Tyler Black, MD Profile picture
Dec 14, 2021 18 tweets 6 min read Read on X
/1 Suicidology Update
"Kids during the Pandemic"

@CDCgov's full dataset, with every demographic.

TOP LINE:
Full lockdown phase: significant decrease (-15%)

SECOND HEADLINE:
Up but within expected for the remainder.

THIRD HEADLINE:
No change if the year taken in total.
/2 Note: GETH plot (my creation!). The previous months are actually TWO FULL pre-pandemic years (Mar-Feb 18-20), and all rates are standardized for population. Error bars are 95% CI for Proportions. All charts read MAR-FEB to capture a "full pandemic year."
/3 Can we break it down by sex? Sure can!

Boys: same pattern, suicides decreased significantly (-18%!) during the strictest school measures, and increased (nonsignificantly, 13%) during the second school year of the pandemic.

Take note of the FLAT March-July (more later)
/4 Girls: The decrease (8%) March-June and the increase (9%) Sept-Feb are well within normal historical changes year to year.
/5 What about the elementary school kids? No significant changes. Due to low #'s dying of suicide, the error bars are. Not even summing months creates significance.

Do you hear that, oh ye misinformation spreaders? YOUNG KIDS DID NOT DIE OF SUICIDE MORE DURING THE PANDEMIC.
/6 Now let's look at high-schoolers (13-17)

A huge difference based on phase of pandemic.
End of School year 2020: -16% and way lower than expected.

Next school year, within expected, slightly higher.
/7 The first school year of the pandemic (with full lockdowns) also represents the FIRST TIME IN 21 YEARS that March-June (school months) had the same low suicide rate as July (non school month). Typically, school months associated with 36-55% increase in HS kids.
/8 Yes, I will repeat that again.

EVERY SINGLE YEAR from 1999-2019, High School kids in the US died of suicide about 40% more frequently on March-Jun vs July. In 2020, when:

* all schools were shutdown
* during a new pandemic

the Mar-Jun rate equaled the lowest rate (July)!!
/9 We can also break it down by CDC Race (please note, CDC Race is clunky and I cannot do anything about that)

White kids in the US had a significant decrease (-18%) in suicide rates in the inital phase, and no significant change in the subsequent year.
/10 Hispanic kids, and non-white kids in the US showed similar patterns. I personally feel its simply underpowered to detect it, but I think white kids did better. There is no statistically significant difference racially for RATE changes, but do keep note of the overall rates.
/11 Especially as it pertains to Indigenous children in the US. While, fortunately, there was no pandemic effect, it's very important to note how ridiculously high the rate of suicide is amongst Indigenous Youth (close to the adult white rate).
/12 I have all the data 8-24 for every group, so I'm happy to answer any questions people may have for this, the best I can. I do have provisional data heading into the 2nd pandemic year (mar-may) at high reliability and the general message is "it settled down"
/13 This puts a final pin in the notion that kids were overall "more likely to die of suicide" during the pandemic. The net effect on suicides of kids in the first year of the pandemic was COMPLETELY FLAT:

Mar-Feb 2019-2020 - 4.1/100k
Mar-Feb 2020-2021 - 4.1/100k

...]
/14 The data is also entirely consistent with a very data-backed position I have been stating for quite some time: when lockdowns were strongest (least amount of school), suicide rates amongst kids were lowest. School is a well established risk-factor for suicide.
/15 For a preview into what we're seeing so far in 2021, I can say from preliminary CDC and embargoed data that I have access to that after around April-ish, things settled back into expected #'s for the remainder of the year.
/16 As always, if you follow me you will find data-driven answers, not speculation. Only a few suicidologists chose the correct path of NOT PREDICTING an increase in suicides in young people. Media, take note. It is always foolish to PREDICT suicide rates, we ain't that good yet.
/17 Data is from CDC:

Provisional Multiple Cause of Death on CDC WONDER Online Database, released 2021. Accessed at wonder.cdc.gov/mcd-icd10-prov… on Dec 14, 2021
/18 Media: please contact me via DM if you would like to discuss, interview, or get more information. Please help me correct the wrong narrative that DOMINATED the pandemic.

All visualizations are mine; media have full permission to use, if using please credit me.

