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Tyler Black, MD

@tylerblack32

11 Jan

@JAMA_current

THREAD: A look at a new study looking at school setting, pandemic, and behaviours in kids.

@JAMA_current article using a cohort design to look at the effects of the pandemic over time. They have an interesting statistical manipulation which I'll describe in a moment!

/1

Now very importantly, the authors acknowledge that the statistical manipulation wasnt enough! It falls short in a number of ways, so they caution very strongly against interpreting this as "causal evidence"

Let's look at what it shows and what its limitations are.

/2

First: what is this?

It is an ongoing survey that is being done of early learning that's been going since 2017. During the 2020-2021 school year, for kids 6-8, 405 parents were surveyed in 4 monthly surveys.

/3

Read 40 tweets

Tyler Black, MD

@tylerblack32

9 Jan

DATA SCIENCE:
COVID data by age.

This is very tricky, so please follow along.

I'll post the graph used as evidence of KID CRISIS first, then the exact same data presented as it's wielded as evidence of NO KID CRISIS.

Ontario COVID hospitalizations:
Kids are in crisis!

/1

Ontario COVID hospitalizations:
Kids are not in crisis! (Same data, same Y axis)

How do we reconcile this?

/2

People who work in epidemiology/public health actually have to hold BOTH GRAPHS in their heads.

Children are not little adults and their health care needs are different. There is a reason that we don't compare children to adults often in epidemiology.

/3

Read 15 tweets

Tyler Black, MD

@tylerblack32

8 Jan

Nevermind me, just collecting evidence.

"School closures are harmful to mental health!"

CITATION: This Simpsons episode which clearly shows that kids functioning deteriorated during summer closure

"Kids need school to feel happy!"

CITATION: "Schools Out for Summer" by Alice Cooper, and this live performance demonstrating the rage and anger kids feel when they are out of school.

@djjazzyjeff215

"School closures are associated with a host of mental health problems!"

CITATION: "Summertime" by @djjazzyjeff215 and the Fresh Prince. When FP references "Schools out and it's sort of a buzz," he is referring to the hallucination-inducong melancholy children feel.

Read 7 tweets

Tyler Black, MD

@tylerblack32

8 Jan

Welcome all my new followers. I know I have been quite popularly shared amongst the #schoolclosings issue.

I'm sorry if this loses you quickly:

* Schools should be last closed/1st open
* The science supports closures during periods of high transmission only.

Still with me?

* many families cant do remote schooling & many kids struggle. And our job as privileged people (I am one) is to do my part to protect them

* We do have good evidence that any pandemic/closure effect disproportionately affects minoritized, racialized, & impoverished kids

Still?

Scientific discussion is importantly antagonistic: we challenge and critique and question and test. But I get very uncomfortable when my tweets are used to harass or demean public health officials. Even moreso knowing how much harrassment they get.

Read 9 tweets

Tyler Black, MD

@tylerblack32

8 Jan

https://twitter.com/CanPaedSociety/status/1479482083986788361

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.

https://twitter.com/CanPaedSociety/status/1479482083986788361

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

Tyler Black, MD

@tylerblack32

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

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