Coronavirus

[pilowsky]

Yes, suicide and other psychiatric problems increased during the pandemic.There have been a number of publications concerning covid-19 and suicide rates.

it is important to note that these studies investigate both suicidal ideation and suicide attempts.

Hill and colleagues reported last month in the journal Pediatrics that the rates of suicide-related behaviours had increased during the covid-19 pandemic.

In this study, we evaluated whether rates of youth suicide-related behaviors have been elevated during the COVID-19 pandemic by examining rates of positive results on suicide risk screens administered as routine screening in a pediatric ED. Comparison of the rate of suicide screen results positive for recent suicide ideation revealed significantly increased rates of ideation in March and July 2020 as compared with screening rates in March and July 2019. Similarly, screen results positive for recent suicide attempts were higher in February, March, April, and July 2020 than in those same months in 2019. Of note, the number of ED visits was substantially reduced during the COVID-19 pandemic. Consequently, direct comparison of rates across years should be made with caution.

And

Across the entire study period, 15.8% (n = 2033) reported past-month suicide ideation, and 4.3% (n = 554) reported a recent suicide attempt (past 3 months).

And

The chi2 difference tests identified significant differences in the rate of recent suicide ideation in March and July 2020 compared with those same months in 2019. The odds of recent suicide ideation were 1.60 times higher in March 2020 compared with March 2019 and 1.45 times higher in July 2020 compared with July 2019. For recent suicide attempts, chi2 difference tests identified significant differences in the rate of suicide attempts in February, March, April, and July 2020 compared with those same months in 2019. The odds of a recent suicide attempt were 1.58, 2.34, 1.75, and 1.77 times higher in February, March, April, and July 2020 compared with those same months in 2019, respectively. Figure 2 reveals rates of positive screen results by month and year.".

Here are the data from Table 1.

Hill, RA et al., (2021) Suicide Ideation and Attempts in a Pediatric Emergency Department Before and During COVID-19 PEDIATRICS 147:3, March 2021:e2020029280

In a review published in The Lancet this month, Gunnell et al., point out that a similar phenomenon occurred during other pandemics.

"The mental health effects of the coronavirus disease 2019 (COVID-19) pandemic might be profound and there are suggestions that suicide rates will rise, although this is not inevitable. Suicide is likely to become a more pressing concern as the pandemic spreads and has longer-term effects on the general population, the economy, and vulnerable groups. Preventing suicide therefore needs urgent consideration. The response must capitalise on, but extend beyond, general mental health policies and practices. There is some evidence that deaths by suicide increased in the USA during the 1918–19 influenza pandemic and among older people in Hong Kong during the 2003 severe acute respiratory syndrome

(SARS) epidemic."

Gunnell et al., The Lancet April 2021

 

Equally interesting is the question is the excess psychiatric morbidity observed during pandemics greater or less than the excess psychiatric morbidity that is known to be observed during other stressful events.

It is not clear to me that this question was addressed in the papers that I have seen so far.

[Cyberyeti]

Btw, here is a study just for our dear friend Cyberyeti:

 

 

In the early months of the pandemic, I would expect some of the main effects to occur longer term, most of my friends who've had issues had them after July, but it is somewhat reassuring. Also as Pilowsky says suicidal thoughts and attempts also matter along with self harming, none of my friends actually killed themselves but 2 attempted suicide and the same 2 self harmed. Another was off working from home for several weeks with his issues and another is suffering now.

 

Has anybody investigated homicides and domestic violence incidents in the pandemic period ? I would expect more domestic homicides and less outside the home, but don't know how that will net off.

[pilowsky]

In the early months of the pandemic, I would expect some of the main effects to occur longer term, most of my friends who've had issues had them after July, but it is somewhat reassuring. Also as Pilowsky says suicidal thoughts and attempts also matter along with self harming, none of my friends actually killed themselves but 2 attempted suicide and the same 2 self harmed. Another was off working from home for several weeks with his issues and another is suffering now.

