When Cindy Dawkins, a restaurant employee in Florida, died of COVID-19 in August, the single mom left behind four children.
Now her kids, Jenny, 24, Tre, 20, Zoey, 15, and Sierra, 12, are among the estimated tens of thousands of children marking the holiday season after suffering the loss of a parent or caregiver due to COVID-19.
"You could feel an emptiness," said Tre of celebrating the holidays without his beloved mom. "I don't know how we can go about fixing that, but it has been a weird experience."
Dawkins and her children, of Boynton Beach, were celebrating her 50th birthday in August when she began to feel sick and declined rapidly, according to Jenny and Tre. They say the last images they have of their mom are her in the back of an ambulance.
Less than 48 hours after being taken to the hospital, Dawkins, who was not vaccinated, died.
“I got to the hospital and walked into the entrance and saw my cousin crying [and] my aunt told me, ‘Your mom is gone,’” recalled Jenny. “That was the worst day of my life.”
In the United States, it's estimated that for every four deaths due to COVID-19, one child loses a parent or caregiver, according to a study published in October in Pediatrics, a medical journal.
A report released Dec. 9 by COVID Collaborative, a coalition of experts in health, education and the economy, estimates that more than 167,000 children under the age of 18 in the U.S. have lost a parent or other in-home caregiver during the pandemic.
With the number of children losing a parent or caregiver to COVID-19 expected to continue to grow as the pandemic rages on in the U.S., there will likely be a generation of children that faces obstacles for years to come, some experts say.
"On average, every public school in the country has at least one child who lost a parent or caregiver due to COVID-19," the CDC study's lead author, Susan Hillis, told ABC News in October. “Not only does it affect the child now, in the short term, but it does really stay with them for the rest of their lives.”
“Good Morning America” spoke with three families who have lost both parents or, in the case of Dawkins, a single parent to COVID-19.
Though the families are from different states and backgrounds, they are now all on a similar journey, navigating grief, shock and financial and legal logistics following their loved ones' deaths.
Now as they face the future largely without an infrastructure in place to help them, many experts are calling on lawmakers to take action.
'He misses his mommy'
Jeff and Amee Hager, of Huntersville, North Carolina, tested positive for COVID-19 on Aug. 23, 2021. Three of their four children also tested positive, and while the kids recovered quickly, Jeff and Amee didn’t, Amee’s mother, Tina Miller, told ABC News.
Jeff Hager, a firefighter, and Amee Hager, a stay-at-home mom, were hospitalized on Aug. 28 and placed on ventilators one week later, Miller said.
The couple, who had no underlying health issues, were not vaccinated, Miller said.
“We argued about it,” Miller said. “We pushed as much as we could until we got to the point where we just agreed to disagree. Because we didn’t want to argue with them whenever we were together.”
In the hospital, “Amee thought she was getting better,” her mother said, but “Jeff was scared. … We just had hope that even though they had to go on ventilators that they were gonna come out of this.”
Jeff Hager, 46, died on Sept. 10, also the date of his oldest child’s birthday, Miller said. Amee Hager, 40, died just over one week later, on Sept. 18.
Their unexpected deaths immediately uprooted the lives of their four children.
The oldest, 14-year-old Garrett, Jeff’s son from his first marriage, is now living full-time with his mother and stepfather, Miller said.
Addison, 13, Amee’s daughter from a previous relationship, is living with Miller and her husband, her maternal grandparents.
Jeff and Amee’s two children together, ages 7 and 6, are living with Amee’s sister, who has two young children of her own, Miller said.
The children “understand that their parents died from COVID,” Miller added.
The reaction from 6-year-old Emmery has been ”very matter-of-fact,” Miller said. “She shared with her new classroom that her mommy and daddy had passed.”
Jackson, 7, is “more sensitive,” Miller said. “He will say that he misses his mommy. And I say, ‘I do, too,’ and we get teary eyed and we hug. But he’s dealing with it very well.”
With the grief process still in the very early stages, Miller said the family is keeping a close eye on the children’s emotional wellbeing.
“We’re just doing everything we can to take care of the kids,” she said. “I hope that they feel loved and are happy and Amee and Jeff would be proud of them.”
2 parents gone in 1 day
When Martin and Trina Daniel, a Savannah, Georgia, couple married for over 20 years, died of COVID-19 within hours of each other, they left behind two teenage children.
