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Tyler Black, MD

@tylerblack32

10 Dec

There are other risks than infection control risks. Inpatients with severe mental illnesses require visits, activities, outings, and passes to their families and loved ones, and without this, they can incur direct harm (loss of function, aggression requiring medication, etc).

/1

Hospitals and administrators and infection control need to work together with MENTAL HEALTH EXPERTS to develop COVID/infection control policies that don't cause significant harm to patients with significant illnesses.

THERE ARE OTHER RISKS THAN INFECTION.

Take a hypothetical person with severe schizophrenia:

Pro of "keeping them in isolation for 10 days":
* reduced chance of COVID

Con:
* increased chance of restraint, seclusion, staff and patient violence, distress, loss of function
* decreased chance of compliance, safety
/cont

Read 4 tweets

Tyler Black, MD

@tylerblack32

29 Aug

One of the most frustrating pieces of knowledge about COVID is that at world-wide 830k deaths already, and a curve that looks like this (knowing the slow decay), that deaths will surpass 1M in a 1-2 months This will make it one of the largest pandemics in modern history.

/1

Viruses for which there are no treatment cause death. Not every death is blamable on poor health policy.

I think of a country like New Zealand, which did everything it could and death still occurred. It's not right to blame all deaths on what leaders do.

/2

But many countries and regions did not heed the basics of viral spread prevention:
* hand hygeine
* stop gatherings
* stay home
* support people who stay home
* contact trace

/3

Read 7 tweets

Tyler Black, MD

@tylerblack32

28 Aug

CW: Suicidology education

**MINITHREAD: Suicidality in kids"

Many youth, parents, teachers, & physicians I work with don't understand the scope of *suicidal thinking* in youth. It's actually relatively common, and it does NOT mean that the child is going to die of suicide.

/1

Suicide is a top cause of death for children, but at the same time, death is quite rare for children. It's important to put this into perspective.

Using 🇺🇸 CDC mortality & youth survey data, we can see that last year, 18.8% of high school kids "seriously considered suicide."

/2

But the context is key. In 2018 (the last measured year available), the suicide rate was 0.0075% of youth 10-19. Overall, youth are about ~2900 times more likely to consider suicide than to die by suicide.

(🇨🇦 10-19 rate 6/100k, 🇺🇸 rate much higher at 7.5/100k)

/3

Read 9 tweets

Tyler Black, MD

@tylerblack32

5 Aug

https://twitter.com/MLevitt_NP2013/status/1288410751586230274

So this Nobel-winning chemist has been "professionally opining" on as the "end of COVID," without actually recognizing basic facts about it. He has many many followers who use him to cite that COVID is overhyped etc ...

Here is why he is WRONG.

/1

https://twitter.com/MLevitt_NP2013/status/1288410751586230274

First, he plots the CDC excess mortality graphs as if they don't change. When they do. Lag is significant. This weeks update added +5580 to last weeks deaths, and almost 8500 deaths excess overall.

This *changes the shape of the graph*

/2

Second, as I tried to point out to this "authority figure" (despite not having any particular expertise in mortality or epidemiology), COVID is a contagious disease and mortality numbers returning to baseline do NOT mean that the disease is over. It will likely, resurface.

/3

Read 12 tweets

Tyler Black, MD

@tylerblack32

24 Jul

https://twitter.com/tylerblack32/status/1286697113238351872

THREAD: School closure and kids

I am an expert in child & adolescent EMERGENCY psychiatry. This is my expert opinion: It's complex, and it is not easy to answer

COVID = BAD
Education = GOOD
In person schooling in a deadly pandemic
= GOOD + BAD

(context link)

/1

https://twitter.com/tylerblack32/status/1286697113238351872

First, the pandemic is bad for people. Without mitigation strategies, it tears through the public and grandmothers, fathers, children die. So far, 640k people have died WITH mitigation strategies, which is (at 6 months) nearly matching the WORLD'S YEARLY SUICIDE RATE.

/2

Second, death is traumatic. While it may be true (?) that kids less likely to spread COVID, it's certainly true that kids are less likely to die from the disease. But grandma? Mom? Teacher? If we don't control the spread of disease, children will be exposed to more death.

/3

Read 22 tweets

Tyler Black, MD

@tylerblack32

24 Jul

@ashleypmiller

@ashleypmiller Well both, sorta. I mean definitely the second. They very selectively and inappropriately cited those studies. A review of evidence that concludes that school decisions should be made cautiously and using best available evidence shouldn't be summarized as a stat about PTSD.
/1

@ashleypmiller

@ashleypmiller as to whether "school closure negatively impacts kids" - it's quite complex and nuanced. As any child psychiatrist will experience, there is significant relationship to "schools being in session" and "psychiatric distress." Suicides rise, ER presentations increase.... /2

@ashleypmiller

@ashleypmiller fights with families over school expectations, social expectations at school, bullying, etc.... we all know that summertime vs school months is markedly different and not in schools favor.

At the same time, school unquestionably helpful for child development.

/3

Read 5 tweets

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