 

Has anybody investigated homicides and domestic violence incidents in the pandemic period ? I would expect more domestic homicides and less outside the home, but don't know how that will net off.

 

I don't have data off-hand but have heard it reported that there has been an increase in domestic violence.

This is a problem that is known to increase during times of powerlessness and helplessness (death of a relative/friend, job loss, etc).

The problem is compounded during a pandemic because the ability to flee is dramatically decreased.

News reporting has it that this problem was exacerbated during the pandemic.

 

You can also expect stocks in gambling-related businesses to increase.

 

During times of stress, people turn to more primitive coping mechanisms.

They are more easily upset by things that would not usually bother them because their ability to feel in control is weakened.

 

It even has a name: "Veneer theory"

The quote is from Wikipedia.

Veneer theory is a term coined by Dutch primatologist Frans de Waal to label the Hobbesian view of human morality that he criticizes throughout his work. Although he criticizes this view in earlier works, the term in this form is introduced in his 2005 book "Our Inner Ape", denoting a concept that he rejects, namely that human morality is "a cultural overlay, a thin veneer hiding an otherwise selfish and brutish nature".^[1]

The idea of the veneer theory goes back to Thomas Henry Huxley and has more recently been advocated by biologists like George C. Williams.

Obviously, there is not complete agreement, but the concept of a thin veneer in civilisation resonates with me when I think back about current events and the past 100 years.

This comes from book chapter:

Let us begin with the Tanner lecture of the primatologist Frans de Waal,

"Morally Evolved: Primate Social Instincts, Human Morality, and the Rise

and Fall of 'Veneer Theory'." Veneer theory "views morality as a cultural overlay,

a thin veneer hiding an otherwise selfish and brutish nature" (de Waal,

2006a, p. 6). De Waal traces the theory to Thomas Huxley (1894/1989)

who, according to de Waal, saw "human ethics as a victory over an unruly

and nasty evolutionary process" (de Waal, 2006a, p. 7). Of course, we could

trace veneer theory back to the doctrine of original sin. For Huxley, morality

is a choice only we humans may make by detaching ourselves from nature

and natural evolution. This is an extraordinary stance for "Darwin's Bulldog"

to take since it restricts the explanatory power of evolution. It also violates

Darwinian continuity since Huxley says nothing about how humans may

have acquired ethical capacity.

 

Overcoming veneer theory: Animal sympathy

J. Garrison

ISBN: 9781349575121 , 9781137505255; DOI: 10.1057/9781137505255_11

The Educational Significance of Human and Non-Human Animal Interactions : Blurring the Species Line / , 2016, p.173-190

 

Editors

Suzanne Rice, A. G. Rud (2016)

[pilowsky]

Here is a paper published in one of the British Medical Journals collection of Journals.http://bit.ly/PhysicalCOVID

 

I would be interested to know what our statisticians make of it.

 

The authors seem to be trying to make a case that sedentary people are more likely to die of COVID19.

 

This strikes me as an obvious non-mechanistic correlation.

 

Sedentary people are more likely to be older, fatter, and suffer from all the co-morbidities that make COVID19 a bigger problem.

 

I came across it because it was in a newsfeed.

Original researchPhysical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients FREEhttp://orcid.org/0000-0001-7633-7345Robert Sallis1, Deborah Rohm Young2, Sara Y Tartof2, James F Sallis3, Jeevan Sall1, Qiaowu Li2, Gary N Smith4, Deborah A Cohen2Correspondence to Dr Robert Sallis, Department of Family and Sports Medicine, Kaiser Permanente Medical Center, Fontana, CA 92335, USA; Robert.E.Sallis@kp.org

Abstract

Objectives To compare hospitalisation rates, intensive care unit (ICU) admissions and mortality for patients with COVID-19 who were consistently inactive, doing some activity or consistently meeting physical activity guidelines.