Martin, 53, and Trina, 49, and their children, Miles, 18, and Marina, 15, were unvaccinated when they contracted COVID-19 in June 2021, Martin Daniel’s nephew, Cornelius Daniel, 31, told ABC News.
After months of debate Martin and Trina eventually decided to get the vaccine and were scheduled to get the shot in mid-July -- the week after they died, their nephew said. Martin and Trina's symptoms hit at the end of June and quickly "spiraled out of control" around July 4.
Martin Daniel died at home on July 6. Trina was hospitalized and died that night, the family said.
Miles and Marina, battling COVID-19 while their parents died, went to the hospital on July 7 for treatment. They were released hours later, Cornelius Daniel said, but had to quarantine for two weeks while dealing with the loss of both parents.
Marina is now living with her cousin, Cornelius Daniel, and his wife and children, while Miles is at college for his freshman year.
For Marina, life changed overnight, and she’s struggling with the emotional challenges, Cornelius Daniel told ABC News.
“Nobody knows how to process losing your parents," he said. "God forbid losing one, but losing two on the same day -- it’s a lot.”
Despite the challenges, Marina’s passion -- soccer -- is serving as a positive outlet, he said.
Miles is doing well in college, Cornelius Daniel said, adding that dozens of other students at Miles’ college have lost parents to COVID-19.
Cornelius Daniel said he’s realized how many children are now lacking the guidance they need, especially with mental health.
“As a country we have to recognize that there are a number of kids in this situation,” he said. “We have kids now who don’t have parents, and outside of just the financial support, they also need emotional and mental health services. Luckily my wife is a school teacher … so she knows some of the counselors … to help get those services.”
And for Cornelius Daniel and his wife, it’s been difficult to address their own grief.
“We kind of place ourselves on the backburner, keep our stuff to ourselves,” he said. “Our focus is solely on Miles and Marina and our own kids, making sure we can facilitate the livelihood they need.”
Their guardianship process is still moving through the legal system, he said, and until it is finalized, Marina and Miles can’t be on his insurance -- making medical bills even more expensive.
“Luckily me and my wife are OK [financially] so we were able to take them in… but it has placed some stress and strain on our finances. We have three kids of our own and we brought in two more. Everybody’s in activities, everybody has things they want to do,” he said.
As for Amee Hager’s mother, Tina Miller, she said she’s now urging everyone to get the vaccine and for young adult parents to have wills in place.
“We are blessed that we are able to take in our grandchildren and provide for them,” Miller said. “But I have often thought about other families who could not provide so easily. There are medical bills, burial expenses, the upkeep of their home until it can be sold and many other expenses that no one thinks about. This could be catastrophic to some families and the children. I never dreamed of all that it involves.”
'Nothing has been made easy'
There is to date no national registry of children who have lost a parent or caregiver to COVID-19, according to experts who spoke with ABC News.
"There's no agency right now tasked really with coordinating services for children affected by COVID," said Rachel Kidman, Ph.D., a social epidemiologist at Stony Brook Medicine in New York and co-author of a study on children losing parents to COVID-19. "There's nobody spearheading that effort to understand the scale of the crisis. Nobody is reaching out to these people ... nobody is helping them navigate this process."
And unlike in the wake of the Sept. 11 tragedy, where a victims' compensation fund distributed over $7 billion, there is also no government-directed victims' compensation fund or national fundraising effort to support the tens of thousands of children whose parents or caregivers have died during the pandemic, although the federal government offers money to cover funeral services for the families of COVID victims.
For some families, that may mean financial difficulties if the parent who passed away was the family’s sole or primary provider.
Dawkins’ children say they have relied on gift cards provided by church members to purchase groceries since the death of their mom, who worked as a restaurant manager and at one point worked multiple jobs to pull her family out of homelessness.
Jenny, a dental assistant, and Tre, a customer service representative for a healthcare company, are now their family's sole providers, a weight that hit them suddenly and one they say feels very heavy. The siblings said they are trying to budget and save as much as possible to prepare for future and unexpected expenses, while also trying to make life as normal as possible for their younger sisters.
The more than $30,000 that was donated to the family through a GoFundMe page has been set aside in savings to prepare for when their apartment lease is up and they have to find a new place to live, according to family friend Janie Yoshida, who stepped in with her husband to pay the siblings' monthly rent so they would not be uprooted after their mom's death.
