Tuesday, May 26, 2020

Isolation and job losses are leading to higher number of suicide attempts   

The lockdown hit me at a time when I was having relationship difficulties  -- magnifying those difficulties.  I too could well have ended it at that time except for strong family support.  I am now at peace

Trauma doctors at a northern California medical center say the hospital they work at has experience more deaths from suicide than from the coronavirus.

The head of the trauma at John Muir Medical Center in Walnut Creek near San Francisco believes the effects of the coronavirus are not just affecting physical health but mental health too.

Dr. Mike deBoisblanc believes that the lockdown restrictions need to end because of the impact they are having on mental health.

'Personally I think it's time,' said Dr. Mike deBoisblanc to ABC7. 'I think, originally, this shelter-in-place order was put in place to flatten the curve and to make sure hospitals have the resources to take care of COVID patients.

'We have the current resources to do that and our other community health is suffering.'

'We've never seen numbers like this, in such a short period of time,' he said. 'I mean we've seen a year's worth of suicide attempts in the last four weeks.'

DeBoisblanc's colleague, Kacey Hansen, who has worked as a trauma nurse for 33 years also shares his concern.  'What I have seen recently, I have never seen before. I have never seen so much intentional injury.'

'They intend to die,' Hansen said. 'Sometimes, people will make what we call a "gesture". It's a cry for help. We're just seeing something a little different than that right now. It's upsetting.'

Doctors Hansen and deBoisblanc say they are seeing mainly young adults die by suicide brought on by the stress of isolation and job losses as a result of the quarantine.

California's shelter-in-place policy is set to last until midnight on May 31.

Staff are encouraging those who are feeling depressed to call The National Suicide Prevention Lifeline on 1-800-273-TALK.     

'Generally speaking the vast majority of people say they feel better after they call and get the resources they need,' Executive Director Tom Tamura said.

'With help comes hope. I think that there are people and organizations out there that you can contact that can get you the information you need and resources you need to get you through this tough time.'

'I think people have found themselves disconnected from the normal supportive networks that they have, churches and schools and book clubs, you name it,' Tamura said. 'And that, coupled with the closure of some counseling services, people were maybe in a little bit of shock. They were trying to weather the storm a bit but as that isolation has grown people have come to realize this isn't a sprint it is marathon.'



Lockdown was a waste of time and could kill more than it saved, claims Nobel laureate scientist at Stanford University

The coronavirus lockdown could have caused more deaths than it saved, a Nobel laureate scientist has claimed.

Michael Levitt, a Stanford University professor who correctly predicted the initial scale of the pandemic, suggested the decision to keep people indoors was motivated by 'panic' rather than the best science.

Professor Levitt also said the modelling that caused the government to bring in the lockdown - carried out by Professor Neil Ferguson - over-estimated the death toll by '10 or 12 times'.

His claims echo those in a JP Morgan report that said lockdowns failed to alter the course of the pandemic but have instead 'destroyed millions of livelihoods'.

Author Marko Kolanovic, a trained physicist and a strategist for JP Morgan, said governments had been spooked by 'flawed scientific papers' into imposing lockdowns which were 'inefficient or late' and had little effect.

He said falling infection rates since lockdowns were lifted suggest that the virus 'likely has its own dynamics' which are 'unrelated to often inconsistent lockdown measures'.

Denmark is among the countries which has seen its R rate continue to fall after schools and shopping malls re-opened, while Germany's rate has mostly remained below 1.0 after the lockdown was eased.

Prof Levitt told The Telegraph: 'I think lockdown saved no lives. I think it may have cost lives. It will have saved a few road accident lives, things like that, but social damage – domestic abuse, divorces, alcoholism – has been extreme.

'And then you have those who were not treated for other conditions.'

Professor Levitt, who won the Nobel Prize for chemistry in 2013 for the 'development of multiscale models for complex chemical systems', has said for two months that most experts predictions about coronavirus are wrong.

He also believes that the Government should encourage Britons to wear masks and find other ways to continue working while socially distancing instead.   

Prof Ferguson's modelling, on the other hand, estimated up to 500,000 deaths would occur without social distancing measures.

Prof Levitt added: 'For reasons that were not clear to me, I think the leaders panicked and the people panicked. There was a huge lack of discussion.'

The 73-year-old Nobel prize winner in not an epidemiologist, but he assessed the outbreak in China at the start of the crisis and made alternative predictions based on his own calculations.

Although Professor Levitt does acknowledge that lockdowns can be effective, he describes them as 'medieval' and thinks epidemiologists exaggerate their claims so that people are more likely to listen to them.

His comments come as other scientists working in the same field also reported that they couldn't verify Prof Ferguson's work.

Competing scientists' research - whose models produced vastly different results - were largely ignored by government advisers.

