5/16/2023 0 Comments Maestral orphanage![]() We then calculated the global numbers of orphans by sampling the TFR for each country 1000 times and using our previously fitted logistic model. We considered uncertainty from the TFR in our global estimates by assuming our TFR was normally distributed with the medium fertility variant estimate for 2020–25 as our mean, and estimating the SD from the low and high variants given. We obtained COVID-19 deaths from each country from Johns Hopkins University and TFRs from the UN Population Division World Prospects data ( appendix p 5). To extrapolate beyond these 21 countries, we relied on the high correlation between total fertility rate (TFR) and the ratio of orphans to deaths (Pearson r 2=0♹3) and fit a logistic model using least squares to estimate the two logistic parameters and gamma, a scaling parameter. We based our estimates on the larger of either excess deaths or COVID-19 deaths for 12 countries with data available, and on COVID-19 deaths for nine countries with unavailable excess death data. ![]() We used data from the 21 countries to develop global extrapolations for the impact of COVID-19-associated deaths on the numbers of children orphaned due to deaths of parents, losing primary caregivers (parents or custodial grandparents), and losing primary or secondary caregivers (parents, custodial grandparents, or co-residing grandparents or kin figure 1). In light of the rise in COVID-19-associated deaths in India since February, 2021, we further used estimates of COVID-19-associated deaths to illustrate the impact of such a crisis on increases in orphanhood and death of caregivers. Where appropriate, we adjusted our deaths by the excess-to-COVID-19-deaths ratio ( appendix pp 7–60). For Russia, where age-stratified and sex-stratified COVID-19 deaths and excess deaths were unavailable, we disaggregated excess deaths using published age-specific COVID-19 infection–fatality ratios estimates ( appendix pp 2, 48–50). If excess deaths were not routinely reported for a given country, we calculated them by subtracting the monthly deaths in 2020–21 from the monthly average between 20. In this Article, we use the term COVID-19-associated deaths to refer to the combination of deaths caused directly by COVID-19 and those caused indirectly by other associated causes, such as lockdowns, restrictions on gatherings and movement, and decreased access or acceptability of health care and of treatment for chronic diseases, which are reported in the excess deaths. ![]() For countries reporting COVID-19 and excess deaths, we used the larger of these two values in each age band to calculate the number of orphans, because we are interested in orphans associated with the pandemic as a whole. We extracted available excess deaths and COVID-19 deaths from March 1, 2020, to April 30, 2021, using 5-year age bands or the level of disaggregation provided. We then synthesise evidence-based recommendations addressing the needs of these children and families. We model data for 21 countries that accounted for nearly 77% of global COVID-19 deaths as of April 30, 2021, to extrapolate a global minimum estimate for the total number of children experiencing COVID-19-associated deaths in parents or caregivers. Here, we use the strongest available data on excess deaths, COVID-19 deaths, and fertility to estimate the number of children younger than 18 years who have lost mothers, fathers, or co-residing grandparents because of COVID-19-associated deaths. The impact of these deaths on children can be influenced by variations in fertility, delayed childbearing, gendered aspects of parental death, and rates of primary caregiving by co-residing grandparents, alongside the prevalence of multigenerational households, which are often linked to pre-pandemic prevalence of female employment and lone parenthood. The Lancet Regional Health – Western Pacificĭata on the magnitude of COVID-19-associated deaths among caregivers are needed to guide global responses.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.
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