COVID-19 is causing reductions in health care access and may lead to 42 to 66 million more children living in extreme poverty. Crowded housing and lack of access to water and sanitation make physical distancing and handwashing difficult, and researchers anticipate increases in domestic and sexual violence and the loss of caregivers. Multi-sectorial interventions to address health care, economic and food security, violence, and family support for illness and death are critical.