David Richards, co-founder of British data technology company WANdisco said Ferguson's model was a 'buggy mess that looks more like a bowl of angel hair pasta than a finely tuned piece of programming'.

Mr Richards said: 'In our commercial reality we would fire anyone for developing code like this and any business that relied on it to produce software for sale would likely go bust.'

University of Edinburgh researchers also reportedly found bugs when running the model, getting different results when they used different machines, or even the same machines in some cases.

The team reported a 'bug' in the system which was fixed - but specialists in the field remain staggered at how inadequate it is.

Four experienced modellers previously noted the code is 'deeply riddled with bugs', has 'huge blocks of code – bad practice' and is 'quite possibly the worst production code I have ever seen'.

After the model's grim prediction, the University of Edinburgh's Professor Michael Thursfield criticised Professor Ferguson's record as 'patchy'.



How Florida's COVID Response, Skewered By the Media, Has Been Succeeding

We've been comparing and contrasting the policies, results and media coverage of New York vs. Florida for some time now, for fairly obvious reasons. New York has been the nation's worst Coronavirus hotspot for months, while Florida received a disproportionate share of negative media coverage for its handling of the virus, even though it seems to be working quite well. As of this writing, the Empire State has suffered approximately 23,000 COVID deaths, while Florida's death toll is approximately one-tenth of that number, despite the latter state having two million more residents than the former. New York's (reportedly undercounted) nursing home death count is nearly triple the entire state of Florida's.

Why, then, has Florida Governor Ron DeSantis been targeted with such withering and accusatory press coverage, while New York Governor Andrew Cuomo has been afforded heroic treatment -- and is only recently starting to face some heat for the objectively bad decisions and tragic results over which he's presided? I'll remind you of this refreshingly candid Politico analysis:

Florida just doesn’t look nearly as bad as the national news media and sky-is-falling critics have been predicting for about two months now. But then, the national news media is mostly based in New York and loves to love its Democratic governor, Andrew Cuomo, about as much as it loves to hate on Florida’s Republican Gov. Ron DeSantis. First, let’s just come out and say it: DeSantis looks more right than those who criticized the Sunshine State’s coronavirus response...Cuomo also has something else DeSantis doesn’t: a press that defers to him, one that preferred to cover “Florida Morons” at the beach (where it’s relatively hard to get infected) over New Yorkers riding cramped subway cars (where it’s easy to get infected). In fact, people can still ride the subways for most hours of the day in New York, but Miami Beach’s sands remain closed. Maybe things would be different if DeSantis had a brother who worked in cable news and interviewed him for a “sweet moment” in primetime.

It's been partisan and ideological media bias compounded by parochial media bias, resulting in embarrassingly bad and unfair coverage. It's had an impact, too, with DeSantis' sky-high approval rating falling to diminished (yet still pretty robust) levels, and Cuomo soaring to dramatic heights. Perhaps those numbers will shift again, as realities and results become clearer to voters, but journalists spent weeks forging narratives that now appear to have cut in exactly the wrong directions, according to actual outcomes. In a valuable National Review piece, Rich Lowry interviewed DeSantis and key members of his team, who revealed how the Sunshine State's leadership -- contrary to current media mythology -- leveraged careful data analysis and laudable foresight into what is shaping up as a profound, under-heralded success story:

The conventional wisdom has begun to change about Florida, as the disaster so widely predicted hasn’t materialized. It’s worth delving into the state’s response — as described by DeSantis and a couple of members of his team — because it is the opposite of the media narrative of a Trump-friendly governor disregarding the facts to pursue a reckless agenda. DeSantis and his team have followed the science closely from the beginning, which is why they forged a nuanced approach, but one that focused like a laser on the most vulnerable population, those in nursing homes. An irony of the national coverage of the coronavirus crisis is that at the same time DeSantis was being made into a villain, New York governor Andrew Cuomo was being elevated as a hero, even though the DeSantis approach to nursing homes was obviously superior to that of Cuomo. Florida went out of its way to get COVID-19-positive people out of nursing homes, while New York went out of its way to get them in, a policy now widely acknowledged to have been a debacle.

The media didn’t exactly have their eyes on the ball. “The day that the media had their first big freakout about Florida was March 15th,” DeSantis recalls, “which was, there were people on Clearwater Beach, and it was this big deal. That same day is when we signed the executive order to, one, ban visitation in the nursing homes, and two, ban the reintroduction of a COVID-positive patient back into a nursing home.” DeSantis is bemused by the obsession with Florida’s beaches. When they opened in Jacksonville, it was a big national story, usually relayed with a dire tone. “Jacksonville has almost no COVID activity outside of a nursing-home context,” he says. “Their hospitalizations are down, ICU down since the beaches opened a month ago. And yet, nobody talks about it. It’s just like, ‘Okay, we just move on to the next target.’”

