THE TWO SIDES beaten in the 2021 All-Ireland series by the eventual champions Tyrone, met in Tralee on Saturday night.
Kerry and Mayo both entered the game unbeaten in the league to date, and while the spoils went to the home team, both remain in the top two spots in Division 1.
Part of the current leading football group, what can either take from the mid-March meeting on a night of torrential rain?
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Kerry dig deep for victory
There were clear parallels that could be drawn between Kerry’s Round 5 tie on Saturday and their Round 1 game in late January in Newbridge. They were in front 1-10 to 0-9 in the 58th minute against Kildare and were ahead of Mayo 1-10 to 0-10 in the 55th minute in Tralee.
Kerry didn’t move the scoreboard thereafter against Kildare, hauled back for a draw as they leaked the last four points of the match. On Saturday something similar looked set to happen as three Mayo points on the spin drew them level but Kerry found the wherewithal to push ahead twice through David Clifford frees, the last proving the match-winner.
In a bruising battle on a sodden night, it was easy to understand why Jack O’Connor was so satisfied afterwards. He cannot influence how lopsided Munster football has become in his team’s favour, they are standout favourites to add another provincial title to their collection by late May.
That system will prompt concerns of them being undercooked by the time they reach the All-Ireland series. O’Connor’s awareness of that explains why he stressed after Saturday night’s game, that this was one they had explicitly targeted to collect a win.
Hitting the net and missing the target
A core strength of Mayo teams is their defensive prowess, specialist markers at the back allow them to push on further upfield. Padraig O’Hora and Oisin Mullin were principally detailed to protect the goalmouth on Saturday night, both taking up position next to David Clifford at different stages.
They were really only unlocked once, but it was a critical moment. Tony Brosnan skipped through in the 21st minute after a move he started himself, that availed of Lee Keegan slipping, with the swift passing of Clifford and Adrian Spillane also integral, before the Dr Crokes man slammed his shot to the net.
Kerry forward Tony Brosnan (file photo).
Source: Ben Brady/INPHO
Kerry were clinical when the first-half chance presented itself, Mayo in contrast were not. Aiden Orme’s connection was poor as he dragged a shot wide and Diarmuid O’Connor was denied by Shane Murphy’s intervention, both in the second quarter when raising a green flag would have boosted Mayo’s prospects.
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If it seems a simplistic analysis, it’s worth thinking back to that aspect of last year’s All-Ireland final and how this can be a recurring issue for Mayo. Kerry have seven goals in this year’s league to date, joint highest in Division 1 with Armagh, and only bettered by Galway’s tally of nine across the top two tiers.
Absent attackers
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Shortly before throw-in, there was a row of seats filled in the main stand at Austin Stack Park. David Moran, Dan O’Donoghue, Gavin White and Sean O’Shea amongst the group that filed in, a reminder of how Kerry’s depth had been tested. The absence of O’Shea, instrumental to Kerry’s progress this spring, was a reminder of how his playmaking talents at 11 will be central to Kingdom aspirations this year. Paul Geaney, a late withdrawal through illness, is another valuable option closer to goal.
Ryan O’Donoghue in action for Mayo against Kerry.
Source: Lorraine O’Sullivan/INPHO
Mayo lacked their own big-name forwards. Tommy Conroy’s season-ending knee problem will continue to be a source of regret for their camp. There has yet to be a sign of Cillian O’Connor in action since his Achilles tendon injury last June brought his year to a halt. Much of Mayo’s attacking strategy on Saturday night revolved around Ryan O’Donoghue as a focal point and if he didn’t score from play, he was a constant menace in winning frees, which he nervelessly converted. Fergal Boland weighed in with three impressive points but Mayo’s forward line lacked the necessary output to win this.
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People who are pregnant are now eligible to get the coronavirus vaccine in more than 40 states — typically ahead of their lower-risk peers. And more than 60,000 of them have already rolled up their sleeves, according to the Centers for Disease Control and Prevention.
Although the Covid-19 vaccines authorized in the US were not studied in pregnancy, early data is now starting to emerge suggesting — as researchers expected — that the vaccines are likely safe during pregnancy and confer protection not only to the recipient but also, potentially, the baby.
