More than 1.5 million children around the world, including 1,19,000 from India, have lost at least one parent, custodial grandparent, or grandparent, as a result of Covid-19, according to a new study published in The Lancet.

Of those, more than 1 million children experienced the death of one or both parents during the first 14 months of the pandemic, and another half a million experienced the death of a grandparent caregiver living in their own home, the study estimates.

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In India, the researchers estimate an 8.5-fold increase in the numbers of children newly orphaned (43,139) in April 2021 compared to March 2021 (5,091).

Children who have lost a parent or caregiver are at risk of profound short- and long-term adverse effects on their health, safety, and wellbeing, such as increasing the risk of disease, physical abuse, sexual violence, and adolescent pregnancy.

“For every two Covid-19 deaths worldwide, one child is left behind to face the death of a parent or caregiver. By April 30, 2021, these 1.5 million children had become the tragic overlooked consequence of the 3 million Covid-19 deaths worldwide, and this number will only increase as the pandemic progresses,” said lead author Dr Susan Hillis, from the US Centers for Disease Control and Prevention Covid-19 Response Team.

“Our findings highlight the urgent need to prioritise these children and invest in evidence-based programmes and services to protect and support them right now and to continue to support them for many years into the future – because orphanhood does not go away,” he added.

The researchers estimated figures based on Covid-19 mortality data from March 2020 through April 2021, and national fertility statistics for 21 countries.

The countries with the highest numbers of children who lost primary caregivers (parents or custodial grandparents) included South Africa, Peru, United States, India, Brazil, and Mexico.

The countries with rates of Covid-19-associated deaths among primary caregivers (>1/1000 children) included Peru, South Africa, Mexico, Brazil, Colombia, Iran, United States, Argentina, and Russia.

For almost every country, deaths were greater in men than women, particularly in middle and older ages. Overall, up to five times more children lost their fathers than lost their mothers.

The researchers call for urgent action to address the impact of caregiver deaths on children into Covid-19 response plans.