Methods We identified 48 440 adult patients with a COVID-19 diagnosis from 1 January 2020 to 21 October 2020, with at least three exercise vital sign measurements from 19 March 2018 to 18 March 2020. We linked each patient's self-reported physical activity category (consistently inactive=0–10 min/week, some activity=11–149 min/week, consistently meeting guidelines=150+ min/week) to the risk of hospitalisation, ICU admission and death after COVID-19 diagnosis. We conducted multivariable logistic regression controlling for demographics and known risk factors to assess whether inactivity was associated with COVID-19 outcomes.

Results Patients with COVID-19 who were consistently inactive had a greater risk of hospitalisation (OR 2.26; 95% CI 1.81 to 2.83), admission to the ICU (OR 1.73; 95% CI 1.18 to 2.55) and death (OR 2.49; 95% CI 1.33 to 4.67) due to COVID-19 than patients who were consistently meeting physical activity guidelines. Patients who were consistently inactive also had a greater risk of hospitalisation (OR 1.20; 95% CI 1.10 to 1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to 1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to COVID-19 than patients who were doing some physical activity.

Conclusions Consistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. We recommend efforts to promote physical activity be prioritised by public health agencies and incorporated into routine medical care.

Data availability statementNo data are available.

This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coro...rts-2021-104080

[pescetom]

I'm not a statistician, but it does say they conducted regression for demographics and known risk factors, which I assume means they are comparing apples with apples in terms of age and comorbidities.

[pilowsky]

...and yet, here is what they say under "Demographics"

The population had a mean age of 47.5 years (SD 17.0), with a median of 47 years (IQR 33.0, 60.0) and included 61.9% females (table 1). 6.4% were consistently meeting PA guidelines and 14.4% were consistently inactive, with the remainder falling in the some activity category. White patients were most likely to consistently meet PA guidelines (9.4%), followed by Asian patients (7.3%), Hispanic patients (5.5%) and African-American patients (4.6%). The mean BMI was 31.2 (SD 7.07). 51.4% of the study cohort had no comorbidities while 17.4% had only one, and 31.3% had two or more. The percentage of those who were consistently meeting PA guidelines was lower among those with chronic diseases (including obesity) and those who smoked.

 

Worth noting that the mean BMI was 31.2.

 

A BMI >29.9 is "obese".

So, the overwhelming majority of people in this group are either overweight or obese.

 

The people in the group come from a Kaiser-Permanente "managed-care" health care system.

It has a major emphasis on prevention yet the population is still mostly overweight or (on average) obese.

When you look at their data you find that the odds ratio for active vs inactive is 1.2. (link to their Table https://bjsm.bmj.com...80/F2.large.jpg)

It is one of the smallest effects found in this retrospective study.

 

[Cyberyeti]

A really interesting article that explains the problem with relying on lateral flow tests as Covid gets rarer:

 

https://www.theguardian.com/world/2021/apr/18/obscure-maths-bayes-theorem-reliability-covid-lateral-flow-tests-probability?CMP=Share_AndroidApp_Other&fbclid=IwAR0LrvmevmERi8Xi_WcQ08m6eR79sewDLRfGSz7zywuZ-yyD3mawbEEPCsk

 

and to Pilowsky - using BMI to define obesity is at best a very blunt instrument.

 

Back when I was younger and fitter, my BMI would have been over 30 with a body fat percentage of zero, I just carried that much lean bodyweight.

[pilowsky]

A really interesting article that explains the problem with relying on lateral flow tests as Covid gets rarer:

 

https://www.theguard...-yyD3mawbEEPCsk

 

and to Pilowsky - using BMI to define obesity is at best a very blunt instrument.

 

Back when I was younger and fitter, my BMI would have been over 30 with a body fat percentage of zero, I just carried that much lean bodyweight.

