Each day after his shift as a machine operator, Eliberto Ortega used to walk through the front door of his east Houston home, take off his steel-toed work boots and call out, “¿Quién es la princesa de Papá?” meaning, “Who’s Papa’s princess?”

His daughter would holler back her own name, bolting into his arms. Ortega would scoop up his little girl and, after the hug, she would ask to carry his lunchbox into the kitchen.

It’s been over two years since Ortega’s daughter, now 8 and a third-grader at Houston ISD’s J.R. Harris Elementary School, has felt her father’s embrace.

Ortega died of cardiac arrest while sick with the coronavirus in July 2021. Since then, there’s been a father-sized hole in the lives of Ortega’s daughter and her younger brother, who is 7. His daughter still struggles at times to sleep at night, as swirling memories of her dad occupy her thoughts. His son has become more reserved, listening to music about loss and longing.

“We still have an invisible string to him all the way up to heaven,” said Ortega’s daughter, whose name is being withheld by the Houston Landing due to the sensitive nature of discussing her mental health. “He’s with you. It’s connected with you but you cannot see the string.”

In Harris County, thousands of students continue to grapple with the long shadow of grief cast by the deaths of parents and caregivers from COVID-19. Yet today, with federal stimulus funding for schools drawing to an end and state lawmakers dedicating virtually no additional money for public schools during the 2023 legislative session, education leaders are starting to make tough choices about whether to maintain mental health support for children like the Ortegas.

Their decisions will have lifelong effects for students quietly struggling with their anguish. Researchers have found the sudden loss of a parent when it comes to impact on academic performance.

“​​Those kids who don’t want to think about or talk about what happened tend to struggle longer,” said Julie Kaplow, executive director of the Trauma and Grief Center at the Texas-based Hackett Center for Mental Health. Professionals trained in trauma-informed care — including those placed at schools — can help children process their grief in a healthy way, she said.

No government agency has tallied the number of pandemic-bereaved children in the Houston area, but the number might reach about 5,000. An estimated 41,000 Texas children lost a caregiver to the virus, according to a maintained by the Imperial College of London, and about 12 percent of the state’s coronavirus deaths occurred in Harris County, Texas Health and Human Services show.

A 5,000-person estimate could understate the magnitude of the losses because parent deaths due to reasons other than infection, such as drug overdoses and other health issues, also increased nationwide during the pandemic.

A family man

In the Ortega family, before the virus that changed everything, Sundays meant time with Dad.

It was the one free day in Eliberto’s six-day work week, said Laura Ortega, his widow. After going to Mass in the morning, the afternoon would become an adventure of his design. Many weeks, the family would enjoy a bite to eat, then head to a flea market. The four would peruse the multicolored stalls and his daughter would ask to go on rides that her younger brother was still scared of. Eliberto, relishing the chance to spoil his daughter a little, would always say yes, Laura said.

The husband and wife met at a Houston nightclub when Laura was 19, him coaxing her onto the dance floor. After that, the couple dated for several years, at first only meeting up at parks to swing on the swing sets, then later watching Eliberto’s favorite Spanish telenovelas and dancing together to música norteña. Eventually, they married.

Both dreamed of becoming parents, but Laura struggled to get pregnant. Several years later, when her belly started to swell, it felt like a miracle. A second child followed a year afterward. It felt like everything was falling into place.

But one evening in 2021 shattered the future Laura had pictured. Eliberto, who had tested positive for the coronavirus earlier that day, took a rapid turn for the worse. As his children slept in the same room, his breathing became raspy, his lungs closing in on themselves. His eyes rolled back into his head as he slumped in his chair. A trickle of blood slid down from his nose.

Desperately, Laura tried speaking to him. She got no response.

“I literally felt at that moment like he took his last breath in my face,” Laura said. “Because after that, I didn’t feel his heartbeat. I didn’t feel nothing.”

Emergency medical staff arrived at the home to perform CPR and transport Eliberto to the hospital. But hours later, doctors pronounced Eliberto dead.

The next day, the kids arose to an alternate universe. As the news sunk in, the brother and sister spent the following days alternating between bewildered silences and hysterics.

It was late July, just a few weeks before the first day of school. The return to classes would inevitably mean classmates and teachers asking her kids how their summers had gone. Laura decided she had to get them help from a counselor.

Mental health needs mount

Across Texas, schools saw a surge of demand for the sort of services Laura was seeking.

The Texas Education Agency’s School Mental Health Task Force found a “staggering increase” in the rates of students experiencing depression, anxiety and other mental health concerns since the pandemic, according to its 2023 report. About half of roughly 750 school districts surveyed by the task force reported rising rates of “distress related to trauma and grief.”

Sean Ricks, senior manager of HISD’s crisis intervention team, said he saw a surge in student psychological challenges during and after lockdown. The district launched a 24/7 crisis hotline that fielded about 600 calls, according to HISD.

“If I can just use the Richter scale … we were used to tremors of 2.5 or 3,” Ricks said. “At the return of the students to school, I would say it was probably a 5.5 or 6.”

A shortage of psychological support for students has long plagued Texas public schools. For nearly a decade, zero districts in the state had all the recommended ratios of counselors, nurses, psychologists and social workers, a .