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More from @tylerblack32

Dec 16
Vaccines and "placebo control"

Placebo-controlled trials compare a vaccine to an inactive substance (placebo). This helps measure how effective the vaccine is. In the case of vaccines, often, the placebo is not "saline", but rather a previous vaccine or vaccine solution.

/1Image
When a safe, effective vaccine already exists, using an inactive placebo means some participants are deliberately left unprotected against disease. This creates unnecessary harm.

/2
Ethical standards require minimizing harm and offering participants the best available care. When a proven vaccine exists, denying it to anyone—regardless of location—is unethical.

/3
Read 9 tweets
Dec 15
🚨🇨🇦Correcting Disinfo🇨🇦🚨
"COVID vaccination didn't work"

In Canada during the Delta wave, vaccination prevented infection (unvaccinated 6x higher chance of being infected). As well, being unvaccinated led to a 22X chance of being hospitalized and an 18X chance of dying.

/1Image
For confirmed infections, the IFR for unvaccinated was a whopping 2.4%. The IFR for being vaccinated was much lower, both due to preventing infection and reducing the consequences of it.

Delta was a very deadly strain, and unvaccinated people died/suffered the most.

/2 Image
When Omicron hit, it was a strain that evaded vaccinations, leading to enormous numbers of infections, even in vaccinated people.

However, the immunity protection vs hospitalization and death was still enormous, and unvaccinated Canadians were 12X more likely to die.

/3 Image
Read 7 tweets
Nov 30
Correcting revisionist history:
"COVID is not a problem for young people in the US"

Covid responsible (not "with", underlying cause) for 2% of all deaths <20. That's 1 out of every 50 deaths of all kids who die. #1 in infectious diseases, 5th in disease overall.

/1Image
COVID-19 deaths created 300,000 American orphans, 330,000 if we count "primary caregivers" and 380,000 if we count "secondary caregivers". That's a lot of childhood harm.

2x as common for Black kids
4x as common for Indigenous kids
1.6X as common for Hispanic kids

/2 Image
Our most vulnerable children, with medical illnesses, suffered the most during the pandemic. Children with heart disease, respiratory disease, neurologic diseases, and chromosomal abnormalities suffered more severe symptoms than did children without those conditions.

/3Image
Read 6 tweets
Nov 28
🏳️‍⚧️FAQ for posterity:

Why do you use pronouns in your bio?
Because it's an easy way to promote inclusivity & to increase awareness of gender expression. It costs me nothing, &because I work with kids who are establishing their identity it shows that I don't make assumptions.

/1
Is being transgender a mental illness?
Being transgender is not a mental illness. It is a natural variation of human phenotype, though some transgender individuals may experience distress, called gender dysphoria, which is addressed through appropriate care.

/2
Can a man be a woman?
Yes. Some individuals identify as a gender different from their assigned sex at birth.

"What is a woman?"
A woman is a female by identity. This can refer to biological sex identity or social gender identity, depending on the context.

/3
Read 14 tweets
Nov 24
🧵RFK Jr. is an antivax, AIDS-denying, absolutely antiscientific conspiracist.🧵

ANTIVAX:
“They get [vaccinated], that night they have a fever of 103, they go to sleep, and three months later their brain is gone... This is a Holocaust, what this is doing to our country.”

/1Image
ANTIVAX:
"I do believe that autism does come from vaccines"

Metaanalyses involving MILLIONS of children have confirmed there is no link. The lie started with another antivaxxer, disgraced fraudster Andrew Wakefield, who fabricated data.

/2Image
ANTIVAX:
"I've read all the science on autism and I can tell you, if you want to know... If it didn't come from the vaccines, then where did it come from?"

Autism primarily from combo of genetic factors & early brain development differences.

/3Image
Read 10 tweets
Nov 19
Battling Election Misinformation
Part 2: "The Mandate"

Contrary to media/republican pronouncements, the election of Donald Trump was one of the narrowest (by popular vote, +1.73%) in history, with only 7 elections since 1800 being narrower.

/1Image
In fact, if we look at the margin of victory when we include all eligible voters, Trump wins with 31.3% of the voting population, compared to Harris' 30.2% and 1% going to other candidates. 37.4% did not vote.

If we only include voters, Trump wins 50.03% to 49.97%

/2Image
When we look at the electoral college results, Trump won 58% of available electoral college votes. This would rank his election 41st out of 57 elections since 1800.

/3Image
Read 7 tweets

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