's the same way now - right? - in young kids. I've had 2-year-olds and 3-year-olds who come in, and all they've known is wearing a mask. And so they grab their mask before they walk out of their house in the same way that they get their backpack. And so I think there's that shared experience that makes it unique from things like cancer, other deaths.

MARTIN: So you're saying this doesn't just affect the individuals. This could affect an entire generation of people and the way they kind of navigate the world. But - the other question I had for you - one of the things that made dealing with HIV and AIDS so difficult is the stigma and that, you know, people - I think people of a certain age all remember the stories. I mean, people not wanting kids to go to school with them - is the same thing happening here? I know this is still kind of - well, we're 18 months into this. Are you seeing signs of that, a stigma attached to people dying because of COVID? And how is it affecting their kids?

KENTOR: Absolutely. So to keep bringing in kind of the comparison of cancer, there's not stigma around cancer, right? Because we know that that's a disease that can impact anybody. And while COVID is also a disease that can impact anybody, it has become such an unnecessarily polarizing thing that's happening. And so we're seeing that distress around or discord around vaccination. If a parent dies, is there a lot of judgment of, well, they probably didn't get vaccinated? Or they weren't wearing masks. They were being unsafe. And so a piece of almost culpability that I would imagine there could be almost a similar response in terms of stigma that kids get when they've lost a parent to suicide.

MARTIN: So your piece is, in part, a call for people to, you know, do more to support youth who are orphaned by COVID-19. What are some of the things that you would like people to be thinking about or doing as we continue to live through this experience?

KENTOR: The No. 1 thing, if there is one piece of advice I could give to existing co-workers, to community members, to pediatricians, it's to openly talk about death - so being really upfront with kids about what death means and what is happening but also not being afraid to talk to them afterwards about that person who they've lost. We - a lot of times, as a society, we stray away from talking about death. And this is an opportunity for, I think, a global reckoning and understanding how do we communicate with these kids? How do we support them afterwards?

MARTIN: That is Rachel Kentor. She is an assistant professor in the department of pediatrics at Baylor College of Medicine and a pediatric psychologist at Texas Children's Hospital. Professor Kentor, thanks so much for talking with us about this important topic.

KENTOR: Thank you for having me.

(SOUNDBITE OF REMEMBER PROPERTY'S "EVERY DAY") Transcript provided by NPR, Copyright NPR.

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