Thread by @tylerblack32

1/ *** Thread: ***
Pseudo-experts mangling child suicide data for political purposes.
************
This thread has statistics, but it also calls out shitty people & shitty behaviour.

Stats now. Drama at #13.

2/ There is a CDC report out that again is being misunderstood and manipulated by wannabe-epidemiologists to advance their political agenda. I refer to this report:

cdc.gov/mmwr/volumes/7…

3/ It uses the National Syndromic Surveillance Program, a program monitoring about 71% of the Emergency Departments in the US.

It shows the drastic change of ED presentations during the pandemic. I've highlighted kids 0-18:

4/ Clearly, pediatric visits absolutely tanked during the pandemic. They have gone to sub 50% levels and haven't fully returned.

5/ From a previous report using the same data set, we can see that the PEDS MENTAL HEALTH related presentations, similarly, tanked, especially compared to pre-pandemic 2020 levels (it was aiming for a record prior to COVID!)

6/ Keep an eye on that report, because it shows the first two weeks of January 2019 and January 2020. We will also have to bookmark that approximately 30% of pediatric mental health ED presentations are coded for suicidal issues.

7/ In the latest report, it compares two time periods:

Dec 15, 2019 - Jan 11, 2020
to
Dec 20, 2020 - Jan 16, 2021

And it shows:

a) Pediatric suicidal presentations to EDs increased by ~178 per week.

b) the proportion of peds ED presentations for suicidality increased by ~2.5

8/ So why isn't this proof that "lockdowns cause harm"? or that there is a "tsunami of suicides" affecting our kids? because a change of 174 per week is totally within normal variance.

Remember, we have an old report using the same data set.

9/ Between 2019 and 2020, the number of mental health presentations increased substantially. This is PRE-pandemic!

2019: ~2000 W1, ~2500 W2 = ~4500
2020: ~2500 W1, ~3750 W2 = ~6250

Over two weeks, an increase of 1750 pediatric presentations, or 875/week.

10/ As ~30% of presentations are for suicidal presentations, we can create an estimate of weekly increase.

About 262 extra pediatric suicide presentations per week between the same weeks in 2019 and 2020. THIS IS BEFORE THE PANDEMIC, BEFORE ANY LOCKDOWN

11/ So this year, an increase of 178 per week is LESS than we saw in Jan 2020!

2020:
262 more suicidal peds ED presentations/week

2021:
178 more suicidal peds ED presentations/week

It is not a spike nor a tsunami.
It's a smaller increase than in 2020.

12/ As to the "PR" rising 2.5... we've been over this many times if you follow me. The ratio of presentations increased, but the number of presentations did not significantly increase.

(from: jamanetwork.com/journals/jaman…)

13/ But this doesn't stop motivated people, like the Very Public self-aggrandizer (shall not be named) & his cohort, and other scaremongers w PhDs & nobel laureates (none of whom, by the way, are suicidologists), of incompetently looking at a number & wrongly interpreting it.

14/ They don't know what it means.

They don't know that the statistics are entirely within variance.

They don't know that their own citations are showing that there has been no large "tsunami effect" on suicide presentations to ER.

They remain in their sinkhole of ignornace.

15/ Any smidgen of a statistic that proves children suffered during a worldwide pandemic that:
* killed >3 million
* left >50k kids without a parent
* upended our lives
* led to policy changes that affected many

Well, to them, magically, they can say "aha lockdowns."

16/ As if we can isolate one factor and say "THIS IS THE FACTOR THAT CAUSED THE HARM."

These inept, ghoulish pretenders of knowledge...

They are bankrupt souls, motivated thinkers, and you should NOT LISTEN to them. They do NOT know what they are talking about.

17/ Worse, they are pretending that their amateur, ham-fisted mangling of data is knowledge you should know. That THEY are the ones with the "truth." When in fact, its a pack of lies.

18/ Please follow good scientists. If you are following someone that AS OF RIGHT NOW, with the limited data we have, believes that we have proof that lockdowns kill kids... well.. you're following a fool.

19/ When the CDC releases a dataset, ask yourself the following questions:

* what is the context?
* what time period is compared?
* what do previous comparisons show?
* do I know if they are referring to raw numbers or rates?
* what is the normal variance for this comparison?

20/ If you do not know these things, you unfortunately, cannot draw strong conclusions.

More importantly:

When looking at a national dataset time comparison, there is NO WAY to identify cause, unless there is a specific PRIOR design choice to specifically look for cause.

21/ At best, we will have correlational data that will FAIL in the Q of "what caused it." We *may* be able to compare suicide presentations in "high lockdown" states to "low lockdown states", but those states are demographically, economically, gunn-ily, and societally different.

22/ This information is important, but it is being misused. I can firmly say that I'd never anticipated that my field of study (pediatric suicide) would become a political device.

But it's gross.
Stop doing it.

23/ And remember, all you "lockdowns kill" peeps:

Prior to the pandemic, suicide rates were 50% higher during school days. So if your answer to distress is simply "go back to school" then you are neglecting how much stress and distress can be caused by school.

24/ See this op ed:

thestar.com/opinion/contri…

I wrote it months ago, but you probably need to read it. It's also based upon my pinned tweet.

25/ I'm tired of bad actors using suicide.

Please, if you follow me and see anyone doing it, just refer them to my various threads:

WHATS THE VARIANCE?:

https://twitter.com/tylerblack32/status/1344689828714131463

PROPORTION NOT NUMBER:

https://twitter.com/tylerblack32/status/1368245100883701760

MISUSING DATA: this thread right here!

26/ And, this is my area of expertise. My "fans" love this one, but it's true. Yes, I'm an expert. In pediatric suicide.

Clinically, I see hundreds of suicidal kids a year. Specifically, I have studied suicide for 15 and pediatric suicide epidemiology for 12 years.

27/ OK, I'm done.

Been a while since I've done a long twitter thread. Feels good.