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Tyler Black, MD Profile picture
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30 Nov, 5 tweets, 2 min read
This is one of the true issues of COVID when it comes to preventing transmission/reducing spread, and protecting children. Eggheads & doofuses will focus on how "rare" it is for kids to die (tho its a leading cause of death in kids), but so many children have suffered d/t COVID.
Doofus: "0.00x% of kids die" - there are other issues with COVID spreading through a community that severely harm children

Egghead: "masks stop kids from reading facial expressions, and being out of school could cause problems" - how about losing a parent to preventable disease
Every human who can be vaccinated should be vaccinated, and we should be doing everything we can to prevent the preventable deaths and illnesses that occur due to COVID. This has *always* been the answer to "how can we help our kids the most?"
While grifters and contrarians make a huge name/$ for themselves selling their myopic ideologies, devoid of any context of humanity or the actual knowledge of the body of science, the calculus for children is unchanged.
I wrote about this over a year ago, and aside from the numbers, it still holds today.

thestar.com/opinion/contri…

(paywall? see my pinned tweet for its origin thread)

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More from @tylerblack32

Tyler Black, MD Profile picture
20 Nov
A Very Grim Milestone:
As of today, 1:1500 people **worldwide** have died due to COVID-19.

This ranks COVID-19 between #4-6 in cause of death in the world, over the past 22 months.

/1
Of course, the world is a big place.

COVID stats:
=-=-=-=-=-=-=
Peru: 1 in 167 dead
Brazil: 1 in 350 dead
USA: 1 in 418 dead
UK: 1 in 475 dead
Sweden: 1 in 675 dead
Germany: 1 in 846 dead
Canada: 1 in 1,295 dead
Australia: 1 in 13,369 dead
New Zealand: 1 in 128,205 dead

/2
Remember, this isn't infection mortality (the chance of dying if you get COVID), this is POPULATION mortality. 0.067% of the population doesn't sound like a lot, but its far higher than suicide worldwide (#10 cause of death, 0.019% Population Fatality Rate in 22 months).

/3
Read 5 tweets
Tyler Black, MD Profile picture
3 Nov
Suicidology update:
-------=======-------

Suicide rates in 2020 in the US are now available via @CDCgov BY AGE.

No significant change in youth groups, decreased in older ages past expected levels.

/1
By racial categories, for men there was variation but the trend of "white and Asian down, Black, Hispanic, and Indigenous" was present. Due to size of the groups the Indigenous men increase is within variance.

/2
In female suicides all groups saw a decrease, but only white women had a drop outside variance.

Women fared better than men for suicide in absolute terms (men outnumber women 4:1 this year), but also relatively (women down 8.3%, men down (2.2%)

/3
Read 6 tweets
Tyler Black, MD Profile picture
31 Oct
While the "serotonin hypothesis" of depression is no longer taught, #SSRIs delay the reuptake of serotonin @ neurotransmitters. We also now know they have a host of other effects (σ1, BDNF, CREB, cytokines, on top of a slew of differences on the various subtypes of serotonin)

/1
The key difference, is that today, we know that the brain changes seen in depression are impairing, and we know that SSRIs work. Instead of drawing a straight line between "serotonin regulation" and efficacy, the honest psychiatrist doesn't understand the current mechanism.

/2
We now suspect that there are a host of effects, second, third, & even tertiary effects, and the complex way in which the brain is interconnected plays a role.

But yes, SSRIs DO block the reuptake of serotonin. It's why we have to be careful about withdrawal and tolerance.

/3
Read 5 tweets
Tyler Black, MD Profile picture
30 Oct
Thank you so much everyone for sharing your experiences. I have to mute notifications now due to virality but I've done my best to read and hear all of you. I'm glad my message resonated with so many. and pretty much 90% of disagreement/exception was respectful.

Thanks, all.
Honestly I'm touched, sometimes i feel this place is all about fights but most got what I was saying and shared so much about the *why* I've said it. If you ever want to see a "reaffirming ratio" look at that thread.

/2
I understand why parents feel scared and worried about the world and why it seems like intruding on their privacy is safe, but please read the responses and all of the hardship, hurt, and fractured relationships that were caused by such behavior.

/3
Read 5 tweets
Tyler Black, MD Profile picture
29 Oct
Child psychiatrist here. It is a very bad idea to search your teens room, and a very good idea to respect their privacy and develop them into humans who trust their parents instead of reasonably distrust them.

Do not take advice from this account. The proper # of searches is 0.
Are you not convinced, worried parent? Consider two scenarios:

Scenario 1: I am in trouble because I am using drugs and something unsafe is about to happen. Even though I'm worried about their reaction, I can trust my parents so maybe I should call them.
Scenario 2: I am in trouble because I'm using drugs and something bad is about to happen. But I don't talk to my parents because they invade my privacy disrespect me and I know that talking to them will result in punishment. So, no, I will not call my parents.
Read 5 tweets
Tyler Black, MD Profile picture
28 Oct
Really interesting RCT showing 10 days of 100mg 2x per day of fluvoxamine reduced bad COVID outcomes.

No taper start either! Just bam 200mg daily. Makes ya wonder.
thelancet.com/journals/langl…
Participants: less than 7 days of covid like symptoms or a covid+ test

n=1497, fluvoxamine vs placebo

Outcome measures: >6h in an ER or admitted to tertiary care

Results: 32% reduction in the fluvoxamine group
While the ITT sample didn't reach significance (including dropouts) for death, it should be noted that the death rate for per protocol participants was;

Fluvoxamine: 1/548 (0.18%)
Placebo: 12/618 (1.94%)
RR: 0.09 (95% CI 0.01-0.47)

90% reduction in death rate.
Read 4 tweets

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