M e d i c a l R ec o r d F e a t u r e Collateral Damage Indirect Effects of the Pandemic Editor's introduction: The coronavirus pandemic has killed 1.3 million plus people around the world and sickened over 55 million (as of Nov. 16). In the U.S., just over 250,000 deaths have been attributed to COVID 19 so far and close to 11.4 million Americans have been diagnosed. In addition to the direct impacts of the pandemic on COVID 19 patients, the toll on our health care system and those who work to provide medical care has been staggering. But these numbers do not tell the whole story of this public health catastrophe - not by a long shot. Physicians are well aware of the 'collateral damage' to public health inflicted by the circumstances of the pandemic. This collateral damage takes many forms, including the effects of care delayed due to patient reluctance to venture into a hospital or office for fear of contracting the virus and due to temporary holds placed on care for all but immediately life-threatening conditions in the early days of the pandemic. The need to limit close contact with other people has had a devastating impact on the mental health of a large number of people. Social isolation-- among vulnerable groups in particular-- and limited access to in-person support for those suffering from substance use disorder and other behavioral health problems has taken a heavy toll not reflected in the infection counts. For many Americans, job loss caused by the economic fallout of the pandemic has meant loss of health insurance. Some people with easy access to safe outdoor spaces such as parks have increased time devoted to exercise, but those without such access may have been forced to exercise less. And being stuck at home much of the time has led to unwanted and unhealthy weight gain for more than a few. To increase awareness of these secondary effects of the pandemic, and of the strategies physicians have devised to combat them, we asked some BCMS members to respond to a few questions. 10 | www.berkscms.orghttp://www.berkscms.org