The story goes on to describe how DeSantis -- often portrayed as a Trumpy yokel, who holds degrees from Harvard and Yale -- closely examined what was happening in other countries to help shape his own response, which was frustrated by a dearth of strong precedent and best practices in America. The governor and his administration quickly developed a healthy skepticism of dire models, relying instead on on-the-ground data. And it turned out that Florida's emergency infrastructure lent itself to very strong data-gathering, on which decisions were based:

Florida was better able to do that than many states because of its routine experience dealing with natural disasters. “Many states simply did not have the data infrastructure that Florida has,” says Mary Mayhew, secretary of Florida’s Agency for Healthcare Administration. “We have an emergency status system that gets stood up, as I mentioned, in the case of a hurricane. Hospitals and nursing homes and other long-term-care providers are required to submit data on a daily basis, twice-daily basis, regarding their bed availability.” The Florida Department of Health produces a report that DeSantis sees every morning: new cases, number of tests, positivity rates, etc. He also gets a rundown of the people who have gone into hospitals and of ICU usage. He can follow the key indicators down to the county level. This allows granular visibility into what’s happening. He cites the example of rural Hamilton County. It had 67 cases the other day. DeSantis was able to call the surgeon general of the state to find out what was going on, and learn it was an outbreak in a prison rather than a wider community spread.

The data and state leaders' experiences led them to almost immediately prioritize protection and mitigation efforts at nursing homes, which retrospectively seems both patently obvious and like a stroke of life-saving genius. Unlike New York, which allowed COVID-positive employees to continue working at such facilities, and required COVID-positive patients to be readmitted from hospitals, Florida did the opposite. Early on, the state government imposed restrictions and screenings for those wishing to enter nursing homes, rushed large supplies of PPE to these facilities as a priority, and explicitly forbade residents diagnosed with the virus from entering the facilities. A top Florida public health official said they established a "hard line" on this issue, working closely with hospitals to explain why 'normal' procedures would not be acceptable during the coronavirus crisis:

Mary Mayhew had daily calls with the hospitals, with people involved in discharge planning on the line. “Every day on these calls,” she says, “I would hear the same comments and questions around, we need to get these individuals returned back to the nursing home. We drew a hard line early on. I said repeatedly to the hospital, to the CEOs, to the discharge planners, to the chief medical officers, ‘I understand that for 20 years it’s been ingrained, especially through Medicare reimbursement policy, to get individuals in and out. That is not our focus today. I’m not going to send anyone back to a nursing home who has the slightest risk of being positive.’”... Early on, when tests had a slow turnaround, there was a lot of pressure to give way, but Mayhew was unmovable on the question...As the health officials put it, succinctly, “We wanted people out, not in.”

When the state was seeing infections at nursing homes presumably caused by staff, DeSantis deployed what he calls “an expeditionary testing force,” 50 National Guard teams of four guardsmen together with Department of Health personnel that tested staff and residents. Most facilities haven’t had confirmed cases. “But the ones that have,” he says, “the majority of them have had between one and five infections. So the infections are identified, but then, you’re isolating either the individual or the small cluster before you have an outbreak.” ...The state has also started a sentinel surveillance program for long-term-care facilities, routinely taking representative samples to monitor for flare-ups. Finally, it has established several COVID-19-only nursing homes, with a couple more in the pipeline. The idea, again, is to get COVID-19-positive residents out of the regular nursing homes to the maximum extent possible.

The article goes on to explain how DeSantis was an early adopter of region-by-region policies, using county-level data and consulting with local officials to drive decisions, as opposed to imposing knee-jerk "one size fits all" mandates across what the governor describes as a "big, diverse" state. Rather than assailing Florida for open beaches in barely-impacted counties and lecturing DeSantis about science, the national media should have been begging him for pointers and tips to share with other governors, especially in the Northeast. We should remain vigilant, of course, and it's possible that Florida's good fortune will take a tailspin based on premature re-openings. There are data points to keep an eye on, even as we work to keep such numbers in proper context and proportion. But things are looking relatively steady and encouraging so far, and if that trend continues, Lowry is right to ask, "where does Ron DeSantis go to get his apology?" Another governor who may end up in that camp is Georgia's. Brian Kemp's controversial reopening strategy has been underway for weeks now:

To repeat, it's too early for anyone to be taking definitive victory laps; uncertainties and risks remain. Officials need to be nimble and flexible based on changing conditions or data. But the hyperbolic critiques and predictions, almost exclusively directed at Republican leaders, are not panning out thus far. That's good news. Let's hope it continues.



For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCHPOLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

Email me  here (Hotmail address). My Home Pages are here (Academic) or  here  (Personal).  My annual picture page is hereHome page supplement


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