“It’s all very positive,” says Stephanie Gaw, a maternal-fetal medicine specialist at the University of California San Francisco Medical Center, of the findings so far.
There have been many reasons to suspect the vaccines should be safe in pregnancy, including the lack of major adverse events reported so far, solid studies in animals, and a good understanding of how the vaccines work in the body (they don’t contain live virus, and they are quickly broken down). “The data that we’re collecting on it so far has no red flags,” Anthony Fauci, the top US infectious disease doctor, said in February.
Meanwhile, new research, published March 25 in the American Journal of Obstetrics and Gynecology, found that the vaccines offer strong immune protection for people who are pregnant, just like their non-pregnant peers.
Preliminary research also suggests vaccines might provide some protection to newborns, who are unlikely to have their own approved Covid-19 vaccine anytime soon (and are also vulnerable to more severe illness). The new AJOG paper joins other early findings that antibodies to Covid-19 generated by pregnant mothers after receiving their vaccines were passed through the placenta to the fetus.
But Covid-19 vaccine rollout to the pregnant population has been inconsistent around the globe.
For months, the US and many national medical groups — including the American College of Obstetrics and Gynecology, the Society for Maternal-Fetal Medicine, and the Academy of Breastfeeding Medicine — say the vaccine should be offered to this group, in large part because there’s strong evidence that pregnancy elevates the risk for severe Covid-19 and death. (Given this data, the American Society for Reproductive Medicine goes so far as to say the vaccine is “recommended” for those who are pregnant or considering pregnancy.)
“If a pregnant patient gets infected during pregnancy, her risk of intensive care admission is around 5 percent,” says David Baud, chief of obstetrics at Le Centre hospitalier universitaire vaudois in Switzerland, where he studies infections during pregnancy. “I do not know of any disease that put a 30-year-old woman at such high risk to be admitted to the ICU.” Furthermore, if the infection happens late in pregnancy, it increases the risk of preterm birth and the baby needing intensive care.
Israel went as far as adding pregnant women to its vaccine priority list in January. But other countries, such as the UK and Germany, and the World Health Organization are still saying most people who are pregnant should wait.
Why the disagreement? The clinical trials of the new Covid-19 vaccines explicitly excluded pregnant people, and we don’t yet have enough follow-up data from individuals who have opted to get the shots to say for sure they are safe for everyone during pregnancy.
Add to this muddled landscape the persistent misinformation swirling around the Covid-19 vaccines and pregnancy and fertility, and it is little wonder some people are still confused or worried. And most organizations still stop short of advising all pregnant people to definitely get the vaccine.
Thankfully, these information gaps are starting to fill in. Numerous studies are underway following the outcomes of pregnant and breastfeeding people and their offspring after immunization. And a handful of them are now starting to report early, reassuring results.
In the meantime, however, a growing number of people have had to come to their own decision, with the optional help of their care provider, with some uncertainty. And no one needs an extra thing to stress about during a pandemic pregnancy.
So more information about the coronavirus vaccines in pregnancy can’t come soon enough.
4 reasons the coronavirus vaccine should be okay to get while pregnant — but why not everyone is recommending it yet
One of the big reasons why, despite Covid-19’s known risks in pregnancy, not everyone has unequivocally recommended the vaccines that currently have emergency approval in the US for pregnant people is that the way they work is fairly new. But we do have some key pieces of information already:
1) These vaccines don’t contain live coronavirus. The only types of vaccines that are contraindicated in pregnancy contain live virus that has been weakened, such as the chickenpox vaccine. (Even fewer immunizations, such as the smallpox vaccine, are not recommended during lactation.) While these vaccines don’t pose a risk to most people, there is a small, theoretical chance they could cross the placenta and infect the fetus.
The Pfizer/BioNTech and Moderna vaccines, on the other hand, contain just a fragment of genetic material, called messenger RNA, that can tell human cells to build a tiny part of the virus’s outer shell, which the immune system learns to recognize and fight off. The Johnson & Johnson vaccine uses a different method, known as a viral vector (the same platform as the already-used Zika and Ebola vaccines), to get the body to build part of the virus’s shell.
In either case, there is no way the vaccine can cause a Covid-19 infection.
