Grief Pervasive as U.S. COVID Deaths Surpass One Million

The grief born from the pandemic won’t just disappear. Learn how it can harm—and how to heal.

two people sitting holding hands

Medically reviewed in March 2022

Updated on May 12, 2022

In the United States alone, COVID has claimed the lives of more than one million people. The tragic milestone was reached on May 12, more than three years since the pandemic began in early March 2020.

"One million empty chairs around the dinner table. Each an irreplaceable loss. Each leaving behind a family, a community, and a nation forever changed because of this pandemic," said President Biden in a White House statement. "As a nation, we must not grow numb to such sorrow. To heal, we must remember. We must remain vigilant against this pandemic and do everything we can to save as many lives as possible, as we have with more testing, vaccines, and treatments than ever before. It’s critical that Congress sustain these resources in the coming months."  

For every American life lost to the coronavirus, there are approximately nine close family members grieving, according to a July 2020 study in PNAS. So, even now as COVID shifts from pandemic to endemic, some 9 million people are experiencing grief, including more than 140,000 children who’ve lost a caregiver.

Death is often viewed as a natural part of life. But the sheer scale and complexity of COVID-related losses over the past few years is more difficult to grasp. The grieving process, which is fundamental to healing, was also disrupted.

Early on, many COVID deaths were as sudden and unexpected as fatal accidents. During lockdowns, people couldn’t sit with their loved ones in hospital rooms or be by their side during their final moments.

And while many were understandably frustrated by not being able to host birthday parties or weddings, others couldn’t plan funerals. These services, where people traditionally gather to collectively mourn and say goodbye, became virtual, socially distant events.

This still matters—even now that life is beginning to resemble something closer to “normal.”

Why?

Scientists have explained that the coronavirus won’t simply vanish. It’s here to stay, and we’ll learn to live with it. Similarly, the grief born from the COVID pandemic won’t just disappear. Grieving is a process, and it takes time.

It’s important to recognize this and take the appropriate steps to mourn because grief has consequences.

How grief can harm
Regardless of its cause, grief takes a mental and physical health toll.

It is associated with a range of emotions, including denial, shock, confusion, sadness, anger, guilt, and despair.

Some people may also develop physical symptoms, such as pain, changes in sleeping and eating habits, digestive issues, and fatigue. In more extreme cases, people may experience anxiety, depression, and thoughts of suicide.

Grief and stress may go hand in hand. Grief can trigger a surge in stress hormones associated with the body’s “fight-or-flight” response. Research suggests that grief weakens the immune system while ramping up inflammation throughout the body. Over time, chronic stress has been linked to a range of health issues, including high blood pressure.

There is also evidence that soon after the death of a spouse or child, people’s risk for heart disease or heart attack are considerably higher.

When grief doesn’t fade
Everyone experiences grief differently. Healing doesn’t always follow a linear path. Waves of grief may come and go at various times. Some people may be able to compartmentalize their loss and move forward in a matter of months. For others, this could take years.

The great number of deaths that result from pandemics are different from losses due to cancer and other diseases, according to a January 2021 article in the Indian Journal of Psychological Medicine. Researchers who analyzed grief in previous pandemics, including bubonic plague during the 13th century and Spanish Flu in 1918, suggest the COVID-19 pandemic may serve as a “gateway” to complicated grief, or what is now known as prolonged grief disorder (PGD).

For those affected, their pain becomes debilitating and long-lasting, preventing them from healing and moving on with their lives.

Amid the COVID pandemic, in September 2021 PGD was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a publication of the American Psychiatric Association (APA), which defines and classifies mental disorders.

Incapacitating grief that consumes most of a person’s waking hours on most days is one telltale sign of PGD. For those with the condition, grief disrupts their other relationships, their job performance, and other areas of their lives.

Other symptoms of PGD:

  • Feeling as though you’ve lost part of yourself along with your loved one
  • Experiencing disbelief about your loss
  • Avoiding any reminders about what has happened
  • Severe emotional pain associated with the death, such as bitterness or anger—or no feelings at all
  • Problems resuming other normal activities, such as engaging in hobbies, being social, or making plans
  • Loss of sense of purpose
  • Extreme loneliness or feelings of detachment

If left untreated, PGD could lead to other serious problems, such as substance abuse, suicidal thoughts, and a weakened immune system.