But facing never-before-seen levels of psychological distress among students amid the pandemic, and simultaneously flush with cash thanks to the passage of a federal stimulus package that sent billions to Texas campuses, districts began investing in mental health.

As of 2022, Texas schools had spent $64 million in pandemic relief grants on student mental health needs, according to data the TEA provided to the Landing. All told, districts planned to devote over $300 million to the issue, according to a , the most recent available. The vast majority of the spending went to bringing on new staff, the TEA data show.

The investments spurred tangible, though modest, increases in the number of adults that students struggling with their mental health could turn to.

Statewide, schools added about 820 school counselors and 230 social workers from 2019-20 to 2022-23, according to the Landing’s analysis of TEA data. The change nudged the number of students per counselor or social worker statewide from 389 down to 363. Although school counselors in Texas are required to have training in mental health support, their jobs typically also involve helping with scheduling and making plans for after graduation.

In HISD, which lags behind statewide averages in mental health resources per child, the shifts were more extreme. Over the same period, the student-to-counselor-and-social-worker ratio decreased from 793-to-1 to 547-to-1. HISD also brought on more staffers known as “wraparound specialists” meant to address students’ non-academic needs and this year that offer free psychological services.

Families like the Ortegas would finally have better access to the services they were looking for, it seemed.

‘They never call back’

That’s not exactly how the situation played out for Laura.

Before the 2021-22 year began, just weeks after the death of her husband, she spoke with leaders at her children’s elementary school. She explained what her kids had experienced and asked what counseling services might be available. To her astonishment, she learned the school did not have a counselor.

J.R. Harris Elementary, facing a tight budget, had no guidance counselor to start the 2021-22 school year, Principal Jessica Rivero confirmed during an early September community event attended by the Landing.

In the meantime, without options at her children’s campus, Laura looked for psychology practices after she enrolled in Medicaid following Eliberto’s death. Medicaid had suggested several providers, so she went down the list calling every number. It yielded nothing.

“They will just say, ‘Well, you can call this place, and you can call this place, and you can call this place,’” Laura said. “And you call them, but they never call back.”

The lag time without access to counseling meant Laura’s children spent roughly six months going to school every day, attempting to maintain a semblance of normal life, with no outlet to process their loss other than with family members who were also grieving.

That unmet need can be dangerous to children, said Bradley Smith, director of the University of Houston’s school psychology doctorate program. Young people often need therapy catered to dealing with traumatic experiences in order to process them in a healthy way, he said.

“The saying, ‘Time heals all wounds,’ that doesn’t really apply to trauma,” Smith said. “Just the passage of time doesn’t automatically take care of things. And so I think we have a lot of kids walking around that are still experiencing negative effects of the pandemic that haven’t been worked out.”

J.R. Harris Elementary ultimately added a school counselor midway through the 2021-22 school year. While the counselor was not a child psychologist, she agreed to meet regularly with Laura’s children throughout the spring semester. The school later added a second counselor.

Talking about the loss of their dad in one-on-one meetings over the course of months helped Laura’s children begin to heal, she said. Then, in mid-2023, Laura finally found a therapy practice that would accept her insurance. Her kids now attend sessions regularly.

Still, it can be hard for Laura to gauge how her children are processing their grief.

This past summer, she received a troubling report from a staffer at her son’s YMCA camp who said she saw him cutting himself with scissors on two occasions. The second time, the staffer said she asked Laura’s son what he was doing, and he said he wanted to be with his father.

The episode triggered her own memories of childhood trauma for Laura, who cut herself when she was young while struggling to find an outlet to process difficult experiences.

“I want to make sure he doesn’t go through the same thing I went through, that it was hard to get somebody to help, or to listen, to hear me out,” Laura said.

A fiscal cliff

Some of the mental health resources that Texas schools invested into supporting students’ mental health may now be in jeopardy.

The federal stimulus money that helped fund many positions will end in the fall of 2024, meaning districts will soon have to make tough choices about whether to keep or cut any recently added roles.

And state lawmakers, despite a nearly $33 billion surplus, ended their legislative sessions in 2023 without dedicating any new mental health funds to Texas public schools. One promised $100,000 or more per district for students’ psychological needs, but it died early in the legislative process. Barring an unexpected call for a special session, schools will not see significantly more funding until 2025 at the earliest.

That means school leaders likely will have to decide whether to pull money from other sources, such as teacher salaries, to pay for keeping recently added mental health services.  Those decisions will play into student learning, said Brian Woods, deputy executive director of advocacy for the Texas Association of School Administrators.

“A student with mental health needs, just like a student who’s hungry or can’t see well, is going to really struggle academically,” Woods said.

In HISD, district leaders hired seven “intensive mental health specialists” for positions that will not extend beyond the deadline to spend federal funds this year, spokesperson Joseph Sam said.

Nearby Fort Bend and Conroe independent school districts added six and 10 new mental health-related roles, respectively, thanks to stimulus funds. The positions will remain indefinitely, district officials said.

And Katy Independent School District said it has yet to decide the fate of 20 roles funded by the stimulus package, which totaled $4 million and included counselors and social workers.

