Tyler Black, MD Profile picture
Suicidologist, emergency psychiatrist and pharmacologist. Data geek, ok, lots of other geek. Views expressed are my own and not my employers'. he/him/his
36 subscribers
Dec 16 9 tweets 2 min read
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.

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Dec 15 7 tweets 2 min read
🚨🇨🇦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.

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Nov 30 6 tweets 3 min read
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

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Nov 28 14 tweets 2 min read
🏳️‍⚧️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.

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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.

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Nov 24 10 tweets 4 min read
🧵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.

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Nov 19 7 tweets 2 min read
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%

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Nov 15 7 tweets 2 min read
"[AIDS] is not being caused by a virus. It's not a virus... These people are dying because of 'poppers'... they were people who were part of a gay lifestyle... "

"This is not a viral disease, but it's a disease that is environmental."

- HHS Secretary Nominee RFK Jr

/1Image Chemicals in water are causing trans kids: "A lot of the problems we see in kids... are coming from chemical exposures, including a lot of the sexual dysphoria that we’re seeing."

- HHS Secretary Nominee RFK Jr

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Nov 7 8 tweets 2 min read
🧵Battling Antivax Disinfo🧵
Vaccination did NOT increase cancer deaths.

Here I took the 6 deadliest cancers (all 5 survival rates under 50%) in a highly vaccinated population (25-54), and we can see ZERO evidence of vaccine-related cancer deaths, all the way to May 2024.

/1Image If i move ages to 55+, we see the same thing, and we are now looking at a lot of deaths from these extremely aggressive cancers, so this isn't some underpowered stuff here. There is NO evidence that deadly cancers have increased due to vaccination.

None.

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Nov 7 11 tweets 4 min read
The Presidential Election
Data Geekery with my interpretations

1) The Country Shifted, but More Didn't.

The final share will be ~ +1.3 to +1.5% for Trump, which is a shift of ~+5.8%.

If America was a room with 65 people in it, only 2 out of the 65 people switched shirts.

/1Image Note: this math might seem like it doesn't work, but we have to remember to include those that voted 3rd party (1.5%ish) and those that didn't vote (about 35%).

Excluding non-voters who were eligible,
2020: 22/43 D & 20/43 R
2024: 20/42 D & 21/42 R

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Oct 15 24 tweets 8 min read
🧵Medical Consent in Minors🧵

Let's do a detailed look at this issue!

Bottom line: yes, in most Western jurisdictions, mature minors who are deemed capable can consent to medical procedures (Sometimes with limitations)

/1 For reference, consider 2 scenarios:

1) a 6-year-old child needs chemotherapy for rapidly progressing cancer

2) a 17-year-old requests hormonal birth control ("the pill") and advice on STI prevention

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Sep 3 5 tweets 2 min read
🚨COVID-19 Vaccination saves lives and improves outcomes 🚨

In this UK study of >3 MILLION PEOPLE who vaccinated, the incidence of mental health problems was significantly reduced when a subsequent COVID-19 infection occurred.

/1Image Looking at the totals who were infected with COVID-19, it is clear that COVID-19 diagnosis was associated with a ROBUST increase in mental health problems after the diagnosis.

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Aug 29 4 tweets 5 min read
Yet another study finding differential impacts (mostly with decrease of symptoms) on the mental health of youth comparing prepandemic to pandemic times.

The media far far far less likely to report on these now common findings.

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jamanetwork.com/journals/jaman… My colleagues and I talked about this at length, that there were many reasons to be cautious about the early "expert predictions" and in fact when good evidence was considered, many so-called evidence based scientists were wrong: dire outcomes on mental health harder to find.

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Aug 4 22 tweets 7 min read
❌Mythbusting❌
Youth suicide & COVID

❌Myth:
responses to COVID "caused" 🔼youth suicides

✅Reality:
We now have 4 years of pandemic data showing that school-aged youth did NOT have an increase in suicides; in fact, rates decreased 18.3% from recent trends AND averages.

/1Image This is true for girls in the US (pretty much right on the 3-year average (-0.8%), and 16.3% less than expected from the 10-year trend).