 

It isn't as blunt as you think. You may have been a Dean Lukin https://www.menshealth.com.au/dean-lukin-lift-of-a-lifetime when you were younger - but when he lost weight, his BMI returned to something sensible.

 

 

 

In a bid to get healthier during the late 1980s, Lukin went on a diet and lost a lot of the weight that made him one of the top Super Heavyweight weightlifters in the world, claiming that his waist was now the size that his upper thighs were during the 1984 Olympic Games.

 

 

My first publication used Bayes theorem. I learned it in High school then applied it a couple of years later.

I suspect it is only "obscure" to the people that write in the Guardian. On the other hand, most of my friends from High School became lawyers/politicians and probably never heard of it.

Just because you don't know something doesn't make it obscure; you just don't know it.

Embarrassingly, I think I got it wrong last year and was corrected (with varying levels of kindness) on this Forum.

 

I noticed that the Brits have something called SAGE (https://www.gov.uk/government/organisations/scientific-advisory-group-for-emergencies/about).

 

When I said elsewhere that 1/100 year events happen every year, SAGE was exactly the kind of body I fantasised would exist worldwide to help us keep safe.

The Americans seem to have this in a very fragmented way (e.g. NTSB) or the Pandemic Playbook - but it is not taken (as) seriously by the government.

 

Someone told me when I was a teenager that there are many things that can't be worked out from first principles; you just have to know them. Guessing doesn't work.

 

 

 

[Cyberyeti]

It isn't as blunt as you think. You may have been a Dean Lukin https://www.menshealth.com.au/dean-lukin-lift-of-a-lifetime when you were younger - but when he lost weight, his BMI returned to something sensible.

 

Possibly if I actually did anything in particular to build muscle, I didn't, that was my natural state. I played a fair amount of sport of many types, but never pushed weights, the only times I went to a gym was for aerobic type exercises.

 

My first publication used Bayes theorem. I learned it in High school then applied it a couple of years later.

I suspect it is only "obscure" to the people that write in the Guardian. On the other hand, most of my friends from High School became lawyers/politicians and probably never heard of it.

Just because you don't know something doesn't make it obscure; you just don't know it.

Embarrassingly, I think I got it wrong last year and was corrected (with varying levels of kindness) on this Forum.

 

I noticed that the Brits have something called SAGE (https://www.gov.uk/government/organisations/scientific-advisory-group-for-emergencies/about).

 

When I said elsewhere that 1/100 year events happen every year, SAGE was exactly the kind of body I fantasised would exist worldwide to help us keep safe.

The Americans seem to have this in a very fragmented way (e.g. NTSB) or the Pandemic Playbook - but it is not taken (as) seriously by the government.

 

Someone told me when I was a teenager that there are many things that can't be worked out from first principles; you just have to know them. Guessing doesn't work.

 

I did a statistics degree so studied Bayesian statistics, but I suspect most people haven't.

 

SAGE has taken a lot of abuse here because they screwed up in the early days of the pandemic in the eyes of many and didn't recommend a lockdown fast enough. There is another body called independent SAGE consisting of scientists who didn't get invited to the real one which has proposed more radical measures. I don't know which one is right.

[cherdano]

Our friend Nick Triggle from the BBC is still at it, minimizing the acceptance of 30,000-100,000 additional deaths after most have been vaccinated.

https://www.bbc.co.uk/news/uk-56830398

[Cyberyeti]

Our friend Nick Triggle from the BBC is still at it, minimizing the acceptance of 30,000-100,000 additional deaths after most have been vaccinated.

https://www.bbc.co.uk/news/uk-56830398

 

I don't see any minimising of it

 

Some models suggest there could be in excess of 100,000 deaths over the coming year or so. But others say it may be no worse than a bad flu season with around 30,000 deaths.

 

When the next wave will come is also not clear. Eventually it is expected the virus will become seasonal like flu. But that cannot be a given for this year - hence the summer warnings.