Districts that decide against retaining pandemic-era mental health support fit into a troubling trend, said Kaplow, the Hackett Center grief specialist. People are eager to forget about COVID-19 and its lasting effects, she said.

“I do think it is in the rear-view mirror of most individuals,” Kaplow said. “I think that the silence around it is making it even more difficult for the children and families who are grieving.”

‘He’s watching them’

Laura does her best to erase the silence and show her children that it’s OK to talk about their father. She frequently sports the cowboy boots her husband bought for her last birthday before he died. She keeps a locket around her neck that, when the light hits it right, reveals an image of the couple stealing a kiss.

She and her kids still sleep in the same room where her husband died because there’s no extra space in the house they share with their cousins. On the wall, she hung a framed picture of her children’s father wearing a white cowboy hat and tan blazer, hands stuffed into pockets, eyes shadowed by the brim, but gaze strong and directly into the camera. A teddy bear named Eric, Eliberto’s nickname, sits on the bed.

Laura’s son said he often brings his father’s voice to mind. If he needs help staying calm, like if someone is annoying him at school, he remembers Eliberto.

“In my head, I don’t forget him,” Laura’s son said. “I know, if I forget him, I’m never going to know him anymore.”

Now, in lieu of the old rituals the family had, they have created new ones. Every Sunday after church, Laura and her children visit Eliberto’s gravesite. Most of the time, the kids race through the headstones in a game of tag or soccer.

Meanwhile, Laura sits by the stone marker, enjoying the fact her children can, once again, play in the presence of their father.

This first appeared on and is republished here under a Creative Commons license.

Now, every new milestone reminds Orlando of her absence: Landing his first job out of college, his younger brother graduating from high school, even smaller occasions like cooking homemade Italian food on Sunday evenings, a tradition of hers that he still keeps alive.

“My life will never go back to normal,” said the older sibling, who, at 23, stepped up to care for his brother, a high school sophomore, and his 80-year-old grandmother. “But I work my best to try to make it as normal as possible and just put one foot in front of the other.”

Across the country, hundreds of thousands of young people, like Orlando, are navigating the delicate journey of moving forward — whether in school, career or family — after losing a caregiver during the pandemic. As of June 2022, more than a quarter million Americans under 18 had lost a primary caregiver to the virus, according to a maintained by the Imperial College of London.

Yet that already staggering tally does not fully encapsulate the scope of the issue. During the pandemic, child bereavement rates increased dramatically, a trend only partly explained by deaths due to infection. 

In 2020, the most recent year for which data on all manner of caregiver deaths are available, the annual number of children who experienced the loss of a parent spiked 25%. Between 2016 and 2019, the number averaged roughly 260,000 annually; by 2020 it had reached more than 325,000, according to a from Judi’s House, an organization that supports bereaved children.

Only 5% of parent deaths in 2020 were from COVID, while 4% were from homicides by gunshot and 22% were from accidental drug overdoses. The latter two causes increased by 41% and 34%, respectively. Parent deaths from health conditions like diabetes and cancer also rose.

“It wasn’t just COVID, we were seeing increases across the board,” said Michaeleen Burns, clinical director of Judi’s House, at a Nov. 1 event hosted by the .

“This trend is not stopping anytime soon,” she added. While the data are not yet finalized beyond 2020, she suspects “we will continue to see that increase in 2021 … and most likely we’re going to continue to see it into 2022.”

With recent test score results shining a light on students’ pandemic learning setbacks, the overwhelming bereavement numbers offer a sobering reminder of the long-lasting social-emotional injuries young people are facing  alongside their academic losses.

Vulnerable communities hit hardest

Children who are Black or Indigenous — groups that have been subject to in the past — experienced the death of a caregiver due to COVID at outsized rates: twice and nearly quadruple the rate of white youth, respectively.

“The loss is disproportionate,” said Catherine Jaynes, researcher at the , an organization that has tracked the pandemic’s toll on children.

In New York City, which became the global epicenter of the pandemic during the early months of 2020, deaths were concentrated in high-poverty neighborhoods, resulting in crushing levels of grief at certain K-12 campuses.

“We had a school community that they lost, I think over 100 family members in one school building. Could you imagine the amount of trauma that that one school was dealing with?” said Tamara Mair, director of interventions for the New York City Department of Education. She declined to specify which campus she was referring to.

The nation’s largest school district held dozens of live consultations to help educators train in grief responsiveness. David Schonfeld, founder of the National Center for School Crisis and Bereavement, led many of those sessions and said he was “deeply impressed” with the city’s response.

Zooming out beyond COVID, children living in West Virginia are more likely than those in any other state to experience the death of a parent by the time they turn 18. Roughly 1 in 8  there, where drug overdose rates are the , go through the trauma of caregiver loss compared to a national rate of 1 in 13. 

At the same time, there may not be adequate support systems in place to help those grieving young people, said Burns.

“There’s huge swaths of the country where there’s the highest concentrations of childhood bereavement where there are no resources,” the Judi’s House clinical director said.

‘The loss … is still present’

Bereaved youth face elevated risks of and , studies show. Even years later, they are more than twice as likely than their peers to show impairments in functioning at school and at home — yet Jaynes says leaders aren’t paying enough attention to the scars many students now carry.

