📰Major update on “external causes” of death (CW suicide, homicide, accidents).

Our team carefully analyzed new CDC datasets for US deaths from January thru July of 2020.

Drug overdoses: up.
Homicide: up.
Suicide: down (!)
Vehicle: down, then up.

medrxiv.org/content/10.110…
🧵/
We took a close look at these causes, modeling the changes over time, and generating expected ranges for 2020.

Drug overdoses: Way up. Even though they were up already before the pandemic, it's clear that things got worse.

Access to buprenorphine may be partly responsible. Weekly Drug Overdose Deaths (all intents), US January 1, 201
Homicide: Very much went up during but prominently after stay-at-home period in US. Weekly Homicide Deaths, US January 1, 2015 - July 30, 2020
Suicide: DOWN. A bit prior to pandemic, but a major drop during stay-at-home period.

As we discussed in our @JAMANetwork paper, there may be an early sense of "shared purpose" that occurred in March-March. jamanetwork.com/journals/jaman…

We worry that over time, the numbers may rise. Weekly Suicide Deaths, US January 1, 2015 - July 30, 2020
All accidents: up during pandemic, not so far out of projected ranges, but significant. Weekly Accident Deaths, US January 1, 2015 - July 30, 2020
Motor vehicle deaths: Lower during stay-at-home period (makes sense). But the increase in the summer=troubling.

Correlates with more DUIs, less seatbelt use, faster speeds, as per national data elsewhere.

Implies re-opening should be accompanies by more highway patrol. Weekly Motor Vehicle-related Deaths, US January 1, 2015 - Ju
All of the increases in these "external" causes of death are preventable.

They are also a small fraction compared to the excess deaths in the total population.

That said, it may be that for younger adults, drug and homicide deaths are a substantial % of excess deaths.
The answer to this: better access to substance use disorder treatment, more gun safety efforts, better patrolling of roads (and campaigns on vehicle safety).

We can do all of this WHILE fighting COVID-19.

In fact, it's a part of it.

Every one of these lives can be saved.
Thanks to @hmkyale @Andy_DCA @ZhenqiuL @EMDocinTraining @ml_barnett and Shu-Xia Li.

This is the "strike force" that analyzed these data in record time and produced a manuscript we are proud of.

Of course it is not peer-reviewed, so we welcome comments.
medrxiv.org/content/10.110…
Lastly, the CDC has put out some interesting data analysis of their own.

cdc.gov/nchs/data/vsrr…
and
cdc.gov/nchs/nvss/vsrr…

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More from @jeremyfaust

15 Jan
Update: most of my colleagues had no symptoms or just arm pain after coronavirus vaccination.

Naturally, *I had to be one of the 10-15% with symptoms (chills, fatigue) bothersome enough to disrupt my usual activities for 24-36 hours.

I affectionately call it “manaphylaxis” 😂
But after a couple doses of Tylenol or Advil I’m mostly ready to do my usual stuff. Similar to my first dose (less arm pain this time).

I mention this because it’s a known thing. This happens to some people.

It’s a lot better than getting actual COVID-19, lemme tell you that!👇 X-ray of COVID pneumonia
But we need to support people who may need to miss work.

Paid sick leave for the 36-48 hours after vaccination for the small but significant subset of people like me will make a huge difference.

Hoping the Biden admin will advocate for this.

We need to lower all barriers!
Read 5 tweets
30 Dec 20
No time to write threads lately, but I must now.

A 41-year old Congressman-elect from Louisiana has died of COVID-19.

But this kind of thing has been happening all along.

This is the crux of my recent work with @RWalensky @hmkyale @Cleavon_MD etc

jamanetwork.com/journals/jama/…

1/🧵
We found that thousands of young adults have died of COVID-19 and that thousands more have died of other causes during the pandemic.

Things have gotten much WORSE since re-opening.

Do not attempt to blame lockdowns.

Data do not support that.

Below is ALL CAUSE mortality. all cause mortality US adults 25-44 from feb thru mid Octobe
It appears to be a combo of COVID, unintentional overdoses, homicide to some extent.

Data on that emerging. cdc.gov/media/releases…

We can eliminate ALL of these deaths with better public health policies. @DrSarahWakeman @MaxJordan_N @ml_barnett @AlisterFMartin @meganranney
Read 8 tweets
17 Dec 20
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.
Read 13 tweets
1 Dec 20
That said, we will try to sum it up in tomorrow’s @Brief_19.

Follow for that and subscribe free here to get research and policy analysis on covid from frontline physicians.

brief19.com/subscribe/
Also we’ve almost ratioed him which is a little unexpected.
Read 4 tweets
30 Nov 20
“I said that if the virus was left to its own devices, it would cause a considerable degree of devastation because that’s what pandemic viruses do. However, I also said that there was an opposing force to that; and that opposing force is us.”

—Dr. Anthony Fauci.
I love this man.
Fie-zuh.
Read 5 tweets
21 Nov 20
Well folks, it’s been real.
🤯
Let me be clear: I’m still going to work and I am protected...for the moment.

But if things continue to worsen, and I die because of this, I blame the weak federal response and incompetence in the face of our sustained pleas for adequate PPE.
Here’s a screenshot of the abstract present at #acep20. @TheSGEM Abstract for paper on failure rates of n95 masks after multiAbstract for paper on failure rates of n95 masks after multi
Read 4 tweets

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