Yoshida, whose daughter attended high school with Tre, said she has helped the family in different ways for years. With Dawkins’ death, she is now guiding and supporting Tre and Jenny through a maze of paperwork and logistics, from getting FEMA benefits to cover their mom's funeral expenses to getting their mom’s death certificate, figuring out household bills and medical expenses and connecting them with a local non-profit organization that arranged for an attorney to handle their custody case pro bono.
"Nothing has been made easy," said Yoshida. "It's complicated and they really haven't had to do anything yet like this in their young lives."
It was not until Dec. 10 that Jenny was able to obtain an in-person appointment at the local Social Security Administration office to start accessing the survivors benefits entitled to her sisters, Zoey and Sierra. The day before, on Dec. 9, she had a custody hearing that granted her full legal and physical custody of her younger sisters, a long-awaited moment that had held up allowing her to do anything else, like obtaining medical insurance for her sisters.
Prior to the pandemic, only around half of eligible children who have lost a parent receive the Social Security benefits to which they are entitled, according to a 2019 analysis by David Weaver, an economics lecturer at Catholic University and former longtime staffer at the Congressional Budget Office.
The average benefit for a child under the age of 18 whose parent is deceased is $900 per month, according to Weaver, who noted that research shows children who access the benefits have lower poverty rates.
Weaver said he would like to see more of a national effort being made to ensure families who lost a primary caregiver to COVID-19 know they are entitled to Social Security survivors benefits.
"I think one of the consequences of not making sure that these children who lost parents have adequate income is you're going to see higher poverty among children," said Weaver. "That’s a serious issue and it has long-term effects as well."
Joyal Mulheron, a public policy expert and founder of Evermore, a nonprofit organization focused on bereavement care, said she would like to see a more coordinated, federal response for all children who have lost a parent or caregiver, whether it be due to COVID-19 or another cause.
Even before the pandemic, it was estimated that in 1 in 14 children in the U.S. will lose a parent or sibling before they graduate high school, according to the Childhood Bereavement Estimation Model.
"We have four pandemics happening simultaneously -- homicide, suicide, overdose and COVID-19," said Mulheron. "So it's not how the parent died, it’s that the parent died. If we go about this as creating a response for children of COVID only, we are now creating new systems of inequity for the children whose parents have died of homicide or suicide, for example."
Experts call for a fast, inclusive response
Kidman, who has spent years researching the impacts on children who lost a parent or primary caregiver during the HIV/AIDs epidemic, agrees with Mulheron, saying that learning from the past will mean developing policies that support all bereaved children, not just those impacted by COVID-19.
"One of the lessons learned from the HIV/AIDS epidemic is that targeting services exclusively to children who have lost parents to HIV/AIDS was highly stigmatizing and not particularly efficient," she said. "It is much more efficient to make sure we understand the needs of those children and that we have policies that are inclusive and meet those needs."
Kidman pointed to the Child Tax Credit -- which gives government money to qualifying parents -- as an example of a policy that would have a broad impact.
"Making that more permanent would help families who have lost not only a parent but a breadwinner, and really make sure that those kids have the basic needs met," she said. "I think that's absolutely critical."
Mulheron said she has had conversations with leaders on Capitol Hill and in the White House about putting more support systems in place for children who have lost a parent or primary caregiver, what she calls a bipartisan issue, but so far nothing concrete has developed.
"We are in a content-saturated environment so cutting through the noise and getting people to actually listen is a hard thing to do," she said. "I feel sometimes like I'm the lone individual who's saying, 'The house is on fire, folks.'"
Mulheron said she envisions an approach like was undertaken to tackle the drug crisis in the 1980s, when multiple federal agencies, led by the White House, came together to coordinate a response, utilizing systems that are already in place.
We need a centralized, nationalized strategy
"You have the power of the executive office to begin getting these agencies to talk to one another, to begin finding these kids and putting the systems that [are] already in existence around them," she said. "We need a centralized, nationalized strategy."
A similar, nationalized approach is being called for by COVID Collaborative, the coalition of experts led by former Massachusetts Gov. Deval Patrick, a Democrat, and former Idaho Gov. Dirk Kempthorne, a Republican.
Their report calls on the federal government to undertake a "coordinated strategy" to identify children who have lost a parent or caregiver and create a COVID-19 Bereaved Children's Fund to offer financial support. The collaborative is also calling for other interventions like expanded access to early childhood programming for COVID-bereaved kids and pre-emptive outreach and case management by state and local governments to help families access support.
