Coping with Loss in the Time of COVID-19 5/28/2020

This week’s SmartCare e-Weekly is pleased to share the sensitive and thoughtful insights of a special guest contributor, Miriah de Matos, MPH, MA, a parent to two young boys who works as Senior Project Specialist for AAP-CA3’s First 5 First Steps & Healthy Development Services program.

As a program focused on integrating behavioral healthcare into the realm of primary care practices in our county, SmartCare seeks to meet the needs of providers and patients (and their parents) through consultative practices that address the biomedical, psychological and social issues. Ms. De Matos’ article poignantly highlights the trans-generational aspects of maintaining a healthy perspective in the face of the losses and challenges faced during the Covid-19 pandemic response.

Reflections: Grieving a Loss

This week, children’s experience of the shelter-in-place order has been at the front of my mind. Adults are forthcoming in their experience of these rapid and extreme changes to the way we operate. Children who are still learning to articulate emotional experiences are typically less direct or clear in voicing their experiences. Nevertheless, we know that children are a product of their environment and the relationships within those environments so they, too, experience the same impacts adults are feeling.

For my children, I have been watching closely to see how this will play out. Over the weeks, my younger child has stopped asking if he will go to school. In some ways, he is living his best four-year-old life to be with his parents and brother every day. For my seven-year-old, a different scenario began to unfold this week. In the beginning of the shelter-in-place order, he was the first on his younger brother’s zoom calls and could not wait to call his friends. Academics are challenging for him so not going to school may have even been a relief. This week, he became more sensitive and even found himself crying without being able to say what was bothering him. I encouraged him to seek out connection with his friends over the phone, but he did not want to do that. A zoom call with his classroom this week sent him running away in tears. It took us several moments of one-on-one time but eventually we discovered it was playing with his friends that he missed. I reflected on what I see when he plays with peers his age, especially boys, and it is often a play of reckless abandonment. There is running, screaming, wrestling and laughing. I chuckled to myself early on observing him on video chats with friends where they rarely had any dialogue but played games or sent pictures. He does not get the same freedom of play on those calls that he gets face to face with his friends. What I realized this weekend is that he is grieving this loss.

I was honestly disappointed in myself when I finally realized that what I was seeing in him was grief. Articles on grief have been trending since the shelter-in-place order when into effect to normalize this experience for adults. Somehow I did not consider that my child might experience grief. Our family is not facing toxic levels of stress during this crisis and, as a parent, I have worked hard to break the cycle of ACEs in my family. Yet, with all of that, I missed that while I may be protecting him from adversity in general I cannot protect a child from big feelings even one as potent as grief. While for many adults and children, their grief may be based on what I define as adversity, it is an unfair assumption to think grief only preys on trauma. Grief preys on loss. For my son, like so many others, he is feeling a loss. I became aware that I had not really clarified for him that this is temporary. Time moves so slowly in the world of a child and by only seeing this experience from my own perspective I had forgotten that.

Parents are in unfamiliar territory during this crisis. This is especially true if you or a parent you are partnering with is unfamiliar with the emotional holding required by young children. Invite the parents you are connecting with during this time to explore how they understand their child’s experience. For some that may mean starting by inviting them to understand how they are experiencing this crisis and then shift the lens to their child. By being present, curious and available we can support our children to build resilience and cope with big emotions like grief, sadness and fear.


he American Academy of Pediatrics, California Chapter 3 provides countywide coordination and support to the First 5 Commission of San Diego’s First Steps program. This program provides home visitation services for expectant parents and parents of newborns. First 5 First Steps promotes positive parenting and enhances child health and development for families who may face hardships and stressors that place them at increased risk for poor health and developmental outcomes. The program seeks to ensure that families have knowledge and understanding of growth and development as well as the parent-child relationship from the prenatal period up to three years of age.

The American Academy of Pediatrics, California Chapter 3 provides countywide coordination and support to the First 5 Commission of San Diego’s Healthy Development Services (HDS) project. This project provides health-oriented services to children ages 0-5 living in San Diego County, including:

  • Developmental check-ups, classes, parent coaching & therapy, including Speech & Language services
  • Behavioral check-ups, parent coaching and therapy
  • Parent Education Support and Empowerment through classes and information
  • Care Coordination for families engaged in HDS services
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