Updated: This story was updated to include provisional data from an internal Centers for Disease Control and Prevention document.
Vickie Quarles remembers her husband Theodis sitting on the edge of their bathtub, praying “one of those prayers that only God can hear.” He had a hard time catching his breath that late December night. He had been quarantining at home for a couple days by then due to COVID-19.
Seeing his distress, Quarles, in Memphis, Tenn., called an ambulance. A few hours later, her husband was dead.
Of her five daughters, ages 2 to 18, only the eldest woke up to see her father off to the hospital that night. The girls now display anxiety. They have trouble sleeping. They don’t want to leave their mother’s side. Her 7-year-old asks: “What if something happens to you and then it’s just us?”
About 40,000 children in the U.S. lost a parent to COVID-19 between February 2020 and February 2021, according to a research paper published in the Journal of the American Medical Association Pediatrics, with children of color being disproportionately affected. Rachel Kidman, a social epidemiologist at Stony Brook University and co-author of the paper, said she and her fellow researchers estimated that for every 13 COVID-19 deaths, a child lost a parent. Their calculations showed that while Black children make up about 14 percent of children in the country, they accounted for about 20 percent of those who lost a parent to COVID-19 over that time period.
Though some estimates show the toll could be higher. As many as 119,000 children in the U.S. may have lost a primary caregiver due to COVID-19-associated death, according to provisional data in an internal Centers for Disease Control and Prevention document recently obtained by ABC News.
As districts across the country seek to return to full-time in-person instruction this fall, teachers, administrators, and school counselors are preparing to see higher numbers than usual of students experiencing grief. Counselors say that, despite efforts to track how the pandemic has affected families over the last year and a half, the true toll of sickness and deaths won’t become clear until all kids are back in buildings.
Grief, and more broadly trauma, among children were topics of discussion at the American School Counselor Association’s annual conference last week. A number of sessions addressed how to help students cope with the losses they experienced this past year, including the loss of life, said Tinisha Parker, the board of directors chair for the organization.
And while some may view the back-to-school season as a return to “normal,” for those students who’ve lost someone, it will feel anything but.
“I don’t know when we’re going to have a normal year, but this one is not going to be it,” said Eliza Eaton-Stern, a 7th and 8th grade social studies teacher at Denver Green School Southeast, in Colorado. “So being prepared to see these different types of trauma, whether it’s the loss of a loved one, or just all the stuff that happened last year, being prepared to see that in the classroom and knowing that you have the ability to help students through it, that’s, I think, going to be the best thing.”
While Quarles tries to help her daughters process their loss, one of her major worries about sending them back to school this fall is that there will be more emphasis on their grades than their mental health.
Grief takes on various forms
Focusing on mostly remote school was hard after the Quarles sisters lost their father. Nights have been particularly stressful—the girls are haunted by the realization that they were asleep when he died.
Quarles’ 11-year-old tries to use meditation to settle down at night. Her 7-year-old needs to be rocked to sleep.
The girls ask why, if the whole family got COVID-19, did only their 48-year-old father die? They break down crying. They get angry.
“Things are rough around here,” Quarles said.
She’s noticed how each of her daughters has reacted differently to their father’s absence and chosen to cope with it in their own ways.
Schools will see a range of behaviors from students in grief across various ages, said Parker of ASCA.
“Some kids, they will have regressive behaviors because they’re missing a person and not understanding why that person is not around,” she said. “In your middle school ages, in your high school ages, you actually do begin to see sometimes a lot of anger that will come out with students, and they’re angry because they do really realize how final death is. And they do realize that this person will not be in their life in the way that they would like going forward.”
Valerie Villegas, in Portland, Texas, has seen some of this playing out at home.
Villegas, mother of six, lost her husband Robert to COVID-19 in January. Since then her 16-year-old son no longer keeps his room clean and has been arriving late to baseball practice after years of getting there early. Her 5-year-old son breaks down crying when he realizes his father won’t be there to take him to the park or read bedtime stories. At other moments, he’ll say his father still talks to him.
Villegas’ 13-year-old son doesn’t want to speak to anyone or be around his family. He’s had difficulty getting school work done, saying everything is “cloudy,” Villegas said. She, like Quarles, wants schools to be proactive with check-ins for her children—especially the teenagers.
