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Suicides on the rise amid stay-at-home order, Bay Area medical professionals say

83 points by abduhl 6y ago

deathgrips 6y ago
At what point are more people killing themselves than are getting saved by quarantine orders? No one is seriously making this calculation.
- mehrdadn 6y ago
  > At what point are more people killing themselves than are getting saved by quarantine orders? No one is seriously making this calculation. >> Doctors at John Muir Medical Center in Walnut Creek say they have seen more deaths by suicide during this quarantine period than deaths from the COVID-19 virus. Looks like some people are, and it made the news.
  - deathgrips 6y ago
    No one in the CDC or state health departments seem to be taking this into account. They're only optimizing for one variable: number of infected and number of covid19 deaths.
    - mehrdadn 6y ago
      You say that as if we've known this since January or something... and as if you have inside knowledge of what those people are investigating right now. Do you? The news on this has just come out. Maybe give them a chance to react before judging?
      - deathgrips 6y ago
        >You say that as if we've known this since January or something Yes, who could have possibly known about covid19 in January? [0] >and as if you have inside knowledge of what those people are investigating right now. Do you? The news on this has just come out. Maybe give them a chance to react before judging? It doesn't take a genius to figure out that forcing people to stay at home, to socially distance themselves from their social support network, and to quit earning a living would have a significant impact on their mental health and a dangerous impact on the mental health of those with mood disorders. Every doctor has been educated on mental illnesses. The CDC had chances to make the right choices in January. It had chances to make the right choices in February. It had chances to make the right choices in March. How long until you think we can judge the CDC? [0] (https://www.reuters.com/article/us-health-coronavirus-testing-specialrep/special-report-how-korea-trounced-u-s-in-race-to-test-people-for-coronavirus-idUSKBN2153BW https://www.reuters.com/article/us-health-coronavirus-testin...)
        mehrdadn 6y ago
        Come on dude. "Known this" in my sentence was not referring to "the existence of COVID-19" but rather "the fact that we would start seeing more suicides than disease deaths today". The right choice was shutting things down. The only question was how long it needs to keep going, which people were still trying to figure out. Now this event might give them more information that might help them figure it out. If you're reasonable you'll give them a chance to see if they'll take it into account. You know full well much of the rest of the executive didn't show remotely as much competence as the CDC about the disease itself for months despite being repeatedly warned even after the outbreak had already occurred, and now you're lashing out at the CDC for not having predicted when the first side effects would start to occur in some cities within 1 day of when you heard the news? Sheesh.
        deathgrips 6y ago
        >The right choice was shutting things down . . . You know full well much of the rest of the executive didn't show remotely as much competence as the CDC about the disease itself for months despite being repeatedly warned even after the outbreak had already occurred This is some "we have always been at war with Eastasia" doublethink. The CDC told people for a long, long time that masks were harmful and using them was stupid. The CDC shut down private and university covid19 testing in Washington. > and now you're lashing out at the CDC for not having predicted when the first side effects would start to occur in some cities within 1 day of when you heard the news? Ask your doctor if job loss and isolation from friends and family is a risk factor for suicide. I talked to a doctor back in early March who predicted that more people would die from suicides than from covid19.
        makomk 6y ago
        We don't know that was the right choice at all. This is a new, untested pandemic response that hasn't been used before, essentially a planet-scale experiment with everyone's futures: https://www.nytimes.com/2020/04/22/us/politics/social-distancing-coronavirus.html https://www.nytimes.com/2020/04/22/us/politics/social-distan... It had some definite opposition from experts when it was developed, and seems to have won out for political reasons.
      - ponker 6y ago
        No, 3+ weeks ago it was obvious that we did “flatten the curve,” healthcare systems would not collapse, NYC would not need 30,000 ventilators, and that is when the stay at home orders should have been lifted. We’re not going to burrow underground until we have a vaccine, so the time is long overdue to start restoring our mental health and economic well being. Those at high risk can isolate further, but the general population has delivered what was asked of it.
        ardy42 6y ago
        > No, 3+ weeks ago it was obvious that we did “flatten the curve,” healthcare systems would not collapse, NYC would not need 30,000 ventilators, and that is when the stay at home orders should have been lifted. That doesn't make any sense. You're basically advocating for stopping treatment as soon as progress is seen, not when the treatment is successful. It'd be like an oncologist saying: > Good news! Your tumor is starting to respond to the chemo, and we've seen a reduction in its rate of growth, so we're going discontinue treatment. The stay at home orders shouldn't be lifted when the curve is flattened, but when the capability is known to exist to keep it flat without the orders.
        ponker 6y ago
        That assumes we go to pre-lockdown behaviors when the order is lifted. Data show that this is not true, that social distancing and work from home started before the orders and will continue after they are lifted. Lifting them allows people to make their own choices.