2) The main coronavirus vaccines are very fragile. Once the mRNA enters the body, it likely only reaches local arm muscle cells before the body breaks it down. This means it is unlikely to enter the bloodstream, and even less likely to make it as far as the placenta. Even if it does get that far, “one of the placenta’s main functions is to be an immune barrier to the fetus,” which adds another layer of protection, says Gaw. And although it contains genetic material, it doesn’t enter our cells’ nuclei, meaning that it can’t cause any mutations to our cells — or those of a developing fetus. This mRNA is so fragile, vaccine developers had to wrap it in nanolipids (which are also presumed to be safe for pregnancy) just to keep it intact long enough to reach muscle cells in the arm.
Experts also expect it is unlikely for the mRNA to make its way intact into breast milk. Preliminary research from Gaw and her team, which is in the process of being peer-reviewed, found no trace of the vaccine itself in breast milk samples from hours and days post-vaccination. And even if a small amount of it were to be transferred to a feeding baby, researchers say it (and any lipid nanoparticles) would get broken down by the baby’s stomach acids.
3) Animal studies look promising. Before any shots were given to pregnant humans, vaccine companies gathered safety data in other pregnant mammals. None of these developmental and reproductive toxicity (DART) studies from Pfizer/BioNTech, Moderna, or Johnson & Johnson suggest any safety concerns for use during pregnancy.
Rats, of course, are not humans, and DART study results do not always translate identically into humans. “Some results are similar to humans, and some are very different,“ Gaw says. Nevertheless, they are a good starting point — when combined with strong safety data in the clinical trials and public vaccinations so far.
4) We haven’t seen adverse events in pregnant people who have gotten it so far. For the Covid-19 vaccine trials, those of “childbearing potential” were screened for pregnancy before each shot, and those with positive tests were removed from the studies. However, a handful of people (12 who got the vaccine in Pfizer/BioNTech’s study and six who got the vaccine in Moderna’s study) ended up having been pregnant at the time of vaccination — and companies haven’t reported any negative outcomes from these individuals.
A newer and much larger data set is emerging from the Centers for Disease Control and Prevention, which is following pregnant people who sign up for its tracking platform V-safe after being vaccinated — and allowing them to sign up for a more targeted pregnancy-specific vaccine registry.
At the beginning of March, the CDC reported data from more than 1,800 pregnant people in the registry who had received Covid-19 vaccines. Among these individuals, there was not a statistically significant increase in adverse pregnancy or birth outcomes. Nor have they found any significant differences in side effects from the vaccine (such as fatigue or fever).
“From a scientific perspective, there’s no specific reason to think that pregnant individuals would have more adverse reactions to the vaccine or that there would be a risk to the fetus with the vaccine, while we know that there is risk with the Covid infection,” says Alisa Kachikis, an assistant professor of obstetrics and gynecology at the University of Washington.
A January study published in JAMA Internal Medicine, for example, analyzed the outcomes of more than 406,000 people who gave birth in hospitals between April and November 2020 and found that a significantly higher rate of those with Covid-19 had major complications. “The higher rates of preterm birth, preeclampsia, thrombotic [blood clotting] events, and death in women giving birth with Covid-19 highlight the need for strategies to minimize risk,” noted the authors.
So why are some, such as the WHO and the UK, still saying most pregnant people should not get the coronavirus vaccine yet? They are waiting for more data.
There are also, of course, other types of coronavirus vaccines in the works, such as protein-based vaccines (which is the basis for Novavax’s shots). This model of shot has been used for years — including for pertussis and hepatitis B — “and we are very comfortable with [their] safety profile,” Gaw says. Viral vector vaccines (which is how the Johnson & Johnson and AstraZeneca/Oxford shots work) have also been used safely in pregnancy, such as for the Ebola and Zika vaccines, although there is less historical data on these.
So, says Kachikis, if what’s hanging people up about getting a Covid-19 vaccine in pregnancy is mostly the novelty of the mRNA vaccines, having other types to choose from — as long as they’re just as effective — could be a good option.
What studies are happening, and what will they help us learn about the Covid-19 vaccine in pregnancy?
The CDC continues to monitor for any adverse outcomes and side effects through its V-safe program — and related pregnancy registry (which will check in with participants in each trimester, after delivery, and when the baby is 3 months old).