“People are forgetting that … the loss that they experienced is still present in their lives,” the bereavement expert said.

It didn’t take long for people in Orlando’s life to move on after his mother, 56, passed away from COVID in 2020, even as he continued to struggle.

“After the four- to six-month mark, people really start forgetting,” he said. “You don’t want to be the one to reach out like, ‘Hey man, I just really need someone to talk to.’ So a lot of that you bottle in, you jar it.”

But rather than fading, the pain takes on different shapes in the months and years after a parent passes, explained Sallie Lynch, who works at Tuesday’s Children, a nonprofit established to support the young people whose parents were killed in the September 11 terrorist attacks.

“We’ve seen over the last 21 years of our work that a kid’s understanding of death changes at a different age and kids tend to re-grieve,” she said.

Adults should validate children’s pain and empathize, but avoid comparing the loss to their own experiences, Schonfeld, the grief expert.

Sam Adams, 19, lives in New York City and lost his younger brother to a rare disease six years ago. Afterward, classmates and educators tried to empathize but sometimes struck the wrong chord.

“I know what you’re going through,” he remembers people saying, but then going on to compare it to, “My dog died, my fish died.”

Stepping up for grieving children

Schools and other youth-serving institutions should also strive to support bereaved children with the “secondary setbacks” associated with their loss, said Burns, of Judi’s House.

“Maybe you had to move homes, maybe you had a loss of income, maybe your primary caregiver is now suffering with their own grief and depression and not able to care for you in the same way,” she said. “It can even lead to early mortality for that bereaved child if they’re not given the support that they need.”

But in order to provide financial assistance, counseling or any other type of support, schools first need to identify students who have experienced loss. And Jaynes fears many may be sipping through the cracks.

“There is no systematic way in this country to identify a child that has lost a parent or caregiver,” she said.

She held up Brazil as a counterexample, where there is a checkmark on all death records to indicate whether the parent has left a young person behind. 

In the U.S., schools could include screeners to diagnose whether their students have experienced the death of a parent, she suggests, so educators are aware of the trauma some of their children may carry.

“Is there a way as a country that we can step up for these children, whether it be COVID loss or any type of loss, to actually support them going forward?” Jaynes asked.

Such mitigations, said Burns, could help grieving youth for years to come.

“Long after the pandemic fades, we are still going to need to be able to support bereaved children,” she said.

Updated, May 12

Just 10 years old at the time, it was as if Eva Torres’s world fell in when COVID claimed the life of her grandmother in April 2020.

Abuela, as the girl called her, had lived just a block from the Bronx apartment she shared with her parents and two older brothers. Grandma was the one who would pick her up from school each day and “hear her 10,000 stories,” said Eva’s mother Angela Torres, “even if she was repeating it for the 20th time.”

After Eva’s grandmother passed, the elder Torres watched her daughter’s grades slip. Her once-bubbly girl seemed withdrawn, weighed down by anxiety.

“[That kind of loss,] it’s something that you carry with you,” the mother told ����Ӱ��. “It permeates into your very soul.”

The Torres children are three of the 8,649 youth in New York City believed to have lost a parent or caregiver to COVID. That’s roughly equivalent to the of Manhattan’s Battery Park/Tribeca district — or 1 out of every 200 youth in the entire city.

The U.S. reached 1 million recorded COVID deaths this week, a grim and once inconceivable milestone. President Joe Biden on Thursday on government buildings to fly at half-staff for five days.

“One million empty chairs around the dinner table,” Biden said in a statement. “Each leaving behind a family, a community, and a nation forever changed because of this pandemic. … [Americans] must not grow numb to such sorrow.”

Yet having experienced the loss of a caregiver to the virus, some parents say schools aren’t adequately reckoning with the fallout for bereaved students.

“We don’t talk about the people we’ve lost. That conversation is completely not occurring,” said Brooklyn mother Melissa Keaton.

Two years after the April 2020 death of Keaton’s father who lived with the family in their Flatbush apartment, Melissa’s daughter, Melanie, still mourns the loss of her grandfather. The 9-year-old used to end each evening by calling out, “Goodnight, Papa.” Now the missing ritual provides a daily reminder of his absence, said Keaton.

“With grief, there’s no time limit,” explained the mother.

Though much of the nation is eager to put the pandemic in the rearview mirror, life will never return to a pre-pandemic normal for children like Melanie who have endured the trauma of losing a loved one, said Keaton.

That’s a reality educators are now forced to contend with. On average in the U.S., each school serves .

In New York City, which became the global epicenter of the pandemic in spring 2020, the issue is even more acute. Many schools in neighborhoods that were hard hit by the virus now serve over a dozen students who lost a caregiver during the pandemic, school social workers told ����Ӱ��. Researchers said they fear the number in some schools may be of a much higher magnitude, as many as 100.

The New York City Department of Education did not provide an estimate confirming or denying those figures.

In the city’s high-poverty, predominantly Black and Hispanic neighborhoods, which suffered disproportionate COVID deaths, it became difficult to track and absorb the losses during the harshest moments of the pandemic, said Ilka Rios, a Bronx public school parent.

“Daily, I would log into social media and it was ‘Rest In Peace,’ ‘Rest In Peace,’” she said.