    - DanBC 6y ago
      No, the CDC will be working hard to understand the rise in rates of death by suicide. Counting death is hard, and counting suicide death in the US is particularly hard because of the regional variations in use of medical examiners and coroners and the cultural drive in some areas to say that a death by suicide was accidental. Here's a link to a CDC page: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm > Finally, the estimates of excess deaths reported here may not be due to COVID-19, either directly or indirectly. Upward trends in other causes of death (e.g., suicide, drug overdose, heart disease) may contribute to excess deaths in some jurisdictions. Future analyses of cause-specific excess mortality may provide additional information about these patterns.
- ibejoeb 6y ago
  It's going to be impossible to track, but surely the financial ruin the governments have compelled people to endure is going to kill many, many thousands of people. It's also not politically advantageous to even consider it, let alone talk about it. In a year, when nobody cares anymore, and people are killing themselves, it will never come back to haunt the policy makers that provoked it all.
  - TeMPOraL 6y ago
    If only many, many thousands of people die due to economic issues, that's still a huge win over what the virus would have done if left to run through the country at full speed. Economic problems would've happened anyway. Global supply chains were already in disarray even before March, as China essentially lost two months of manufacturing output, container ships stopped sailing, and the whole chain was pushed into oscillations it'll take a year or more to recover from (affectionately known as the "bullwhip effect"). Airlines and hotels were done the moment the virus landed in Italy - at this point everyone with half a brain started to cancel any trip they could cancel, weeks before governments in Europe got a clue and started locking down their borders. The only way the government could've saved restaurants, nail salons, et al. from suffering similar fate would be by suppressing all information about the virus and going to full denial mode. Otherwise, the customer base would've mostly evaporated anyway, lockdown or no lockdown, and you'd still have rolling shutdowns as place after place had to be quarantined for 2+ weeks after some employee or customer was found sick. With hotels and restaurants barely surviving on fumes, the pressure on the food supply chain would've been only little worse than it is with these places shut down. Anyway, it's not like the governments around the world started to shut down their countries because they were bored, and wanted to stir things up. They actually dragged their feet for weeks after people following the evolution of the virus started stocking up, limiting interactions, pushing for WFH and practicing social distancing.
    - noobaccount 6y ago
      I immediately know two things about you: 1. You don’t live alone. 2. You have a job. I think we’re all a little short on empathy these days.
- deleted 6y ago
  [deleted]
- jazzyjackson 6y ago
  It is the same conflation as "the lockdown hurts the economy"/"an out of control pandemic hurts the economy" Maybe being told to stay indoors spikes hopelessness, or it could be that living in a country with an out of control pandemic with no end in sight spikes hopelessness. There's a lot of factors that make the world a stressful, bleak looking place besides stay at home orders.
  - makomk 6y ago
    We have other pandemics that we could probably test this hypothesis with, but I suspect that it would be more accurate to say that how we see this particular pandemic is what causes both the massive economic damage and the feelings of hopelessness, suicides, etc. Businesses are losing customers not because the government imposed a lockdown, but because people think they can stop the pandemic and avoid death by staying away. Though there's probably not going to be much enthusiasm from the media towards exploring this idea, since it puts the economic damage etc squarely on their heads.
    - TeMPOraL 6y ago
      > Businesses are losing customers not because the government imposed a lockdown, but because people think they can stop the pandemic and avoid death by staying away. Though there's probably not going to be much enthusiasm from the media towards exploring this idea, since it puts the economic damage etc squarely on their heads. Perhaps let's first explore the question whether they were right. Epidemiology 101 seems to say they absolutely were. The less people interact in close quarters, the less a sickness spread. I have a feeling we're forgetting here that there's an actual virus on the loose. The pandemic isn't a media construct, it's not a mass hysteria. So I think we should also entertain the option that a virus spreading fast through our communities is also responsible for some of the economic damage.
      - noobaccount 6y ago
        Maybe we overreacted just a little bit. Some of these people might’ve just needed a friend.
- raziel2p 6y ago
  maybe let's focus less on the lockdown as the cause of this, and more on the awful social security and mental health services. lockdown/quarantine doesn't suddenly turn normal people suicidal, it just escalates already existing economic hardships or mental problems. also, should be obvious, but we cannot know how many more people would've died if there was no lockdown, so comparing numbers as they are today is really dumb.
miguelmota 6y ago
Isolation paradox: Isolating will help you be less susceptible to illness. Isolation is known to cause higher levels of loneliness, depression, fear, anxiety and weaker immune system increasing susceptibility to illness.