Pfizer/BioNTech started giving vaccine doses in their pregnancy-focused, placebo-controlled clinical trial this February. They are first running a smaller safety study of just 350 healthy pregnant participants before scaling up to give the vaccine to a total of about 4,000 people who are at between 24 and 34 weeks gestation. (This study design, however, will still leave some questions about the safety and efficacy of the vaccine, especially earlier in pregnancy.)
Moderna has created a registry that people can sign up for after receiving their vaccine while pregnant. For its part, Johnson & Johnson plans to conduct trials of its vaccine in pregnant participants later (likely after it studies the vaccine in children).
In the meantime, other researchers are racing to collect and study data from the natural experiment that started in December, when many pregnant people began electing to get vaccines as they became eligible because of their high-risk work in hospitals or long-term care centers.
At the University of Washington, Kachikis is leading a study to also follow vaccination in people who are pregnant. Thousands of people from around the US and the world who have received the vaccine while pregnant have already signed up for the registry, she says. (People who are pregnant or lactating but have not yet gotten vaccinated can also sign up, as can people who are considering becoming pregnant within the next two years.) This research will help them track any adverse outcomes, as well as gather additional data, such as whether any vaccinated individuals (or their newborns) later get Covid-19.
An additional large-scale clinical trial, which has not started enrolling participants, aims to track 5,000 women and their offspring over the course of 21 months. Other smaller studies are in the works as well, such as one at Duke University.
At UCSF, Gaw and her team are in the midst of separate observational studies. They will more closely follow a smaller group of participants — 100 or so of whom are pregnant and roughly 50 of whom are lactating — “to determine whether the Covid vaccines are equally effective in pregnant and lactating women, how long antibody responses last, and whether immunity is transferred to the baby,” Gaw explains.
Other vaccines are routinely given in pregnancy, such as pertussis, in large part to provide protective antibodies to the fetus and protect the newborn until they are old enough to get the vaccine themselves.
Covid-19 antibodies have been shown to transfer across the placenta in women who were positive for the virus at delivery. The new AJOG study found that even higher levels of antibodies were present in the umbilical cord after Covid-19 vaccination than after natural infection. “The research shows really promising results,” Kachikis says.
If these antibodies prove to be protective, it could be especially helpful, as newborns and infants will likely be among the last to have an authorized vaccine — and have the highest rates for complications and death from the virus among children. “There is still a lot of data that needs to be assessed, but for individuals who are thinking of ways that the vaccine may benefit their newborn, this is really encouraging,” Kachikis says.
More nuanced research might also eventually help advise on optimal timing for the Covid-19 vaccine during pregnancy. For example, Gaw notes, “there needs to be sufficient time for the mom to develop a robust antibody response, and then pass [this] to the baby.” After extensive research, the Tdap vaccine is recommended around 27 weeks of gestation so as to provide the best protection for the infant after birth. Without such information for the Covid-19 vaccine, many experts are recommending that those who decide to get the shot treat it like the flu shot — getting it as soon as it’s available to them, regardless of where they are in their pregnancy.
People who are lactating were also excluded from the vaccine trials. So researchers at a number of institutions are now working to study how the vaccine might impact breast milk contents and a nursing child. A study from October 2020 showed that most people who had recovered from Covid-19, as well as those suspected of being infected, passed on antibodies to the virus in their breast milk.
The recently released AJOG paper found a high level of antibodies in breast milk from women who had received the Covid-19 vaccine. Gaw’s team also has new findings, which are currently in peer review, that show a solid dose of Covid-19 antibodies in breast milk samples after vaccination. This, they hope, will provide some protection from the virus for babies.
“It’s all reassuring,” Gaw says. But “all the studies have been small…[so] we can’t 100 percent determine safety until a lot more people have been vaccinated and it’s been reported on.”
Wait, why weren’t pregnant people included in the early research to begin with?
Pregnancy has, for decades, been considered a “vulnerable” condition when it comes to researching new medical treatments and preventions, meaning people who are pregnant have been excluded from general trials in much the same way as have those who are unable to give informed consent, like children and those with severe mental disabilities.
