Thread by @jeremyfaust

This Spring, I noticed my colleague @Cleavon_MD tweeting about young people dying of COVID.

Many people of color.

I wondered if these sad cases were statistical anomalies.

Must be that these were "rare" cases, I thought.

I was wrong.

It was real. ja.ma/38b4ayh
🧵

I gathered together a team of people to help look at this.

In various ways, we assessed the data.

It led to the work above and this @nytimes op-ed as well.

nytimes.com/2020/12/16/opi…

This has been an important example, for me, of testing assumptions.

I assumed one thing but wanted to check if I was right or wrong.

When I realized the opposite of my initial assumption was true, I knew we had to get this message out.

@RWalensky @hmkyale made this possible.

And the insights/continued work from @EMDocinTraining + @Cleavon_MD helped us see bigger parts of the story--including things that did not make the final paper but informed the work in important ways; for example, the number of YEARS OF LOST LIFE among young adults is staggering

And that the stories kept piling on.

Brilliant work by @Andy_DCA and @ZhenqiuL made it so we could present these findings with total confidence in their legitimacy and statistical integrity.

And of course, help from state DPHs and the CDC.

Recent data from CDC also shows (not in our JAMA paper but mentioned in The NY Times essay), that indeed people of color in the age group we assessed have carried the *majority of this burden.

So to my White colleagues who "don't see the deaths" in young adults:

It's happening.

The message is clear: young adults do die from Covid and likely there is an increase in other preventable causes of death like overdoses (unintentional)--shaping up to be a big piece of the excess death puzzle. (note: suicides do not yet appear to be).

Here's the so what: Young adults are LOW on the vaccine priority list.

We need them to *stay with us* on masking, distance, and hygiene.

Survive long enough to get the vaccine!

That is the message.

That's why this knowledge is useful.

It implies that choices today matter!

I'd like to add something on a personal level.

The scientific and collaborative aspects of this project have been noteworthy and meaningful parts of this experience.

We tested a null hypothesis--that there really was NOT a large increase in deaths in young adults during the pandemic.

And we REJECTED that hypothesis, leaving only the alternative--that young adults in the US are indeed having the worst year for mortality in modern history.

This is an important message and a profound one. So, we carried out the work with as much integrity and care as we possibly could and with great teamwork.

So, I'm sad to report the data, but proud of the team and the work that brought the numbers to light.

The mentorship of @RWalensky and @hmkyale has been unparalleled. Brilliant and also supportive of the team.

Leaders and team players. Player-coaches!

Also, for all the complaining we do about peer review, the editors at JAMA and NYT truly made this work better. I'm grateful.

All of this, and the idea that we made a small difference with this work (which was unfunded!) gives me the energy to dive back in to the next project....

Now...back to it!

Thanks all and stay safe!