- deathgrips 6y ago
  It's not really a paradox because it's understood. Isolation signals to your body that you are being excluded from your tribe or low on the social ladder, which means your world is now more threatening than it used to be, so you need to use more energy to be hyper-vigilant and responsive to stressors.
  - postsantum 6y ago
    Social status alters immune regulation and response to infection in macaques https://science.sciencemag.org/content/354/6315/1041.full https://science.sciencemag.org/content/354/6315/1041.full
    - deathgrips 6y ago
      Really cool, thanks for the link!
deathgrips 6y ago
>"We all share a concern for the health of our community whether that is COVID-19, mental health, intentional violence or other issues. We continue to actively work with our Behavioral Health Center, County Health and community organizations to increase awareness of mental health issues and provide resources to anyone in need. If you are in a crisis and need help immediately, please call 211 or 800-833-2900 or text 'HOPE' to 20121 now. We are all in this together, and ask the community to please reach out to anyone who you think might be in need during this challenging time. Thank you." Translation: we will do nothing to help you after isolating you from your support networks. Call us when you want to kill yourself.
- theWhores 6y ago
  > Call us when you want to kill yourself. (and what we'll do is have you arrested via ambulance, throw you in jail or a medical ward like a drunk, and not much else, unless you have insurance)
mattigames 6y ago
For an opposite example in Japan the stay-at-home order actually reduced the number of suicides[0]. Maybe mental health treatments being so expensive in the US plays a large role in this and the quarantine is just the trigger. [0] https://www.theguardian.com/world/2020/may/14/japan-suicides-fall-sharply-as-covid-19-lockdown-causes-shift-in-stress-factors https://www.theguardian.com/world/2020/may/14/japan-suicides...
- TeMPOraL 6y ago
  That, or access to said services - which usually depends on the job you have, and many Americans suddenly found themselves without one. A blogger/psychiatrist shares some examples of how this plays out in general: https://slatestarcodex.com/2020/04/24/employer-provided-health-insurance-delenda-est/ https://slatestarcodex.com/2020/04/24/employer-provided-heal... Relevant in particular are all those examples following the pattern of "$something happened, had to switch insurance, now I can no longer see the doctor that helped me over the years, and the new one starts from scratch/does something that essentially cancels the effects of years of therapy". Now throw in the pandemic, and I can easily imagine this starting to be reflected in suicide rates.
- closeparen 6y ago
  "When I don't drink water, I feel thirst" is a not a medical problem for your doctor to fix, it is a description of how humans work. "When I don't have social interaction, I feel despair" is the same. The healthcare system can at best poke the parameters of these systems around the margins. It's not going to eliminate human needs.
  - mattigames 6y ago
    I would like to see some numbers on that, in general people that are mentally strong are less likely to succumb to suicide when isolation hits, and would explain why other countries such as Netherlands and Japan are seeing a _decline_ of suicide rates, decades of being unable to afford mental health are probably a factor in that; I admid there is a good chance it's not as big of a factor like I imagine, and accumulated stress factors seen only in America are to blame.
holler 6y ago
> "I mean we've seen a year's worth of suicide attempts in the last four weeks.” Damn.
SimplyUnknown 6y ago
Funnily enough, yesterday an article appeared[1] claiming the number of suicides in the Netherlands has dropped up to 20 percent. Cause as of yet unknown. Also unclear whether this effect is temporary. One hypothesis the article states is that in normal life people's sensory inputs are overwhelmed and cause anxiety. The sudden calmness the lockdown introduced might have a positive effect. This is, however, in contrast with the paired increased loneliness. [1] https://nos.nl/artikel/2334626-tot-20-procent-minder-zelfdodingen-in-coronatijd.html https://nos.nl/artikel/2334626-tot-20-procent-minder-zelfdod...
- mattigames 6y ago
  Similar suicide rate decline happened in Japan, decline of work stress factors (e.g. commuting, office, boss) are suspected as the cause. https://www.theguardian.com/world/2020/may/14/japan-suicides-fall-sharply-as-covid-19-lockdown-causes-shift-in-stress-factors https://www.theguardian.com/world/2020/may/14/japan-suicides...
  - PopeDotNinja 6y ago
    I wonder what the effects of mass working from home would do for Japanese culture. The concept of salary person sleeping at their desk until it's time to leave is a foreign concept to me. I'd have a hard time believing it if I hadn't heard about it so much.
- theWhores 6y ago
  Probably because business in Amsterdam is down. With all the whores and drug addicts out of business, the profile for deaths of despair likely hinges that much on one single municipality/metro area.
- svaha1728 6y ago
  In the US the culture is imploding, and 20% are without livelihoods, which might explain the opposite effect.
DXA9zE 6y ago
Note that the Netherlands was not "locked down." Only certain places of business have been suspended, like brothels. People go about their lives as normal.