Part of the reason for this might be due to the damaging legacy of thalidomide. This drug was given to pregnant women around the world starting in the 1950s as a way to ease nausea (although it was never approved specifically for use in pregnancy in the US). Soon, thousands of these babies were being born with devastating birth defects. This hammered home for scientists and the public that, when it comes to pregnant women and their fetuses, much more care ought to be taken in giving medications or vaccines.
But this conclusion, many are now saying, has it backward, as the oft-repeated phrase indicates: Protect pregnant people “through research, not from research.” If thalidomide had been carefully and systematically studied for pregnancy, it likely never would have been approved for use (or used unofficially) in this population, preventing the majority of these tragic outcomes.
“It can’t be emphasized enough that pregnant women should be included in vaccine trials from the get-go,” Kachikis says.
Gaw agrees: “We actually cause harm by not including [pregnant people] in early research, as they have to wait longer for good data to be published.”
So when will we have more data about the coronavirus vaccine in pregnancy and lactation?
One big challenge with researching anything to do with pregnancy is that it takes a long time: nine months, plus follow-up time to monitor infant outcomes. And subsequent study during lactation while you’re at it, and maybe preconception research, too.
Consider that it took vaccine makers just 10 months to develop the Covid-19 vaccines and ensure they were safe and effective in adults. But with formal studies in pregnant people just getting underway (and with many having not yet started, and others, like Pfizer’s, currently limited to late pregnancy), it could be late 2021 or beyond until we have comprehensive, robust safety data for all stages of pregnancy. And even later to assess long-term outcomes for babies.
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Follow-up to the early work Gaw and colleagues are doing at UCSF will take “at least six to nine months, as we have to wait for a sufficient number of babies to deliver,” Gaw says.
Kachikis and her team at the University of Washington plan to follow the outcomes of people who sign up for their list for about a year, with hopes to continue more long-term follow-up. For example, they plan to test babies months after birth to see how long antibodies from vaccines given during gestation persist — and if these antibodies are equally as effective at fighting off the coronavirus as those found in the vaccinated adults.
But they aren’t waiting that long to start sharing what they learn. “The focus is on getting any data out,” Kachikis says. And “if multiple groups can get some data out, that will be better than having absolutely nothing,” which has been the situation, she notes.
For now, much of the official guidance in the US stresses the need for people to conduct their own analysis of the known increased risks of Covid-19 in pregnancy with the remaining unknowns of the vaccine. And this calculus is not the same for everyone.
“As more evidence is coming out, it’s tilting to more benefit of getting the vaccine,” Gaw says. “But every individual has a different level of risk they’re willing to take” — as well as the amount of risk they might have of contracting the virus or getting extremely sick from it. The bottom line, based on the latest Covid-19 vaccine research in pregnancy, she says, is that “it’s looking more and more like it does work, it does pass antibodies to the baby (although we don’t know yet how protective they are), and there doesn’t look like there’s any harm at this moment.”
Additionally, even those who are reluctant to advocate the vaccine for all pregnant people just yet, such as the WHO, do suggest it should be available to those at high risk of exposure to the virus or underlying health conditions that increase their risk of severe Covid-19.
And some might elect to wait until there is more solid data. So to help move along the plodding process, people who are pregnant and have gotten the vaccine — or are considering it — can contribute to getting more and better guidance sooner by opting in to registries and studies.
Katherine Harmon Courage is a freelance science journalist and author of Cultured and and Octopus! Find her on Twitter at @KHCourage.
It’s been nearly a year since Julie Horowitz-Jackson’s mother, Arlene, died of Covid-19 in a nursing facility in Philadelphia. “What hit me recently is that the world is opening back up, and my mom’s still dead,” Horowitz-Jackson says.
At this point in the Covid-19 pandemic, as vaccines get rolled out in the United States and around the globe, there is a glimmer of hope that life will safely start shifting back to “normal” in the coming months. But so many people, like Horowitz-Jackson, are still working through their grief, and it won’t just disappear when the virus does. Horowitz-Jackson, 51, says she was coping well with the loss of her mom until recently, when, in Chicago, where she lives, she saw many people out and about, celebrating St. Patrick’s Day in large crowds. “I get angry,” she says. “I get angry that people aren’t taking it seriously.”
With over 550,000 reported Covid-19 deaths in the US and 2.8 million worldwide, a massive grief crisis is upon us — with large, unaddressed mental health and economic implications.