How to heal and move forward
Even if you think of lost loved ones every day, the acute pain associated with their absence tends to diminish over time. The journey, however, may be winding and look different for different people. You may have ups and downs and changes in your feelings or behavior at various times. But there are five predictable stages many people experience at one point or another along the way:

  1. Denial: you don’t want to believe that it has happened
  2. Anger: you lash out at others or even objects
  3. Bargaining: you wonder what you could have done differently
  4. Depression: you experience sadness, fatigue, loss of motivation
  5. Acceptance: you begin to adapt and reconnect with others

These stages may vary from one person to the next and you may not experience them in any particular order. But being aware of them can help you recognize and understand what you’re going through.

There are also some strategies that can help you cope with your grief, including:             

Don’t be afraid to talk about it. You may want to bury your feelings and not relive something hard but talking about the person you lost with friends and family can help you process what’s happened. It can also keep you connected to others at a time when you may feel isolated.

Acknowledge your feelings. Grief can trigger a wide range of emptions. Whatever you’re feeling is okay and it’s important to recognize it.

Don’t abandon self-care. Grief takes a toll on the body. It’s important to follow a healthy diet, get quality sleep, and do even little things to protect your health and well-being, such as taking a walk or a hot shower. 

Cherish your memories. Celebrating people’s lives rather than dwelling on their death is a way to honor them. Planting a garden in someone’s memory, starting a charity, passing down heirlooms, and passing on a name to a new baby are all things you can do to remember a loved one who has died.

Find a support group. Interacting with others who are also coping with loss can help you feel less alone. You could learn what has worked for others and try to apply these coping strategies to your own life.

Avoid making rash decisions. During the grieving process, it may be wise to hold off on making major life decisions, such as moving, changing jobs, or having a child. Try to be patient as you learn to adapt.

Don’t hesitate to seek help. If your grief is interfering with your ability to function in your daily life, if you have symptoms of PGD, or if need help managing your loss, it’s time to talk to a healthcare professional, such as a trained psychologist. Your primary care physician (PCP) can help you find someone who specializes in grief. Talk therapy and other treatments could help you manage your feelings and improve the quality of your life.

Article sources open article sources

The White House. Marking One Million American Lives Lost to COVID-⁠19. May 12, 2022.
Centers for Disease Control and Prevention. “COVID Data Tracker.” Mar 25, 2022.
Ashton M. Verdery, Emily Smith-Greenaway, Rachel Margolis, et all. “Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States.” PNAS. Jul 10, 2020.
U.S. National Institutes of Health. “More than 140,000 U.S. children lost a primary or secondary caregiver due to the COVID-19 pandemic.” Oct 7, 2021.
Susan D. Hillis, Alexandra Blenkinsop, Andrés Villaveces,et al.; COVID-19–Associated Orphanhood and Caregiver Death in the United States. Pediatrics December 2021; 148 (6): e2021053760.
Varshney P, Prasad G, Chandra PS, Desai G. Grief in the COVID-19 times: Are we looking at complicated grief in the future? Indian J Psychol Med. 2021;43(1):70-73.
American Academy of Family Physicians. “Grieving: Facing Illness, Death, and Other Losses.” Dec 2, 2019.
Mental Health America. “Bereavement And Grief.” Accessed Mar 24, 2022.
American Heart Association. “How grief rewires the brain and can affect health – and what to do about it.” Mar 10, 2021.
Wei D, Janszky I, Fang F, et al. Death of an offspring and parental risk of ischemic heart diseases: a population-based cohort study. PLoS Med. 2021;18(9):e1003790.
Harvard Health. “Grief can hurt — in more ways than one.” Feb 1, 2019.
Fagundes CP, Brown RL, Chen MA, et al. Grief, depressive symptoms, and inflammation in the spousally bereaved. Psychoneuroendocrinology. 2019;100:190-197.
Carey IM, Shah SM, DeWilde S, Harris T, Victor CR, Cook DG. Increased Risk of Acute Cardiovascular Events After Partner Bereavement: A Matched Cohort Study. JAMA Intern Med. 2014;174(4):598–605.
C. Killikelly, G.E. Smid, B. Wagner, P.A. Boelen, Responding to the new International Classification of Diseases-11 prolonged grief disorder during the COVID-19 pandemic: a new bereavement network and three-tiered model of care, Public Health, Volume 191, 2021, Pages 85-90, ISSN 0033-3506.
Mayo Clinic. “Complicated Grief.” Jun 19, 2021.
American Psychiatric Association. “APA Offers Tips for Understanding Prolonged Grief Disorder.” Sep 23, 2021.
American Psychiatric Association. “New paths for people with prolonged grief disorder.” Nov 2018.
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American Psychiatric Association. “Grief: Coping with the loss of your loved one.” Jan 1, 2020.

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