Racial disparities in caregiver loss have been in New York City than in the rest of the country, with Black and Hispanic children experiencing the death of a parent or caregiver at 3.3 and 2.6 times the rate of white NYC children, respectively. Nationally, Black and Hispanic children also suffered greater loss than their white peers, but the difference was less dramatic, at 2.1 times.

The 8,649-youth total itself is likely an undercount, said University of Pennsylvania researcher Dan Treglia. The , for whom Treglia did the work, provided the tally of COVID-bereaved children to ����Ӱ��, derived, he said, by combining the city’s coronavirus death numbers from the Centers for Disease Control and Prevention with household-level data from the 2019 American Community Survey.

“These estimates are a lower bound,” said Teglia. “Because New York City was hit so early, we were still figuring out how to recognize and code COVID-19 deaths.”

‘Slipping through the cracks’

But as the city continues to grapple with the fallout, advocates fear that governmental systems are ill-equipped to identify the young people left behind.

“We don’t know who these children are,” said Catherine Jaynes of the COVID Collaborative. “There’s no systematic way to identify them.”

The nation’s largest school district has no internal mechanism letting them know when a student experiences the death of a loved one. Death certificates do not list whether deceased individuals were a parent or guardian and no agency, as far as representatives for the Department of Health were aware, cross-checks records to identify bereaved children. Instead, the onus to let teachers and school leaders know of a recent loss falls on the grieving family.

“We are alerted to a death in the family by other family members or people who are close to the family,” said DOE Press Secretary Nathaniel Styer in an email.

Teachers ought to be aware of the circumstances students are going through, said Nkomo Morris, a counselor at Harvest Collegiate High School in Manhattan.

If you know a student has recently experienced the death of a family member, “you’re not going to be like, ‘Why are you late to class?’” she said. “You’re gonna pay more attention to them, you’re going to be a little sweeter to them.”

When students at her school experience trauma in their outside lives, it gets recorded in an internal system called , which automatically sends an email notifying the student’s teachers and counselors, said Morris.

But on other campuses, the response is less streamlined. Danielle Shapiro-Nussen works as a special education teacher at a District 75 school in the Hunts Point section of the Bronx and suspects there may be students who have experienced the death of a caregiver without the school becoming aware.

“It’s possible that some of these families have gone through a tremendous loss … and we don’t know,” she told ����Ӱ��. “Unless a family member said, ‘Yes, we lost a [loved one],’ there’s probably no way we would have known.”

“I think there are thousands of children who are slipping through the cracks,” said Ayana Bartholomew, a former program officer overseeing efforts to support COVID-bereaved children at the who left the organization in mid-April.

A introduced mid-April in the City Council seeks a more complete accounting, requiring the Administration for Children’s Services to produce quarterly reports on the impact of the death of parents or caregivers dating back to January 2020.

The country as a whole has not done enough to account for the “downstream consequences” of caregiver loss through the pandemic, said the Collaborative’s Treglia.

Bereaved youth have than those who have not lost parents, he pointed out. They are more than twice as likely to show impairments in functioning at school and at home, even seven years later, meaning these children need both immediate and long-term counseling and support to deal with such a traumatic loss.

President Joe Biden used memo to draw attention to the long-term effects of COVID, including the fallout for young people who lost caregivers, but the announcement “doesn’t outline any plan or commitment,” Rachel Kidman, a social epidemiologist at Stony Brook University, says in a recent in The Atlantic. Although the administration has disbursed some funds to grieving families, including to defray funeral costs and for mental health supports, “no law or executive order has provided any resources specifically for pandemic orphans,” the story points out.

Supporting COVID-bereaved families

The COVID Collaborative’s report calls for a more robust nationwide response.

“We recommend a White House Executive Order to provide for screening (for COVID-related caregiver loss) in public and publicly subsidized schools, early childhood education and healthcare settings, along with public-private partnerships to facilitate screenings in other circumstances,” the authors write.

No such program yet exists, but on a smaller scale, efforts have cropped up to identify and provide aid to those who lost a caregiver to the virus. Montefiore Health System launched its “” in 2020, combing through medical records to identify New York City and Lower Hudson Valley households with children that lost a parent to COVID. By filtering COVID deaths by age and cross-checking the notes recorded by health care workers, such as whether nurses helped the patient FaceTime loved ones, the initiative reached 475 families.

“It was a heavy lift,” admitted Deirdre Sekulic, assistant director of social work at the Bronx hospital, who personally made many of the phone calls to eligible households.

“Lots of these were families that were kind of OK before the pandemic. They might have been paycheck to paycheck, but they were going along surviving,” she said. “The unexpected death of somebody just destabilized them.”

Through the program, each household received $2,000 in cash assistance and were connected with social programs such as disability benefits or food stamps. A measure under consideration by the California legislature would create , with as much as $8,000 available to eligible youth when they turn 18.

And though not COVID related, experts point to an effort in Allegheny County, Pennsylvania as a stand-out example of local government systematically identifying youth who lost caregivers. A hotbed of the opioid epidemic with an overdose rate triple the national average, the county’s Department of Human Services matched death records to birth certificates and identified 18 or younger who had lost a parent to an overdose.