“For a large share of people, these [losses] lead to bouts of prolonged grief disorder and depression,” says Ashton Verdery, a Penn State sociologist who studies the societal costs of bereavement. “But also they have huge impacts on their finances, on their employment, on their relationships, and on all kinds of aspects of thriving in the world.”
And new research here provides a broad window onto the lasting scope of our national tragedy.
“These losses that are felt now will be felt for some time to come — even individuals who aren’t born yet will potentially be missing these relatives who might have been alive during their formative years,” says Mallika Snyder, a graduate researcher at UC Berkeley who is also working on estimates with colleagues of the “excess bereavement” felt in the United States and other countries this year.
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There’s no exact figure on the amount of “excess bereavement,” but it’s likely very large, and very devastating.
So many more people are grieving this year than normal
Lately, I’ve been trying to understand the long-term consequences of the Covid-related death — the blank spaces and shadows it leaves behind. Death is not a one-dimensional statistic. It ripples across time, leaving holes in people’s present and future where their loved ones would have been. So, so many people are sensing these holes in their lives right now.
Recently, Verdery and colleagues estimated that, roughly, every person who dies from Covid-19 in the United States leaves nine grieving people behind. Since more than 550,000 people have died of Covid-19 here, then there are nearly 5 million people who’ve suffered the loss of someone close to them.
Verdery’s work is based on a statistical model of the personal connections people typically have. The Centers for Disease Control and Prevention collects data on who is dying of Covid-19, but not the survivors they leave behind.
That said, Verdery says his team’s work suggests a huge swath of people are dealing with loss. “Each death [regardless of their age at death] is going to leave a 4-year-old, a 50-year-old, a 60-year-old, a 10-year-old bereaved, on average,” he says.
And researchers know from past disasters that those losses can leave a lasting mark.
Meghan Zacher, a sociology researcher at Brown, has recently re-analyzed some mental health and wellness data collected from survivors of Hurricane Katrina, in an attempt to predict some of the long-term consequences of the pandemic. “Katrina and Covid are different in really important ways,” she stresses. “This isn’t an apples-to-apples comparison. But there really isn’t an apples-to-apples comparison to the pandemic, at least in modern history.”
She and her co-authors found that the experience of losing a relative or a friend during the storm and its aftermath had the “largest effects on mental and physical health, one year after the storm,” she says. “Also things like fearing for your loved ones’ safety had sizable impacts, as did unmet medical needs. And those are all things that people have experienced during the pandemic.”
Many people experiencing loss from death could benefit from counseling. Covid-19 swells their numbers.
The loss of a loved one is really hard, and not everyone copes in the same way. But there’s some research into the broad buckets of need grieving people fall into. And that helps us understand the immediate impact this bereavement crisis is having in the country — and around the world.
Survey research suggests that, at least in Western contexts, around 60 percent of people dealing with a loss cope by relying on friends and family to support them. “They handle it in their own way,” says Catriona Mayland, a physician and researcher at the University of Sheffield who studies end-of-life issues. It’s not necessarily easy for this group to deal with loss. But they manage.
A further 30 percent might need some more structured help. “So that might be group bereavement support from a faith-based or community-based group,” Mayland says.
And then around 10 percent of those who lose someone close to them experience symptoms qualifying them for a prolonged grief disorder, a diagnosis that soon will be included in the DSM (the psychology/psychiatry official diagnostic manual).
The diagnosis recognizes that sometimes grief rises to the level of severely interfering with the normal function of life, and that people experiencing prolonged grief could benefit from mental health care.
That 10 percent figure is both small and large. It means that, yes, most people cope with loss in their own time. But it’s also not uncommon for someone to need extra help.
And then consider the Covid-19 pandemic. Again, there could be 5 million people grieving losses due to the pandemic. If 10 percent of those people qualify for this diagnosis, that’s half a million people.
There’s even some limited research from the Netherlands suggesting losses due to Covid-19 are harder to take, resulting in more grief, compared to deaths from more typical natural causes.
Talking with people who have experienced loss, it’s easy to see why. Horowitz-Jackson’s family is Jewish, and it’s custom for the family and surrounding community of the deceased to hold a week-long open house “shiva” period, where there’s near-constant company in the home.
