Thread by @tylerblack32

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Thread: Mortality in 2020 and myths
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2020, unsurprisingly, came with excess death. There was an 18% increase in overall mortality, year on year.

But let's dive in a little bit deeper. The @CDCgov has updated WONDER, its mortality database.

/2 First, let's get you acquainted with my graph. It looks noisy because I wanted to give you the best data possible.

Graph: monthly rate of SUICIDE in the US, for every year going back to 1999. Teal represents 2019 and red 2020.

/3 I wanted you to see the trends, so there are 5 years 2014-2018 represented in the dark blue.

On the bottom, the summary of raw # of deaths 2019 vs 2020, and if this represents a significant difference (p<0.05)

/4 This graph shouldn't be surprising to you if you were following me before. what does it show? Overall, there was a decrease in suicides in April and May, with an overall significant decrease of -3.6%.

/5 There was a ton of media about gun purchases at the beginning of the pandemic. Using WONDER, we can separate gun deaths from non-gun deaths.

Here are the non-gun suicide deaths in 2020, showing a larger decrease (-8.3%)

/6 Here are the gun suicide deaths. For 2020 We see the similar dip in April, but pretty much on pace with 2019 after that. The difference between gun suicides for 2020 (-1.0 to +3.7%) is SIGNIFICANTLY higher than the difference in non-gun suicides for 2020 (-10.7 to -6.0%).

/7 I am quite certain that one of the reasons that America did not see the same drop of suicides (America -3.6%) as its Canadian (-32%), Australian (-10%) and UK (-10%) cohorts is because of gun ownership. One of the many reasons suicide prevention is reducing gun ownership.

/8 This may seem counterintuitive to some, but transport accidents went up significantly. Most public health experts believe this is due to less drivers = more speed = more catastrophic accidents.

3,000 extra deaths in America due to traffic accidents in 2020.

/9 Whenever I present the suicide data, I get "but what about overdoses?!?!" from anti-protective-measure types. But let's really look at it, shall we?

Absolutely, overdoses increased, and significantly. An extra 20k deaths occured in the US.

/10 Most experts share that toxic drug supply due to nobody being able to mule drugs/skyrocketing prices/less availability are reasons for higher drug overdose fatalities, as people forced to use higher potency drugs/synthesize toxic drugs.

The marginalized suffer the worst.

/11 However, Do pay attention, class.

Drug overdoses were +18% higher in January and February compared to 2019, before the pandemic. If we go back to 2019, Oct-Dec are 15% higher than in 2018. So there was likely a PREPANDEMIC increase going on.

/12 Still, the pandemic bump is obvious and large. Things "settled" back to the January-February +18% in November, but its clear that the pandemic had large effect on ACCIDENTAL drug overdoses.

/13 People use the awful (and trust me, its awful) "deaths of despair" metric to try and stuff together drug overdoses, suicides, and alcohol overdoses AS IF THEY ARE THE SAME THING. They are not. Drug overdoses, coded like this, are NOT intentional. They are accidental.

/14 How do we know this? Because coroners investigate all drug overdose deaths, and have 3 categories.

a) ACCIDENTAL drug overdoses for when the coroner has good reason to believe the death was accidental and intent not present. This is the above.

/15 .

b) INTENTIONAL drug overdose deaths. These are drug overdose deaths in which the coroner determines that the drugs were taken with the intent to die.

Here, we can clearly see that these drug overdose deaths DECREASED significantly.

/16 .

c) UNDETERMINED drug overdose deaths. This is when the coroner is unsure the intent of the use. For 2020, there was no significant change compared to previous years (obviously within 6 year variance too). October looks unique, but did not test high compared to 2019.

/17 So no, the drug overdose increase are likely not simply where all the "Decreased suicides" went. Drug overdose is a unique phenomenon and the complete shutdown of international borders/travel wreaked havoc on drug supply.

/18 Governments would do well to institute safe supply, and for anyone who purportedly cares about people dying of drug overdose, you want the following:

* safe injection sites
* safe supply of drugs
* humane universal income for all people
* legalization and decriminalization

/19 Homicides? Wow did Americans get murdery in the pandemic. Huge, never-before-seen increases in homicides across the country.

/20 Before I get a (ahem) contingent claiming lawless "urban" (ahem) areas, I will point out that the increase was seen in all urbanization counties in the US.

/21 Buuuuuuttttt... gonna get all Canadian on ya and point out the gun problem again. If we go to non-gun homicides... no major increase. Well, it's up 9.4%. but... check out the difference when we look at gun homicides.

/22 Ka-BLAM-o! (quite literally).

The "pandemic effect" on gun homicides is astronomical. +34% deaths.

Americans: Y'all really need to get rid of your guns. Seriously. It's killing you.

/23 Pregnancy/Childirth deaths were overall up 16.3% on the year. Compared to 2019, much higher (+223 deaths). For the 5 year variance... not sure it passes the visual test of "different than before"

I worry what we will see when we break down by race..

/24 To check on a few things people have wondered about:

a) cancer deaths did not increase.
b) cardiac deaths increased
c) stroke deaths increased
d) alzheimer deaths increased

/25 Very likely, these deaths are direct (died before detection)/secondary consequences of COVID infection itself. Only one cause can be listed as the "underlying cause of death;" i'm betting many covid-accelerated deaths are coded in these diseases due to pre-existing histories.

/26 Remember, most evidence points to the COVID death tally in 2020 (350,812) to be an UNDERCOUNT, not an OVERCOUNT.

/27 Well, that's enough mortality. If you've stuck it through this far remember 3 things:

1) myths about covid deaths propagate far and wide; we are just now getting the data we need

2) getting vaccinated and stopping spread of covid is how we save lives here

3) love y'all.