All Vinay, Wes, & Stefan need to say is, "our article, had it been heeded, would have led to even more spread of COVID, threatening the lives of many more, and obviously now would have resulted in more children dying. It's clear now that emergency authorization was appropriate."
Instead, its a bit embarrassing to say, but they seem more interested in redefining their message (Stefan embarrassingly now claiming all they wanted was for ACIP to meet...) than admitting that there can be a downside to being too cautious during an emergency situation.
Of course, the title gives away the message which is... and I'm not kidding, "We should wait longer for more data to come in before making this decision." Image
As of this writing, is abundantly clear that:
* unvaccinated people, importantly children drove our most recent waves
* myocarditis is NOT a significantly concerning risk of the vaccine for kids
* vaccination prevents death and illness from kids, INCLUDING when we consider risk
It is also abundantly clear that had any regulatory authority actually *listened* to these three, we would have more kids dying, more covid spreading, and we would have done so in caution of a side effect that is now not a concern.

Simply, "The article was best when disregarded"
I am not simply "dunking on a 7 foot rim" because these three were dangerously wrong.

Many of us who understand clinical care, the uniqueness of pediatrics, and child mortality were VERY CLEAR that their article should be disregarded, and these three mocked us.
I am used to being mocked, this is an online space. What I feel needs calling out is that ALL of our (now obviously not only legitimate but right) concern about their (now obviously wrong) article was labelled as "attacking," "bad faith," and "silly."
I am certain that Wes and Vinay can't, but I believe that Stefan is a good & smart person who should be able to clearly state something like my first tweet in this thread. I'm not expecting it, but I think its possible.

/fin, probably.

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More from @tylerblack32

3 Dec
Full Subgroup Analysis, US Suicides 2020
-=-=-= LONG = THREAD =-=-==-

2020's effect on suicide can now be analysed thanks to @CDCgov at the yearly level. Very shortly I'll be able to look monthly as well.

This is the whole US population, but we can now do subgroups. /1
The big headline: Children 10-14 did NOT have a significant increase in suicides. It was well within expected rate variability. Error bars shown.

Because of small #'s, the rate changes can be drastic.

The 2020 increase was less than '00, '04, '07, '09, '13, '14, '17 and '18 /2
In other words, no evidence that the "lockdown" phase of the pandemic caused more child suicides, and no evidence that 2020 was associated with a significant increase in child suicides. /3
Read 16 tweets
3 Dec
Suicidology during the Pandemic (US)
=-=-=-=-=-=-=-=-=-=-=-=-=-==-=
(and a quick lesson in visualization)

Suicide rates decreased significantly when the pandemic started, and remained lower than 2019 for the remainder of the year. This is the monthly breakdown.

#COVID19 /1
This is the best way to visualize yearly changes, and media types/communication types, please take note. This graph contains all of the necessary information to put a yearly change into context.

This graph is my invention, called the "GETH"

Why is it the best, you ask? /2
FIRST: it standardizes each month and year to "per 100,000 per year". Populations change over time and months have 28-31 days. This variation matters and without controlling, introduces error. /3
Read 11 tweets
30 Nov
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?"
Read 5 tweets
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
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
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

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