Patience and trust in the classroom are key
ASCA recommends schools have a ratio of one counselor for every 250 students. But the national average was one counselor for every 424 students in the 2019-20 school year, which is the latest year for which data are available, according to the organization.
Many schools are facing budget constraints, but they will be able to use federal relief aid tied to the pandemic for students’ mental health needs, including hiring more school counselors and school psychologists.
While it’s widely known that students will be coming back to school this fall with a lot of social and emotional needs, schools can’t rely only on the one or two counselors in the building to support those needs, said Parker.
In addition to more counselors and therapeutic service professionals, schools need social-emotional learning to be integrated into curriculum across the board, Parker added.
“If we’re only waiting for students to get to the level where they need to see a counselor for social-emotional concerns, we waited too long,” Parker said. “We need to be on the preventative side with social-emotional learning strategies, and that work happens most productively in the classroom where they’re with the teacher every single day.”
Teachers can nurture a culture of acceptance, for example, assuring students they have something to offer the classroom environment, and affirming and validating them as individuals.
When it comes to how grief in particular can play out in the classroom, teachers may face a gamut of scenarios.
In the case of Chris Polley, an English, journalism, and film studies teacher at Columbia Heights High School in Minnesota, there was a student who skipped classes for a bit after her grandfather, who lived abroad, passed away earlier this year. The grandfather had been a father figure to the student, and travel restrictions prevented her from going to see him in his final days.
To best support her, Polley—with the administration’s blessing—allowed the student to forgo due dates, leaving her grade blank until she was ready to complete the work. She eventually became a class speaker at graduation.
“If I had made that grade an F in the gradebook, she might not have thought that she would have had a chance to recover from it,” Polley said. “Because I just left it blank, she knew there was always that opportunity.”
Patience and second chances are key for grieving students, he added.
But these students also need a sense of community, an assurance that they are not alone in what they’re going through and that they can trust their teachers to help them.
Eaton-Stern, in Denver, had a student a few years ago whose mother died of the same brain cancer that had taken her own mother’s life. She connected with the student through their similar grieving experiences, creating a space where he felt he could talk to her and wasn’t afraid to ask to step out of the classroom when needed.
“Something that I’ve found has been really important with all my students dealing with grief is knowing that somebody is prioritizing you and your mental health over the things that you’re doing in the classroom,” she said.
Group counseling, family check-ins help
Forming connections with others experiencing grief has helped Villegas and Quarles, both of whom are members of Covid Survivors for Change, a national network and advocacy group for people who lost someone to COVID-19 and survived it themselves.
Quarles now hopes that, in returning to in-person instruction in the fall, her daughters can connect with other students who understand what they’re going through. Spending the school year at home left them feeling as though they were alone in their pain, she said.
Some schools, aware of multiple students experiencing grief, are creating opportunities for those connections through group counseling. At Charles N. Scott Middle School in Hammond, Ind., counselors like Lydia McNeiley are going to offer small groups in the fall during electives or advisory periods for students who suffered a loss in the past year.
At El Rancho Unified School District in Pico Rivera, Calif., middle school counselor Jacqueline Felix has been leading group grief counseling virtually. The district saw an increase in the number of community deaths after winter break, with caseloads of students losing a parent tripling compared to any other year, Felix said.
Group counseling sessions held over Zoom involved check-in questions and mindfulness activities, including listing attributes of the person who died, bringing attention to positive memories of that loved one. But counselors and other support staff in the district also created more social groups during lunch to foster relationships. The district plans to continue group sessions in the fall, especially knowing that some students can take a whole year to process their grief and then seek out services, Felix said.
At home, Quarles has created family check-in times on Thursdays and Sundays where they all gather at the dining table to talk about how they are feeling and coping that week. She encourages her daughters to let it all out however needed, even allowing them to curse if they must because she knows it’s unhealthy to hold it in.
The girls passed their classes, Quarles said, and she hopes sending them back to in-person school in the fall will help them get support from friends. But Quarles knows that life will never be the same for them, or for any of the other families she knows who lost a loved one.
“Me as a parent, me as an individual, I get sick of hearing people say, I’m so ready for the world to go back to normal,” Quarles said. “There’s no normalcy for us.”