 

It's why government scientists are insisting we move forward carefully.

 

But why in the long-run we can learn to live with Covid.

 

The implication is that after this year we can live with it, but we have to be careful this year, which seems a reasonable interpretation of what the scientists are saying. Also the 100K is probably from the model that suggested everything would be 2-3 times as bad as it has proven to be at every stage. Unless an apocalyptic new variant appears, 100K seems horribly unlikely as by the time of the predicted peak, the vast majority of adults will have had at least one dose of vaccine and a small majority will have had both.

[cherdano]

I don't see any minimising of it

 

A rise in infections is sadly inevitable, (...)Some models suggest there could be in excess of 100,000 deaths over the coming year or so. But others say it may be no worse than a bad flu season with around 30,000 deaths.

He is implying another 30,000 deaths would be a success.

 

There is nothing inevitable about another wave of this magnitude. Vaccinations. Hand out N95 masks to everyone working along-side others indoors. Proper sick-pay for those who have to isolate due to a positive test or a contact-tracing call and cannot work from home. A serious improvement of ventilation in public buildings.

And finally, when case numbers are low enough, do proper contact-tracing - not just calling up recent contacts (and don't restrict yourself to silly 2m rules), but also find out where someone got infected, and who else could have gotten infected by that person (backward tracing).

[Cyberyeti]

 

Proper sick-pay for those who have to isolate due to a positive test or a contact-tracing call and cannot work from home.

 

That is the one thing that will have the biggest effect.

 

Obviously I can't verify these calls, but I've heard several people claiming to work in test and trace phoning in to radio programs saying that people are simply putting the phone down on them when they find out where the call is from, or they suspect using caller display and not taking calls from them to avoid being told to isolate.

[pilowsky]

There is something truly strange about the world we live in when these two headlines appear on the same day:

 

https://www.bbc.com/...d-asia-56870410

Indian hospitals say their patients are dying because of a shortage of oxygen as Covid case numbers and deaths set new records for a third day running.

 

and

https://www.npr.org/2021/04/22/989797337/out-of-thin-air-nasa-rover-makes-oxygen-from-martian-atmosphere

Out Of Thin Air: NASA Rover Makes Oxygen From Martian Atmosphere

[johnu]

That is the one thing that will have the biggest effect.

 

Obviously I can't verify these calls, but I've heard several people claiming to work in test and trace phoning in to radio programs saying that people are simply putting the phone down on them when they find out where the call is from, or they suspect using caller display and not taking calls from them to avoid being told to isolate.

It's nice to know that the US doesn't have a monopoly on sociopaths.

[hrothgar]

Good article in Vanity Fair about vaccine distribution

 

https://www.vanityfair.com/news/2021/04/why-the-us-still-cant-donate-covid-19-vaccines-to-countries-in-need

[pilowsky]

Vaccine distribution in Australia is useless.

To date, the roll-out is risibly small https://www.abc.net....t/13197518?nw=0

 

Politicians claim all kinds of reasons for this - shortage of supply, poor production, mean Europeans.

 

But for the past 30-40 years, successive governments paid lip service to science.

Quietly dissipating and denigrating the pursuit of academic work while pumping money into "important" endeavours like the Australian Institute of Sport.

 

To give some perspective about the value that the world places on Science, it is worth remembering that this year the Nobel prize for Medicine is worth $USD 1,192,546 (converting SEK10,000,000).

The Nobel prize is typically shared between 3 people (the maximum permitted in the rules) who are not dead (also in the rules).

 

Each of the winners of the US tennis open will get USD3,800,000 this year.

 

Much as I understand that hitting balls with sticks takes practice, this disparity makes no sense to me.

 

One beneficial effect of the coronavirus was that, for a short while, there was no sport on the radio.