Mulheron and other experts say they worry about both the short and long term consequences of such a large population of children losing a parent.
Compared to their counterparts who have never lost a parent, bereaved children are at greater risk for lifelong consequences including low self-esteem and heightened depression, poorer academic performance, health risks like diabetes and elevated mortality, substance abuse and financial difficulties, research shows.
"Losing a parent as a child is one of the adverse childhood experiences," said Ashton M. Verdery, associate professor of sociology and demography at Pennsylvania State University, who co-authored the study with Kidman. "If kids who lost a parent or caregiver to COVID follow the standard trajectory of people whose parent or parents have died, their life circumstances will most likely be negatively affected."
As Kidman put it, "Responding adequately now is really critical for investing in their lifelong health."
Kids in need of mental health support
One aspect of bereaved children's recovery that most worries researchers is mental health, and whether kids who have specifically lost a parent or caregiver to COVID-19 are able to access the resources they need.
In recent weeks, the U.S. surgeon general and groups including the American Academy of Pediatrics and the Children's Hospital Association have all warned of a growing mental health crisis among young people, a crisis that experts say is even more exponential for bereaved children.
Kids are resilient but this is a very real risk factor
“We know kids affected by family death are at higher risk for worse educational outcomes, behavioral problems,” said Emily Smith-Greenaway, associate professor of sociology and spatial sciences at the University of Southern California, who co-authored the study with Kidman and Verdery. “And certainly kids are resilient, but this is a very real risk factor for … mental health, behavioral, developmentally poor outcomes.”
Vicki Jay, chief executive officer of the National Alliance for Children’s Grief, said her organization has had difficulty getting mental health resources to the right kids because they don't know exactly who or where they are.
With schools now back in-person across the country, the alliance is working to equip them with mental health resources and educate teachers on identifying bereaved children who may need more help.
"Schools are the one constant across the United States that have access to kids all the time," said Jay. "So if they can help us identify, and if we can support the schools and get them equipped and help them recognize the role that grief plays in the healthy outcomes of a child, then that's a great avenue for us as a country to do."
Jay said she worries that bereaved children may be left behind in the pandemic, which has controlled so much of the country's mental health resources and, with its ongoing length, led to what Jay calls "compassion fatigue."
One of the obstacles is people don’t think that kids grieve
"One of the obstacles is people don’t think that kids grieve. It’s easier to think that they’re resilient and that they’ll bounce back," said Jay. "They are resilient but not without our help. They can’t be resilient alone."
Jay and other experts say they are also concerned about about the racial disparities in mental health treatment and access, especially due to the fact that children of color have been disproportionately impacted by the loss of a parent or caregiver during the pandemic.
According to the CDC study released in October, one out of every 168 American Indian/Alaska Native children, one out of every 310 Black children and one out of 412 Hispanic children have lost a parent or caregiver due to COVID-19, compared to one out of 753 white children.
Data shows that Black and Hispanic children and American Indian/Alaska Native children, in particular, are more impacted by mental health issues than their white counterparts, but are less likely to be able to access treatment.
"All of our research says that when you invest in a child at the point of loss, it really is an investment into creating a healthy adult," said Jay. "And the opposite of that is when you don’t, then many times you have an adult that has their own struggles."
Cindy Dawkins' daughter Jenny said she and her siblings have not sought out professional mental health treatment since their mom's death, but are trying as best they can to talk openly about their grief.
"They say I'm annoying but I'm asking them, 'Are you okay? How do you feel?,'" Jenny said of the family's conversations. "I have to ask because I don't want them to be in a real messed-up mindset."
Describing a hard adjustment around having open and honest conversations about mental health with his younger sisters, Tre added, "It’s been weird, obviously, because they’re our little sisters and we were the normal brother and sister relationship. Now we have to navigate it to where they’re comfortable coming to us with stuff like that."
Tre and Jenny both said they are focused on the promise they made to each other immediately after their mom died, which was to do whatever it takes to keep them and their younger sisters together as a family of four.
I think about what she would do in every situation.
"My mom always told us that she wants us to be better than her," said Jenny. "I think about what she would do in every situation and just try to make it better."
Readers looking to support children who have lost a parent or caregiver can consider donating to the National Alliance for Children’s Grief, a national nonprofit organization that provides resources and education to help support children and teens grieving a death.
ABC News' Cheyenne Haslett contributed to this report.