“A first step [for localities looking to support grieving youth] could be … understanding where these bereaved children are located,” said Treglia. “Then you can develop a more targeted approach to finding them and you can tailor interventions to their needs.”

‘So much pain’

Even without a systematized method for identifying COVID-bereaved youth, New York City schools have implemented other measures to help students in mourning. In spring 2021, the city announced it would hire .

“There was a clear understanding that they would need more of us,” said April Gurley, a 10-year veteran who this year stepped into the role of supervisor of North Queens school social workers. “We were [responding to] this massive amount of trauma and grief that was happening in our city.”

The Department of Education has also invested in professional development for teachers, with trained in grief sensitivity by David Schonfeld, founder of the .

One positive result that has come of the pandemic, said the expert, is that far more educators have become attuned to the needs of grieving students. conducted by the New York Life Foundation and the American Federation of Teachers, three-quarters of educators reported that COVID has opened their eyes to the immense impact of grief and loss.

Teachers serving children who have experienced the death of a loved one should acknowledge the loss rather than ignore it, Schonfeld advises.

“There’s a tendency to avoid talking with children who have been through a crisis or dealing with a death because you don’t want to upset them,” he said. “Saying nothing is exactly the wrong thing to say because it communicates either that you’re unaware or you’re unwilling to provide support.”

But professional development is only a first step, said Morris, of Harvest Collegiate.

“Being trained in this and actually doing it with a real teen are two very, very different things,” the counselor said.

Last year, in a college advising session, a student disclosed to Morris that they had lost a grandparent. The student was not close with their parents and “their sense of themselves as a person came from that grandparent,” Morris recalled.

“I was shocked,” she said. “They were experiencing so much pain.”

On the fly, she had to figure out how to support the teen, who she said had largely checked out of their academics. She referred them to the social work team, but touched base periodically over email and text. “Hey, how are you doing?” she would ask. “What can I do to help?”

Unfortunately, many NYC students dealing with grief aren’t lucky enough to receive support from a counselor like Morris. When Melissa Keaton, the Flatbush mother whose father passed away, sought out mental health support for her daughter, the therapists she contacted were at capacity, she said, and the school mental health services did not reach out to the family.

Meanwhile, a book the class read called features a young protagonist whose parent has just died. The reading triggered painful memories for Melanie.

“I did email the teacher to let her know that it’s a sensitive topic,” recalled Keaton. “And she just said, ‘OK, well, I’ll keep that in mind,’” but provided no accommodations.

Such instances, said the DOE, are outliers.

“Every one of our schools is a caring and supportive environment where our students can connect with one another, communicate with a caring adult, and access the resources they need to heal as we emerge from the pandemic,” said spokesperson Suzan Sumer.

But despite educators’ best efforts, pandemic circumstances continually put teachers in emotionally charged situations that they don’t always know how to best navigate, said Shapiro-Nussen.

Recently, a first-grader who had lost a parent in September was exiting the classroom when she turned and asked whether the Bronx special education teacher planned to see her mother after school. Shapiro-Nussen was unsure of what to say; she herself had lost her mom to COVID.

“No, sweetie, I’m not gonna see my mom for a really, really long time,” the educator responded. “My mom is on a really, really long vacation.”

“Was it the right choice?” wondered Shapiro-Nussen. She asked the school counselor. Next time, be honest, the counselor advised.

Angela Torres, for her part, turned to those around her for support processing the loss of her mother. She created a COVID bereavement group that met regularly over Zoom in 2020 and grew to about 20 members through word of mouth, Facebook posts and circulating information at her church. Those conversations allowed her to finally begin to heal, she said.

Schools can take a page out of that book, she said, and facilitate conversations between peers and caring adults to help grieving students like her daughter recover.

“Community,” said Torres. “That’s our ticket out of this.”

Illustration by Marianna McMurdock for ����Ӱ��.

When he fell ill from the coronavirus in April 2020 and went to the hospital during New York City’s deadly first wave, the young girl, then just 7, turned to her mother.

“He’ll be OK, right?” she asked. 

Her mother, Melissa Keaton, days later had to tell her daughter that their beloved “Papa,” who was 61, wasn’t coming back to the Flatbush apartment he had shared with them and where he helped care for his granddaughter.

“My father was in the hospital,” Keaton told ����Ӱ��. “We never heard from him. We were never able to see him or speak to him. Once he passed, [Melanie] didn’t get to see that visual, final goodbye.”

The young Brooklynite is one of more than who are believed to have lost parents or caregivers to COVID during the pandemic — roughly 1 in every 450 young people in the U.S. under age 18.

The count updates the already-staggering October estimate that had lost caregiving adults to the virus, and is four times more than a springtime tally that found nearly had experienced such loss. In a Dec. 9 titled “Hidden Pain,” researchers from the and published the new total, which they derived through combining coronavirus death numbers with household-level data from the 2019 American Community Survey. 

The death toll further underscores the daunting task facing schools as they seek to help students recover not just academically, but also emotionally, from a pandemic that has already stretched 22 months and claimed more than 800,000 American lives. It’s an issue of such elevated concern that Surgeon General Vivek Murthy, on Dec. 7, used a rare public address to warn Americans of the pandemic’s . An accompanying calls out the particular difficulties experienced by young people who have lost parents or caregivers to the virus.

