PRB-1 million covid deaths-Background

The Long Shadow of COVID-19 on the U.S. Population

It will take us many years to understand the long-term effects of COVID on our health, well-being, and way of life.


KCBS Radio recently covered the news that the United States is nearing a million recorded deaths from COVID-19. In an interview with news anchor Melissa Culross about that grim milestone, she asked me the following: “Experts are saying that the deaths brought on by COVID-19 will change the shape of our country. In what ways might we see this happen?”

Where to begin? To put a million deaths into context: That’s bigger than losing every single resident of San Francisco. And we have reason to believe that’s an undercount—it’s entirely possible we’ve already lost more than 1 million people to COVID-19.

It’s undeniable this disease has changed the country in myriad ways. People have lost loved ones, delayed marriages and having babies, dropped out of the labor force, and lost their support networks.

Some of these changes may be temporary—you can delay a wedding ceremony and still get married—but others are permanent. The estimated quarter-million children who lost a parent or caregiver to COVID-19 won’t get that person back. (And decades of research tell us that such adverse childhood experiences can lead to lifelong emotional, behavioral, and health issues.)

Many survivors of the disease also face major health challenges, and we’ve only just begun to understand how long COVID will affect our society. And while the job market is robust in 2022, in the first year of the pandemic millions of Americans—women in particular—lost their jobs or left the workforce, and inequality has been on the rise.

How Has COVID-19 Affected Children?

There’s this mythology that children aren’t affected by COVID-19. But if we go back to 2020—when much of the country was in lockdown to prevent the spread of the virus—nearly as many children ages 0-17 died from COVID-19 as from cancer.1 We certainly wouldn’t say cancer is no big deal, and more recent data suggest that child deaths from COVID-19 were even higher in 2021 than in 2020.

The pandemic isn’t over, and while it’s true that children have less risk of dying than adults, COVID-19 isn’t a cakewalk for kids, either. Recent research suggests that children born during the pandemic may experience slight developmental delays, perhaps due to extra stress faced by their mothers. And, as noted above, the children who lost a parent or caregiver will face unique challenges.

We also know that the pandemic has taken a toll on just about everyone’s mental health. For example, in a July 2021 survey, nearly two-thirds of California parents expressed concern about their oldest child’s mental health. Given that there was a growing youth mental health crisis even before the pandemic, and less than half of youth who need treatment receive counseling, there is cause for concern and considerable room for policy change.

What’s Next?

There’s somewhat of a “fog of war” phenomenon in trying to understand the implications of this pandemic while it’s ongoing. It will take us many years to really grapple with the true impact of COVID-19 on our way of life.

More than a century on, we’re still learning things about the 1918 flu pandemic. Just two years ago, new research showed that infants who were in utero during that pandemic had shorter lives and poorer health than those born before or after.

Other research has shown that entering the job market during a period of economic turmoil can have long-term negative consequences for young adults. In midlife, they work more and earn less, are less likely to be married, are more likely to be childless and to die prematurely than young adults who enter the workforce in a healthier economy.

In the coming decades, we will likely learn similar things about how the COVID-19 pandemic has affected our long-term health and well-being. We’re only now scratching the surface of how the pandemic has reshaped our lives—and we face a long road ahead dealing with the aftershocks.


1 PRB analysis of the 15 leading causes of death for children in 2020, using the CDC WONDER database.