Over four million people have now died from COVID-19. It's a staggering number—one that's hard to conceptualize. When discussing how COVID has changed the world, we often talk about this still-rising death toll. What we don't often discuss are the families—and children—left behind.

A new study estimates that for every two people who die of COVID, one child is left orphaned. By the end of June 2021, estimates show that nearly two million children lost a parent or grandparent caregiver who lived in their home.

Researchers analyzed data from 21 countries and published their findings yesterday in The Lancet. Dr. Susan Hillis, the study's co-lead author, also co-authored a blog post for the World Bank, where she explained their results—and what they mean for children.

"At this rate, one child is orphaned every 12 seconds due to a COVID-19-associated death, and the toll is growing."

She continued, "Children orphaned by COVID face a constellation of risks which often arrive with rapid and broad consequences. The threats of poverty, malnutrition, displacement and separation from siblings or other family members, school dropout, depression, violence and child marriage can emerge suddenly from the Pandora's box of COVID-19."

These are significant issues that have the potential to impact children for the rest of their lives.

The countries with the highest rates of primary caregiver death include Peru (10.2 per 1000 children), South Africa (5.1), Mexico (3.5), Brazil (2.4), Colombia (2.3), Iran (1.7), the USA (1.5), Argentina (1.1), and Russia (1.0).

And we know the pandemic isn't over. Just this week, Dr. Scott Gottlieb, a former chief of the Food and Drug Administration, commented on the highly contagious delta variant. During an appearance on CBS's Face the Nation, Dr. Gottlieb said the delta variant is "so contagious" it will infect most unvaccinated people, adding "it is going to be the most serious virus they will get in their lifetime in terms of the risk of putting them in the hospital."

What can be done?

The researchers say in addition to all current strategies to help end the COVID-19 pandemic, countries need to adopt a new one: prevent, prepare and protect.

"The strategy put forward by our team is to PREVENT death of their caregivers through the rollout of vaccinations and continued attention to mitigation, testing, tracing and isolating; to PREPARE extended or foster families to care for children left without parental care so as to avoid the institutionalization of children; and to PROTECT these children from their increased risk of poverty, vulnerability and violence, including by supporting remaining parents and caregivers with child-sensitive social protection combining cash transfers with caregiver support."

Dr. Hillis and economist Laura Rawlings argue, "The growing numbers of children orphaned by COVID-19 need our support."

"The economic, developmental, and psychological impacts on these children will reverberate across generations, a tragic legacy of COVID mortality."