🦠BREAKING GOOD NEWS!

Suicide deaths in Massachusetts did NOT increase during the stay-at-home “shutdown” period in March, April, May, 2020.

The notion that suicide deaths increased during this period here is simply inaccurate, we now can confidently say.

🧵/
Here’s a briefing summarizing our findings in the @nytimes: nytimes.com/live/2020/10/2…

And a direct link to the new research: medrxiv.org/content/10.110…

Let’s unpack this 2/
But first, if you or anyone you know is at risk or having mental health concerns, please call the National Suicide Prevention Lifeline at 800-273-8255.

....
This is work I did with @hmkyale Sejal Shah and a great stats team at @Yale, Chengan Du, Shu-Xia Li, and Zhenqiu Lin.

A great @BrighamWomens @harvardmed / @YaleMed collaboration, with the help of the MA Department of Health.
We looked at this from every angle, and even accounted for the several dozen deaths from March-May whose final cause has yet to be determined.

We just went ahead and assumed they could be suicides.

No change.
The gray zone in the figure is the range of expected suicide deaths that would have been expected to occur during 2020, based on 2015-2019 trends.

As you can see, we were well within normal ranges (why January 2020 was a bit worse than usual, we don’t know).
The dashed green line shows what the suicide death numbers would be if we account for the handful of deaths from March-May that are still under investigation.

We just assumed they “could” be suicides, just to be extra conservative.
We do not know if suicides will have gone up after or since.

Data are not yet complete enough.

But we are not surprised by this finding.

What *could drive an uptick in suicides would be downstream economic problems in the absence of support/stimulus/aid.

But...
It’s not yet known if increases in suicides have since occurred.

If it has, will it be worse in states with longer shutdown periods (eg Massachusetts) or in places that opened sooner and had a far worse past few months both in terms of covid and the economy?

Remains to be seen.
For now, we can say that people claiming a huge increase in suicides was occurring during the shutdown here were basically just *making that up*

We have to be data driven, not driven by a “gee whiz, that sounds right, so it must be!” mentality.
Here’s the link again and thanks for reading.

NYT: nytimes.com/live/2020/10/2…

Original article: medrxiv.org/content/10.110…
Lastly, again, if you or anyone you know is at risk or having mental health concerns, please call the National Suicide Prevention Lifeline at 800-273-8255.

Be well, everyone.

/fin.

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More from @jeremyfaust

2 Oct
⚠️ Let's start over.

(This thread will review the timeline of early events of this crisis, and then towards the end, I will add my analysis of what went wrong)

🦠COVID-19 is a life-threatening disease.

It is caused by SARS-CoV-2, a coronavirus.

1/
Cases first emerged, likely jumping to humans from fruit bats, in late December. The first cases were reported then.

At first, the WHO and CDC did not know whether this was contagious between humans.

But by January 9th, we knew that it was a coronavirus.
On January 11, China furnished the genetic sequence of the virus initially called nCoV-2, and now referred to as SARS-CoV-2.

By January 14, human-to-human transmission was a real concern.
Read 17 tweets
30 Sep
Unfortunately, I have come to the conclusion that I need to resume publishing weekly excess mortality reports for Massachusetts.

I‘ve been monitoring this all summer but stopped publishing when we had many weeks without excess deaths.

Today, I see signs that our streak ended.
In addition, I should add that I believe our relatively long shelter in place and phased re-opening meant that we could see this coming.

Cases were <200 per day for a while.

Now we see that doubled.
The point of reopening when cases are low is to be willing to make behavioral modifications (partial shutdown/restrictions) in MOMENTS LIKE THIS.

@MassGovernor.
Read 4 tweets
22 Sep
📢2020 will be the deadliest year in modern American history.

We will see >3 million deaths for the first time ever.

In fact, well over that number.

Join me for a thread on basic epidemiology and how we count deaths and where things stack up, historically.

🧵 ...
We'll probably see 3.15 - 3.25 million deaths this year (from all causes).

That is around 300,000 or more will be more than was "expected"

But is that normal variance?

Is that just a "bad year" combined with a bigger population?

No and no.
How do we keep track of deaths in this country?

It's easy.

The CDC counts all the deaths, and divides by the population.

(We're not talking about deciding what caused the deaths. This is ALL CAUSES).

We express deaths as "deaths per 100,000 people."

So how are we looking?
Read 13 tweets
12 Aug
Reviewer comment: "A standard element of ICMJE reporting guidelines and instructions for authors is to note the software used for analysis."

Reply: "Averages were calculated on my iPhone 11."
“And checked for accuracy using long division”
Using #2 graphite pencil.
Read 4 tweets
12 Aug
Q: Why have so many SARS-CoV-2 models failed?
A: Failure to account for asymptomatic spread.

My collaborators @biomathematicus+@JacobBAguilar are among the world's great minds on this.

medrxiv.org/content/10.110…

That's why they found an *Ro of 12* in San Antonio.

Let's discuss🧵
The main finding in our new paper is that in order to get the R down below 1, a place like San Antonio would have to do a good shutdown for up to 83 days.

Which might ring a bell!

That's about how long the places that beat this thing stayed closed.

More on that later.
First, the Ro (R-naught) or basic reproduction number must be understood.

It's a combination of biology (things about the virus) and behavior (how we live).

The earlier estimates missed asymptomatic spread.

So they said Ro=2.68.

That was very, very wrong.
Read 11 tweets
21 Jul
Beautiful writing in @TheLancet today.

A generation after it unwittingly set vaccines back a generation, this is welcome:

"Dystopian realities generate utopian visions...

1/
..."The dramatic emergence of SARS-CoV-2 into our lives and the subsequent COVID-19 pandemic have spawned the active development of nearly 200 vaccine candidates...
..."Science reveals itself to the world in real time in all its glorious uncertainties, but also in all its careful, hard-won, and real achievements. As COVID19 vaccine trials progress rapidly and with much expectation, two such achievements are published..."
-Bar-Zeev and Moss
Read 4 tweets

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