/1 A great summary given by the @mehdirhasan regarding the rhetoric around schools, "trauma," & kids' mental health. I was so pleased to see these nuances injected into the conversation.

I'd like to talk about a different aspect, but please watch first!

/2 Wayyyyy back in July 2020 when schools were approaching I worked very hard to get the word out: schools are actually quite nuanced when it comes to kids' mental health. It still holds, and I'll be reiterating some of it here.

/3 How about this CDC data (I compiled/visualized) of # pediatric suicides per day? School days are associated with a 40-50% increase in suicides compared to non-school days.
/4 At my tertiary pediatric hospital, the times of least referrals, ER presentations, and emergency hospitalizations?

Summer break.
Winter holiday.
Spring break.
Easter weekend.
/5 Schools are GREAT and I love them (I did 26 years of schooling myself, I'm a supergeek!), and they bring SO MUCH POSITIVE... I cannot stress enough that I am PRO schooling LOVE KIDS in school...
/6 ...but think for a just a moment. Try to remember in the "before times": prior to the pandemic, did we have any mental health concerns about our kids, child suicides, racism, homophobia, declining mental health, etc?
/7 Did we, prior to COVID, believe "returning kids to school" would magically end their mental health crisis? Resoundingly, no.

In fact, one of the most common "prescriptions" I wrote for the kids I see in crisis? Time off school.
/8 Because, for kids, school is a full time job. It has their future & hope & excellent qualities but it also has all their stress and social challenges. It's the things parents fight about with them and the expectations they try to meet.

School
Is
WORK
For
Most
Kids
!!!
/9 I get that the economy needs bodies working again, & that our kids may lose out on standardized test scores. And there might be many harms of school closures. But schooling is stressful AND COVID is stressful and adding the two together can be an awful lot to manage for kids.
/10 It's not "boo school closures/yay school open"! Nobody thinks that schools should be shut forever (well, some kids might vote for that, but we tend not to listen to what kids actually say anyway)!

The TRUE scenario: how to minimize stress to kids.

/11 Why can't we maximize virtual technologies and make them more available to free up in person class sizes to minimize spread for those who must absolutely attend?

Why can't we prioritize socialization and connection and healthy activities when these are likely most safe?
/12 Our schools can gear our kids towards overwork, stress, burden, and many schools have:

* done little to stem the tide of bullying
* not added robust mental health curriculum, and
* piled on tons of work/homework
* maintained child-incompatible hours
* REMOVED arts/play
/13 I would love to see the mental health aspect of this discussion move away from the simple "should they be in/out for their mental health" to the EXACT SAME THING workplaces and organizations are recognizing.
/14 Every single company, from TWITTER to MICROSOFT to JOHN DEERE to FOX NEWS to MSNBC to (in my world) pretty much every health care/hospital system, has figured out that the post-pandemic work environment will look different, with many improvements from lessons learned.
/15 Why can't parents / politicians / SDs / teachers see that the post-pandemic school can be different?

Is it so much for us to take the opportunity to ensure that the school that kids are returning to are not only COVID-safe (pssst covid is airborne), but also CHILD safe?
/16 like...
a) Is all that homework necessary?

b) is "one time for school" compatible with healthy family structures for all households?

c) could we spend significant time on a mental health curriculum to teach kids how to navigate the real world
/17 ...

d) can we finally eliminate "attendance awards," which unhealthily rewards overwork & going to school when sick/too stressed forever?

e) are we certain school play/work balance is OK?

f) could modern technologies like video games/video tech help with education?
/18 I definitely don't have all the answers and literally A)-F) are just spitballed in the half hour that I typed all this.

Just remember: schools are also a source of stress and we have to consider the impact of adding stressors to stressed out kids.
/19 If all you remember is one thing, please add this to whatever calculus you learned in school for your decisionmaking.:

School and everything surrounding it is also stressful and pre-pandemic, it was also associated with significant childhood distress.

/fin

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More from @tylerblack32

8 Jan
Not to directly contradict a major society in Canada, but BC has not been experiencing a spike in suicidality, emergency mental health presentations, or severe MH admission rates during periods of school closure.

In Feb to May 2021, with schools fully open here, yes, yes we did.
This statement should give the society pause. Being a letter to Ontario govt, of course, it's Ontario centric (every Canadian organization is). But schools have been open for the entirety of the 2020 2021 year and closed for precisely 1 week (Jan 4 to 8, 2022).

Same spikes.
If we saw the same spikes in mental health challenges in 2020-2021 with schools open that Ontario saw with schools closed, what does that suggest?

We will be directly testing in school/out of school data here in BC, and actually publishing numbers that are peer reviewed.
Read 15 tweets
7 Jan
"Returning to school" solves NONE of the pre-pandemic mental health problems our kids, which were increasing and substantial. It is not the same world it was pre-pandemic, and we are all under pandemic pressure.

It is a fantasy to pretend like "returning" brings things back.
I mean... I get the fantasy. It's alluring. We all kinda wish we could go back to 2019 and just... you know... keep going there.

But we can't. Kids are under MORE pressure today, not less, and its not just 'missing school' (in fact, if you asked them...)

/2
It's 1.5 million kids worldwide being orphaned.

It's entire economies and ways of life shifting.

It's a postpandemic world that is mid-new-variant and another worse variant away from retreat.

/3
Read 7 tweets
7 Jan
Good news from Ontario - the omicron "vaccine hole" seems to have a ceiling that's holding. There is still mild protection from vaccine, whereas ICU/hospitalization remains robust. (Updated today)

Suspect a portion is due to "who goes for tests."

/1 Image
In BC, the variable of age plays large into the seemingly negative vaccine effectiveness. Age is such a massive variable that age standardization flips whether or not vaccines show effectiveness to reducing cases.

/2 Image
While the monthly stats still look quite vaccine-protective, this is shifting rapidly and the past few days have seen higher rates of vaccine cases than unvax cases.

/3 Image
Read 12 tweets
4 Jan
/1 =-=-=-=-=-=-=-
Thread: Mortality in 2020 and myths
=-=-=-=-=-=-=-

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)
Read 27 tweets
4 Jan
This graph is now dynamically created based upon the latest @CDCofBC dashboard. #vaccineswork, even in the last month of this awful pandemic.

#stats #covidbc #bcpoli #epitwitter

/1 Image
Vaccination effectiveness dashboard

/2 Image
Raw data from @CDCofBC Image
Read 5 tweets
31 Dec 21
Hi @FrontiersIn : A paper of yours (editor: @GetchellNancy) missed some very important (and honestly basic) statistical issues, and is contributing to a narrative that is not supported by the paper.

#twitterpeerreview
#reviewer2stepsinanddoesthejob
#statstwitter
The paper should have been challenged on review:

* why not iterate 1 year vs other 5 years for all years '16-20 (resolves all issues)
* why not challenge the finding in "communication at 1 year" increasing for 2020 when clearly the significance comes from the low 2017 #

/2
Had it done so, the conclusion of the paper would be markedly different: "2020 showed similar and expected fluctuations as has been seen in the prior 5 years in all domains," and it would not be used as evidence that "pandemic measures effects harm child development"

/3
Read 8 tweets

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