“As the nation looks to recover from the COVID-19 pandemic, there is an urgent need to address the crisis of children left behind,” said COVID Collaborative CEO John Bridgeland in a addressing his organization’s co-published research.

Bereaved children have higher rates of depression and post-traumatic stress disorder than those who have not lost parents, according to that followed grieving children for multiple years. They are more than twice as likely to show impairments in functioning at school and at home, even seven years later, meaning these children need both immediate and long-term counseling and support to deal with such a traumatic loss.

“For these children, their whole sky has fallen, and supporting them through this trauma must be a top priority.”

The sky had indeed fallen for the Keaton family. 

After having suffered a single seizure three years prior, Melissa Keaton said she developed full-blown epilepsy after losing her father, experiencing multiple uncontrolled fits. Melanie witnessed her mother in spasms on the floor on at least one occasion.

The elementary schooler’s virtual classroom was unequipped to help the young child process her multiple traumas, her mother said, and the school mental health services did not reach out to the family. Meanwhile, COVID-related lessons — for example, on the vaccine — triggered painful pandemic memories for Melanie, making online class occasionally upsetting, with her school missing signs she was struggling emotionally. 

Of all children who have lost caregivers to the virus since COVID-19 struck, a disproportionate share are Black. Those losses among African-American youth like Melanie have come at more than twice the rate of white young people, according to data in the new report. Indigenous, Hispanic and Asian youth have also suffered outsized losses, the numbers show.

“The children most likely to lose a caregiver to COVID-19 are also most likely to have faced previous adversities,” said Dan Treglia, co-author of the report and associate professor at the University of Pennsylvania. That ups the stakes, he added, on providing support to help those young people heal.

Also particularly vulnerable are the 70 percent of all COVID-bereaved children who are 13 years old or younger. More than 13,000 children of all ages lost their only in-home caregiver.

Despite dire need, however, professional help often remains inaccessible. In Melanie’s case, Melissa Keaton said she turned over every possible stone seeking mental health support for her daughter, but was unable to secure counseling. Well before the pandemic drove greater demand, reported offering mental health services to students and 52 percent said that inadequate funding was “a major limitation” in their ability to provide those services, according to 2017-18 data from the National Center for Education Statistics.

“Trying to find a therapist or someone for her to talk to, it was impossible,” she explained. “Calling, you know, office after office and everyone is at capacity, there’s nothing available.”

The COVID Collaborative and Social Policy Analytics report recommends that policymakers devote resources to grief camps, group counseling and therapy to support children like Melanie as they move forward and recover. They recommend the creation of a bereavement fund for affected families, similar to that which was created for relatives of Sept. 11 victims. Schools, the researchers say, can play a critical role in ramping up mental health services and mentoring for students.

The American Rescue Plan, which will send a total of $122 billion to U.S. schools, includes funding that some campuses are using to responding to students’ mental health needs, especially when it comes to pandemic-related traumas. So far, of school systems have invested some of their relief money in social-emotional learning materials, according to a Dec. 13 tabulation from the data service Burbio, which has tracked how districts are using the influx of federal dollars.

But with or without support, the Keaton family will continue to feel a gaping hole in their household. The holidays, Melissa Keaton said, are especially hard. They always used to spend Thanksgiving watching football with her father. His Dec. 23 birthday was a regular part of their Christmas routine.

“We have these people who have lost family members, and they’re kind of forgotten, the unknowns. We don’t talk about it because everyone wants to get past it and get back to normal,” she said. 

“But for people who have lost someone, certain things will just never be normal.”

The day I found out my grandfather died, I cried so hard I threw up. Two days later, I went back to school.

I walked through the front doors holding back tears. It wasn’t that I felt uncomfortable crying in public. I just wanted to avoid combining a mask with a runny nose.

First period went by without a hitch. Second period was on track to end the same way until I decided to verbally respond to an email from my history teacher. At the time, my school had a hybrid schedule with three rotating groups. For example, if Cohort A was in school on Monday, Cohorts B and C would do school virtually.

The night before coming into school that day, I’d sent my teacher a message. The email read: “Hi Mrs. Hollman, yesterday after school, I found out that my grandfather had passed away. I just wanted to let you know in case I ever started crying during class. I’m trying my best to hold myself together, but I just can’t help it.”

She responded: “So sorry to hear that. It sounds like you were close. How old was he? When’s the funeral? If you need to turn off your camera or step off Zoom any time I understand.” Two simple questions, and yet I couldn’t send a reply. Looking back, I realize that I waited because the grief trapped in my body had nowhere to go.

Why? That’s a long story. It makes me think about how hard the isolation of the pandemic has been on kids my age, particularly those who had previously battled loneliness and depression.

When I was born, my parents lived in a tiny apartment in Brooklyn. They wanted to move to the suburbs to raise their family but hadn’t saved up enough money. With only my dad working (and my mom staying at home to take care of me), my parents eventually decided to send me to China to live with my grandparents. By the time my parents finally bought a house in the suburbs, I was five years old. At the time, moving back to the United States was an unwelcome and drastic change. I didn’t understand a word of English, and my grandparents were all I knew. They took me to the park, cooked my favorite meals, and tucked me in at night.

