We know now — definitively — those populations who are at risk from COVID, and those populations which are not. In general the world is too connected, and popu

We know now — definitively — those populations who are at risk from COVID, and those populations which are not. In general the world is too connected, and populations too mobile, for a virus like SARS-CoV-2 to be contained, save for special case island nations that are willing to keep borders closed or visitors quarantined and ensure compliance until a vaccine becomes available. For the rest of the world, what is abundantly clear in countries that are willing and able to perform the requisite testing, is that this is a virus that spreads easily and rapidly but thankfully in those under 50 is vanishingly unlikely to kill if it is symptomatic at all. With over 10 million confirmed cases worldwide, likely in excess of 100 million actual infections, COVID could burn out in it’s own before widespread vaccination is available. Not due to containment measures, but due to enough people gaining immunity. In my non-expert estimation, the public health response to COVID will ultimately result in about an order of magnitude more deaths, or roughly an order of magnitude more years of life lost, than due to COVID itself. The longer we continue lockdown-type policies, the greater the damage done. COVID spread anyway, COVID continues to spread, although now it seems to be mostly in less risky populations as case counts surge and hospitalization and death rates remain constant. Some of this is of course simply sampling bias now that testing is more available for lower risk populations. We also see people who know they aren’t at any real risk willing to be exposed in order to live their lives. Most inexcusably is that the most vulnerable populations (e.g. in nursing homes) were not adequately protected and even directly harmed by policies while the general masses bore the economic and social brunt of the involuntary enforcement measures. In general every person who gets COVID and is asymptomatic or minimally symptomatic is basically someone getting an early access vaccine, and this can only be regarded as a positive in exerting a downward effect on R. I think that speculating about long term effects in largely asymptomatic populations is an academic exercise which misses the forest for the trees. We need to reopen emergency rooms for the cardiac patients, reopen oncology departments for the chemo patients, reopen primary care clinics for health screenings, and reopen gyms, all to reduce/prevent well known and proven morbidities that cost millions of lives a year, not just continue to incur increase death in our most prevalent causes of death out of fear or politics.