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Jan 31 17 tweets 6 min read
Talking to kids when they're struggling🧵
For parents (or anyone who cares for kids!)

It can be really scary to notice something in your kid & be worried suicidality/self-harm.

How do you approach kids?

I've had this conversation >10000 times so I have some tips!

Be CALM

/1Image CALM is a memory-trick to remember the key concepts of communicating to a struggling kid but also to remind you to be in control of your own emotions. If you are prepared, you will defeat your initial instinct, which will be to FREAK THE BLEEP OUT!

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Jan 30 18 tweets 5 min read
Suicidology
Predicting Suicide Death

A recent study looking at >2M Americans presenting to ERs with MH concern shows the difficulty of "predicting suicide" - we can't predict suicide to help guide important clinical decisions.

The problem: Sensitivity vs PPV

/1Image They used machine learning EMR-coded variables (outpatient visits, medications, previous appointments, age, etc etc) - you can see the entire dictionary used to "predict" here (word doc):

They had 2,069,170 ER visits and 899 suicides within 90 days.

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Jan 20 10 tweets 6 min read
Debunking Antivaxxer Tropes:
"Antivaxxer is a slur" 🧵

Many many many accuse me of using a "slur" when I say "antivaxxer". It is a twitter shorthand for sure, but it is not a "slur", and I use it without regret or remorse.

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I certainly believe that if one is an "anti-vaxxer", they are not using science, reason, or reality to understand vaccines.

& I note a distrubing trend in antivax and some concerning other beliefs.

That being said, when I say antivax, I only mean "antivaccine belief holder"

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Jan 19 17 tweets 5 min read
Debunking Antivaxxer Myths
"🇪🇺 Vaxxed Countries have higher mortality"
No, they don't.

This is COMPLEX:

a) countries had different PRE-VACCINE infection (offers more dangerous protection than vax but indeed protection). Obv, vaccination NOT correlated with pre-vax death.

/1 Image b) The FIRST VACCINATION SERIES against OG COVID was phenomenally effective at preventing infection, transmission, illness, hospitalization, and death (VE >80-90% in all).

This is clearly evident by one of the most striking correlations you'll see!

COVID deaths vs Vax:

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Jan 18 19 tweets 8 min read
Edward Dowd is popular with antivaxxers.

He presents data to scare people into believing that vaccines have caused harm, & he continuously is on the bandwagon that C19 vaccines cause cancer. This is contrary to the damage.

Here, he's using a report using 1998-2019 data.

/1 Image In fact, there was such a DROP in incidence (assumed to be due to lack of access to health care) in 2020, that they had to amputate the model at 1998-2019 so that it wouldn't project a decrease! (a reasonable thing to do!)

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Jan 17 8 tweets 4 min read
Jordan Peterson is not being "silenced."

He will have a huge platform & can say what ever he wants as long as there is right wing grift.

He is a licensed professional being held standard.

/1 Image It is against his license to publicly suggest to die by suicide.

It is against his license to publicly & intentionally call physicians 'criminals,' people "not beautiful" or "appalling self-righteous moralizing things."

His license prohibits misgender people intentionally.

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Jan 17 23 tweets 8 min read
Mythbusting in the pandemic
Mortality in Canada

Data of ALL 🇨🇦 mortality 2000-2022 to test this myth, so lets run through the proposed causes of the antivaxxer "#diedsuddenly", & other mortality issues.

First up: ❤️
Ages 20-39 (86% vaccinated!)
no excess heart deaths!

/1 Image OK but what about ischemic heart disease (heart attacks).

Still no, in this 86% vaccinated group.

And antivaxxers who "See something" in 2021, do you also "See something" in 2014, 2006, and 2002? thats why we use comparator error bars.

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Jan 14 7 tweets 2 min read
Awful, stigmatizing people like this nonclinical psychologist who claims to be an expert in trauma, really do discount the experiences of SO MANY who get very unwell and do not have a history of trauma. Believing trauma causes everything actually causes severe harm to many.

/1 Image There are many causes of mental illness that ARE KNOWN that have nothing to do with trauma, and many that ARE NOT KNOWN that have nothing to do with trauma, and it's even possible to have a history of trauma and have it NOT contribute to an illness, or it might be crucial.

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