[thepossum]

 

https://www.theguardian.com/world/2021/apr/18/obscure-maths-bayes-theorem-reliability-covid-lateral-flow-tests-probability?CMP=Share_AndroidApp_Other&fbclid=IwAR0LrvmevmERi8Xi_WcQ08m6eR79sewDLRfGSz7zywuZ-yyD3mawbEEPCsk

 

 

I guess I shouldn't have wasted 30 seconds scanning this article. I gave up reading any news publication (even "respected" ones) for anything science related early last year

 

I hope poor Bayes' spirit doesn't have access to a Guardian subscription

[cherdano]

I guess I shouldn't have wasted 30 seconds scanning this article. I gave up reading any news publication (even "respected" ones) for anything science related early last year

 

I hope poor Bayes' spirit doesn't have access to a Guardian subscription

LOL

[johnu]

If you have children that attend this school you should get them out of there before they are taught to be terminally stupid.

 

Miami Private School Won’t Allow Vaccinated Teachers Near Students, Citing Misinformation

 

In a letter to faculty and staff sent last week and obtained by The New York Times, school co-founder Leila Centner reportedly requests that teachers who have already been vaccinated inform the school so they can be physically distanced from students. Teachers should tell the school if they get vaccinated before the end of the school year “as we cannot allow recently vaccinated people to be near our students till more is known,” or wait until the school year is over to be vaccinated. Centner adds that teachers who receive the vaccine over the summer will not be allowed to return until clinical trials on the vaccines have finished.

 

In a separate letter, sent to Centner Academy parents on Monday, Centner cites a false claim that “tens of thousands of women all over the world have recently been reporting adverse reproductive issues” from being near people who have received the vaccine.

 

“It is our policy, to the extent possible, not to employ anyone who has taken the experimental COVID-19 injection until more is known,” Centner writes.

 

Presumably this is a QAnon or Fox Propaganda screwball conspiracy meant for their most severely mentally incompetent followers.

[pilowsky]

If you have children that attend this school you should get them out of there before they are taught to be terminally stupid.

 

Miami Private School Won't Allow Vaccinated Teachers Near Students, Citing Misinformation

 

Presumably this is a QAnon or Fox Propaganda screwball conspiracy meant for their most severely mentally incompetent followers.

 

No, the same people exist all over the world.

If you can believe the world was created in 6 days, you can believe anything.

[helene_t]

I hope poor Bayes' spirit doesn't have access to a Guardian subscription

I may be biased because I consider the Guardian a less-terrible-than-average-British-newspaper, but I don't think the article does such a bad job.

 

But it's a bit disappointing that they start the article with "only 1 false positive in 1000" and then proceed as if that has a well-defined meaning. They should either spell out "only one out of 1000 tested non-Covid cases result in a false positive", or they should subsequently have written "it depends what 1 in 1000 is supposed to mean". As it is, they make it more obscure than needed.

 

Anyway, newspapers, even The Guardian, are not great sources of science news and background. So far I agree with you. Better to read Scientific American or New Scientist.

[thepossum]

I may be biased because I consider the Guardian a less-terrible-than-average-British-newspaper, but I don't think the article does such a bad job.

 

But it's a bit disappointing that they start the article with "only 1 false positive in 1000" and then proceed as if that has a well-defined meaning. They should either spell out "only one out of 1000 tested non-Covid cases result in a false positive", or they should subsequently have written "it depends what 1 in 1000 is supposed to mean". As it is, they make it more obscure than needed.

 

Anyway, newspapers, even The Guardian, are not great sources of science news and background. So far I agree with you. Better to read Scientific American or New Scientist.

 

It was the stuff about obscurity and anomalies that got me

 

To be honest even the alternative publications you mention are no longer (sorry, never were) high on my list

[cherdano]

If you don't think Bayes theorem is obscure, you should get out of your bubble a bit more.

[hrothgar]

If you don't think Bayes theorem is obscure, you should get out of your bubble a bit more.

 

FWIW, my department at work often uses a (better framed) version of this

same example as one of our early round interview questions.