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Tyler Black, MD

@tylerblack32

Aug 12

@cdc

The @cdc's new guidance is like "people are going to smoke anyway, so we don't recommend that they don't smoke."

If the politics push against evidenced public health, the public health position should push against the politics! Not "oh the politics are bad here go ahead."

This capitulation to what "the public is accepting" is a failure of the basic duties of health care practitioners: to give people the best information in decisions regarding their health.

The CDC is going against *its own evidence* in its recommendations.

CDC's evidence is clear that:
1) masks work
2) mitigations work
3) vaccination is crucial
4) ventilation matters
5) even with a history of infection, vaccination prevents worse outcomes

Read 5 tweets

Tyler Black, MD

@tylerblack32

Aug 4

@CDCgov

🚨POST-COVID & Kids🚨

New @CDCgov report showing quite clearly that children are at significantly more risk for life-threatening diagnoses after COVID infection. Very convincing evidence that prevention of COVID-19 in children is very important to reduce childhood mortality.

/1

In every age demographic, life threatening and severe disorders are more significant after COVID infection. We also see a drop in muscle/neurological/psychiatric disorders post-COVID in kids. I have some hypotheses on that.

/2

This is true of symptoms (not diagnoses) as well, though less dramatically so.

/3

Read 7 tweets

Tyler Black, MD

@tylerblack32

Aug 2

Pretty incredible stuff. When Kirsch includes ALL trials instead of his normal narrative source for "antidepressants no better than placebo", he concludes: antidepressants better than placebo.

We've been saying that for decades in response to his papers.
bmj.com/content/378/bm…

Kirsch is famous for claiming that antidepressants were no better than placebo and now his paper unequivocally shows that they are. Yes, we have much more to learn, but especially in severe depression, his paper supports AD use.

We can't know who will benefit or who won't vs risks, so informed consent is crucial.

But I'm not kidding you, pretty much every professional response that have ever responded to Kirsch's papers have stated exactly what this current paper shows.

Read 4 tweets

Tyler Black, MD

@tylerblack32

Aug 2

Richard Bentall, author of a review of ECT & a vocal opponent of ECT, who has claimed that "the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified," reveals he knows nothing about catatonia and that it "just doesn't happen anymore."

🤔🤔🤔

This should really undercut any gravitas has in discussions of ECT. If you haven't considered acute psychiatric illness, you shouldn't be speaking about ECT.

ECT, in acute situations like severe catatonia (due to stress, illness, depression, psychosis), is lifesaving.

ECT is an imperfect treatment with risks and benefits, but it has a tremendous role in catatonic crisis. Because catatonia can arise out of any severe/acute assault on the brain, it touches all diagnoses.

Read 4 tweets

Tyler Black, MD

@tylerblack32

Jul 29

US Pediatric Suicide in 2021
By Region
=-=-=-=-=-=

With historical context, changes can be best interpreted. This is very important as many media/pundits/presenters lazily present year-over-year trends as if it can tell the full story. It can't.

Here's the US since 1999:

/1

Suicide rates during the pandemic are within expected trends, & no increase is significant. The highest increase in the past 21 years was in 2017 for boys and 2004 for girls. The 2021 rate is a record for American girls, but again, well within the trend we would expect.

/2

We'll now look at things regionally, and start with the HHS region 1 (CT, ME, MA, NH, RI, VT). We can see, that trends are within expected for boys and girls, and these noisy rates bounce quite a bit. (missing values for the girls in earlier years is due to CDC rule)

/3

Read 17 tweets