For as long as I knew him, my grandfather had a nicotine addiction. He started smoking cigarettes at fourteen, and the problem only worsened as he got older. By the time he reached his sixties, he could not walk up a flight of stairs without heaving. He never had cigarettes in his pockets, but it was hard not to notice the smell. During my stay in China, I followed him everywhere to make sure he didn’t smoke. I even spied on him from behind curtains. Once, I caught him hiding a cigarette on the ledge of the stone wall that surrounded the house. After he walked away, I rushed out and stood on my tippy toes, feeling for the cigarette along the length of the wall. When I found it, I ripped it in half, emptied out the contents, and left it there for my grandfather to find.

I did annoying things like that a lot, but my grandfather never raised his voice at me or told me to leave him alone. He’d just chuckle and call me a “bad egg.”

Unlike my relationship with my grandfather, the one I share with my parents has always been tense. My parents are what you might consider “typical immigrants.” They’re Chinese nationals who left in their early twenties to pursue a better life for themselves and their future children. For them, discussing mental or emotional health has never been easy or necessary. When you grow up splitting a single egg with your siblings, there is no time for “feeling blue.”

Whenever I struggled with difficult emotions, my parents did as well. Loneliness was met with anger, sadness with dismissiveness, fear with biting words. I have never felt comfortable speaking to my parents about my emotional or mental wellbeing, and only do so when I want to feel worse than I already do. In other words, never. It doesn’t help that my parents are barely home: They leave for work hours before school ends and come home minutes before I’m about to fall asleep. I know that owning and operating a restaurant isn’t easy, but I wish I had time to say more than “good morning” and “good night.”

My brother isn’t exactly someone I can confide in either. He’s five years younger than I am, and didn’t have the same close relationship with our grandfather. To him, grandpa was some old guy who lived on the other side of the world. I didn’t know how to explain to him, or any of my friends, that knowing grandpa isn’t somewhere on earth felt like a part of me was being violently ripped away. So I stayed silent, isolated, unsure of how to cope.

At the end of second period, once all the students left, I turned to Mrs. Hollman and said, “He was about to be eighty.” I remember tightly clenching my hands, digging my nails into my palm. But once the first tear broke free, the rest followed in an unbroken stream. I then blubbered out everything I had been holding in. I finally had someone to listen to all the words I wanted to say. I don’t remember exactly what Mrs. Hollman said. No quantity or quality of words could ease the pain, but that’s okay. At least she listened.

After arriving at my next class, I quickly asked to go to the bathroom so I could clean myself up. Luckily, I was the only person in there — awkward stares and questions avoided. I blew my nose, wiped my mask, put it back on, and tried all the .

I have these memorized because in freshman year, when my depression and anxiety were unmanageable, I’d often randomly burst into tears. I think every one of my teachers from ninth grade saw me cry at least once.

The first time I acknowledged my mental health problems was with my eighth grade English teacher. A toxic friendship, low self-esteem, and persistent feelings of failure made me wish I could stop waking up in the morning — at the age of fourteen. In school, I would stare at a wall without noticing that an entire period had gone by.

My English teacher at the time, Mrs. Doane, noticed my odd behavior and pulled me aside after class one day to ask whether I was okay. The answer was no, but that’s not what I said. Mrs. Doane didn’t believe me, and I’m glad she didn’t. By continuing to use the power of, “How are you?” she gradually got me to open up. And through our conversations, I learned that I needed professional help.

It took me three years of consistent, agonizing steps in the right direction — steps so microscopic that they didn’t seem to exist at all— before I finally felt I was meant to live.

Death from COVID-19 complications isn’t something most students have to worry about. But the consequences of pandemic-induced social isolation shouldn’t be underestimated. A surge of in Clark County, Nevada, convinced district officials that schools need to reopen as quickly as possible. from the Centers for Disease Control found that emergency room visits for suspected suicide attempts among teens increased 31 percent last year compared to 2019; for teen girls, the attempts were over 50 percent higher.

Reaching out to students struggling with depression may seem next to impossible when teachers and administrators have so much to deal with as a result of the pandemic. But I know I wouldn’t have made it this far without my teachers.

Students certainly need additional help. I have an idea about how technology can be used to open a new frontier in mental health support. Students, with the help of their guidance counselors, could launch peer-support video conferences. Although these conferences wouldn’t replace professional counseling, they could help students cope. Any time during lunch or even after school, a student who is struggling could join such a group and talk with a fellow student who is there to empathize, ask questions — and most importantly — to listen.

It’s been five months since my grandfather passed. Things have gotten better. Sometimes an entire day passes where I don’t think of him at all. But on the days that I do, I feel a deep sense of longing that nothing can alleviate.

I’ll be a senior next year, so I’ve started looking at colleges, thinking about prospective majors and planning my future. But although life goes on, I’d give anything to call my grandfather again and tell him one more time to stop smoking.

Cindy Chen is a junior at James Caldwell High School in Caldwell, New Jersey.

“Pandemic Notebook” is an ongoing collection of first-person, student-written articles about what it is like to live through the coronavirus pandemic. Have an idea? Please contact Executive Editor Andrew Brownstein at Andrew@The74million.org.