“Shiva Zoom was about the worst thing I’ve ever experienced,” she says. Particularly, she remembers how her father, hard of hearing, struggled with the technology. “The ritual of seeing each other and leaning on one another,” she says, just couldn’t be facilitated as well over the internet.
Mayland worries, too, that “there actually could be an upward shift” in the number of people needing more than informal support after a loss, since due to the social distancing restrictions of the pandemic, “normal support” from family and friends may be limited.
Which is all to say: More people than usual may need support to deal with their loss.
Bereavement can impact health and well-being differently at different ages
A person older than 65 who loses a spouse has a “shockingly elevated” increased risk of dying over the next year, Verdery says — estimates range from 15 to 30 percent higher risk of dying. There are many reasons: Our loved ones take care of us when we’re sick, they prod us to get checked out by a doctor, they provide emotional and sometimes financial support. When a loved one gets taken out of the picture, so many cracks can form in the foundations of our lives.
There is, quite literally, a condition called “broken heart syndrome,” or takotsubo cardiomyopathy. It’s when, in reaction to a sudden surge in stress, the heart’s left ventricle weakens.
The experience of loss can be particularly impactful on the trajectory of a life when it comes to young people: When a person under the age of 18 loses a parent, they become less likely to finish high school or college. “Because we know that education is so strongly linked to all manner of life course outcomes — like involvement in the prison system, socioeconomic status in adulthood, unemployment spells, early pregnancy, all sorts of stuff — this does suggest that some of these bereavement events might be really derailing,” Verdery says.
The impact of these deaths is so powerful that bereavement is thought to be a source of racial disparities in health and education in America. By age 20, a Black child is twice as likely to experience the death of a mother and 50 percent more likely to experience the death of a father. The pandemic is likely to make this trend worse — as we know Covid-19 has been taking minorities at younger ages than white people dying from it.
And American society doesn’t do well to protect these grieving kids. It’s estimated that less than 50 percent of children who experience the loss of a parent receive Social Security survivors benefits (which they may be entitled to). “This is one of the most staggering statistics that I found,” Verdery says. “The kids are already dealing with so much. And we’re not even getting them in touch with the benefits they’re entitled to.”
What should we do about this?
After experiencing the loss of her child, Joyal Mulheron, a former adviser to Michelle Obama’s “Let’s Move” campaign, felt the extreme, life-altering pain bereavement can bring. “I basically drove to work every day for 18 months and cried to and from work,” she says. And it wasn’t just her personal pain that was horrible — she also realized that society often overlooks bereavement issues.
Now Mulheron runs Evermore, a bereavement-focused nonprofit, and hopes the pandemic will be a wake-up call for the country to start paying closer attention to the societal strain bereavement puts on the country. “The challenge is no one is thinking about it as an event that can change the course of an individual’s life,” she says.
For instance, she points out that “bereavement is not part of the FMLA” — the Family and Medical Leave Act, which provides time off for those caring for sick family members, but not to cope with their loss. She calls for better housing protections for those who lose financial support after losing a loved one, more transparent funeral pricing, and better Social Security assistance for kids who lose parents.
She also simply would like to see this issue be studied more thoroughly. “We’ve not had the data to really contextualize this,” Mulheron says. “We’ve really thought of a death event as a personal tragedy, rather than a family or a community experience.” At the very least, Mulheron would like to see the White House establish an Office of Bereavement Care, to set a national agenda on this issue.
On a smaller scale, Mayland, the physician who studies end-of-life issues, says it can be helpful just to find spaces to talk about grief, and more helpful still if friends and family reach out with an ear to listen. “Sometimes it’s therapeutic to be able to tell a story,” she says.
“Each time I talk about it, I feel like I’m honoring her memory,” Horowitz-Jackson, the Chicago woman who lost her mother, says.
And don’t forget, Mayland stresses, “Individual kindness can have an impact. It often is the small things that actually can make a difference.”
If you’re reading this, having lost someone to Covid-19, know that you are not alone. So many people are experiencing loss in the country right now, and the pain might not go away when life appears to return to normal.
For some additional resources on bereavement, check out Refuge in Grief, a website and online community with worksheets and courses for processing grief. And you can read more about therapies designed to help people with complicated grief here.