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Tyler Black, MD Profile picture
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24 Dec, 7 tweets, 2 min read
**NEW DATA Note: 2019 PRE COVID.**

CDC 2019 mortality data is out.

White: -2.2%
Black: +2.7%
Asian/PI: +1.5%
AI/AN: +0.5%
Hispanic: -1.4%
Total: -2.0%

(no group showed changes that fall out of the 95% confidence interval for comparing rates)

/1 Image
By sex, both displayed decreasing rates: (3% in ♀️, 2% in ♂️). The ratio is 3.7♂️ per 1♀️ (20-year-range 3.5-4.4)

♂️-to-♀️ suicide ratio is highly influenced by societal & cultural factors; each country's gender ratio is different (Canada 2.9-3.5, Hong Kong 1.8-2.4)

/2 Image
Both sexes showed decreases in virtually every age group, save the 25-39 male group which showed a tiny increase. The biggest drops were seen in child/teen males, and females <40.

/3 Image
This is about as granular as I can get. CDC-coded race, sex, and ages are compared to 2018 levels to show the areas of greatest change.

/4 Image
Takeaway, part 1:

All of the Chicken Littles who rang the COVID alarm (and got serious media play) by claiming "US increasing rates will get even worse in 2020" were doubly wrong.

* rates did not increase during COVID
* OR 2019!!

"predict by trend experts" are USELESS

/5
Takeaway, part 2:

Like we are seeing in 2020 with reductions in suicides, there is very likely systemic racism embedded. That is, improvements are first seen in White Americans, generally.

/6
Likely the actual data of 2019+2020 in America will be that suicide rates overall improved slightly; completely counter to the narrative of so-called experts spewing all over the media in 2019/20.

Descriptive data is just that - it is not prescriptive.

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More from @tylerblack32

Tyler Black, MD Profile picture
24 Dec
THREAD: Updated Suicide Data for Canada

Statistics Canada has released 2019 (!! note !! pre-COVID, yes that's a thing) suicide data. Canada's long-standing relative "flatness" continues, with expected variation. Image
1/ This is one of my ways to present layered suicide data - a heat map showing the highest rates. For males, we can see that the highest rates are drifting older, but overall, the most recent years are lighter. Yay! Image
2/ And though female rates are overall much lower, we can see that there was a spike in younger women that has gradually dissipated. Image
Read 7 tweets
Tyler Black, MD Profile picture
10 Dec
with some caveats (this study was conducted during very low community spread, significant protections were in place), this shows us that when the numbers support it, and with good policies, in person schooling is possible!
The knowledge of the UK situation is very important to put this study into context. Only a few years at each age group were invited to in person class, so schools were significantly less populated than normal (1/8th to 1/4 of the population).

/2
This restart happened when community spread was very low.

/3
Read 6 tweets
Tyler Black, MD Profile picture
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 Profile picture
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 Profile picture
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 Profile picture
5 Aug
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
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

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