I'm so grateful to all my followers (except if you follow to hate on psychiatry, boo you). This has been a trying year but I enjoy so many aspects of the #twitterverse, especially within #medtwitter, and the opportunity for me to grow and learn. /1
I wanted to thank a few people very specifically, because they changed my life. @uche_blackstock invited me into a mentor zoom chat, where I met and connected with @gboladi, who went on to become the national chair of the @bmsacanada with support from @doctorsofbc. /2
So thank you Dr. Blackstock for helping me move from "acknowledging" inequity into doing something about it. /3
Thank you to future Dr. Olarewaju for how hard you've worked to establish something that will be generationally important for Black (future) medical students in BC and Canada. /4
And thank you to that wonderful organization for establishing a political presence in Canadian Medical School that has been sorely necessary. /6
As well, a tremendous thank you to @drayanajordan & @ADocNamedDani for hosting @Black_trivia_nt, and inviting me, a very white person, and showing me a hospitality that I will never forget. The joy and passion and togetherness is unrivalled. I studied my HBCUs!!! /7
I owe special thanks to @lashnolen for being just an awe-inspring bright star of Twitter, and to my two twitter/media mentors, @drjengunter and @doctoryasmin. /8
If there is a theme - it's that I've learned tremendously about my privilege, and especially from Black women. There is so much to be done, and is important for us in the majority to materially contribute. /9
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Variance 🧵:
Why the media (and non-experts who "dabble" in mortality statistics) particularly suck at reporting the numbers of suicide
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Quite frequently, someone will send me an article like this.
1/ Suicides are up 67% between the ages of 12-17 in Pima County.
By "mid-Nov 20", there have been 43 teen suicides, compared to 38 in total last year!
Without context, it certainly seems that the pandemic or the lockdown is to blame.
2/ Sure enough, i go to @CDC Wonder and fire up Arizona suicides for 2019 between 12-17 and I see there were 36 suicides in 2019 (not sure why there is a discrepancy between AZ DOH and CDC, but this is actually common by about 5%ish).
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.
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!
2/ And though female rates are overall much lower, we can see that there was a spike in younger women that has gradually dissipated.
(no group showed changes that fall out of the 95% confidence interval for comparing rates)
/1
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
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.
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
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
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