- SimplyUnknown 6y ago
  I don't know if you live in the Netherlands, but stating "only certain businesses like brothels have been suspended" is a massive understatement of the impact of the "intelligent lockdown" as it is called. Bars, gyms, schools have been closed for two months now. Only a few restaurants offer take-out and more offer delivery. Dining in is not possible. Work-from-home is default for everyone I know. Nursing homes have only just been allowing visitors again. It is true that the Netherlands was not locked down, but people definitely are not going normal about their lives.
  - DXA9zE 6y ago
    > It is true that the Netherlands was not locked down, but people definitely are not going normal about their lives. True, it's even better than normal. Let's not pretend that the extent of California's reaction to the coronavirus is even comparable to that of Netherlands, Japan, etc..
    - SimplyUnknown 6y ago
      > True, it's even better than normal. That's definitely not true. > Let's not pretend that the extent of California's reaction to the coronavirus is even comparable to that of Netherlands, Japan You are right, it's not. But that wasn't the point. But pretending that California is the only one suffering and taking measures while the Netherlands or Japan are not is also out of touch with reality.
      - DXA9zE 6y ago
        To the extent that it's relevant to the article in the OP, it could sure be better than normal for a lot of people. Working from home where previously it was not available, minimum wage being paid for people forced to stay home. It's basically a forced vacation. I'm sure some business owners are unhappy, but frankly I find reduced suicide rate predictable.
DXA9zE 6y ago
Japan, like the Netherlands, was not "locked down"
- the-dude 6y ago
  Do you happen to live there? I do. Lots of shops closed, WFH for large parts of the population. Schools of all sorts closed, sports club closed, severe limits to groups of people. No hairdressing, no driving-school, I could go on. edit: I am talking about NL
  - DXA9zE 6y ago
    Are you being arrested and criminally charged in Japan for being outside? Japan is not locked down. California is locked down.
    - deleted 6y ago
      [deleted]
    - watwut 6y ago
      Why was this downvoted? It is true that there is difference between "it is illegal to go outside" and "a lot changed, but you still can go for walk or sport".
      - lern_too_spel 6y ago
        It is not illegal to go outside in California either. Walking, running, bicycling, etc. are encouraged.
        ibejoeb 6y ago
        None of those things are "encouraged." There are non-stop radio spots telling people to stay home. You've got cheeky stuff like Randy Newman singing lyrics like "get away from me" to the frankly dystopian line from George Takei saying, "Stay in splendid isolation." The are otherwise normal people that are still terrified. Anecdotally, I know people who have had the thing and still won't participate in society because they are convinced that they could die. We've really done a good job of disturbing people, and we're going to see weird fallout from it.
jlangenauer 6y ago
One thing to note is that this article quotes one doctor and one nurse at a single hospital. They have obviously seen more suicide attempts than usual, but we must remember this is a single data point and could just be a statistical anomaly. It would be interesting to know if this phenomenon is repeated elsewhere in California or the US, but without knowing that, we can't draw too many conclusions from this article.
- DanBC 6y ago
  We can't draw too many conclusions from the article, but a rise in the rate of suicide would not be a surprise. We know that economic uncertainty, isolation, or lack of access to support all increase deaths by suicide.
  - jxramos 6y ago
    Yep, it's interesting we're absorbing costs in known areas to unknown costs in unknown areas. I'd say focus on the known, and get more skeptical about the worst case scenarios we're comparing against. As always the "compared to what" question is sometimes not even an entity in reality for comparison but a hypothetical, maybe driven by fear.
    - TeMPOraL 6y ago
      Arguably, we know even less about by how much exactly "economic uncertainty, isolation, or lack of access to support" increases suicide rates than we know about how deadly the virus is.
      - jxramos 6y ago
        I don't know about uncertainty per se or on isolation but I know at least with respect to economic downturns, recessions, and slumps and all the relation has been quantified to some extent by economists or social scientists from what I understand. Not sure how much the increase goes but it's considered a measurable thing apparently and has enough history to sketch out some kind of correlation from what I understand. Known territory in otherwords.
boomboomsubban 6y ago
As the article doesn't provide any of the actual numbers of these events, Walnut Creek has 35 confirmed coronavirus cases. The county has 1155 cases and 33 deaths. Suicides is a rare cause of death, usually around .01%. Unless the actual totals are also mentioned, I'm always skeptical of articles attributing some huge change in the rates to some phenomenon. If my really terrible math is correct, this could he around 10 more suicides over this period, which an overworked medical staff may have played a factor in.
- greenyoda 6y ago
  Suicide is not such a rare cause of death. In the U.S., suicide is the second most common form of death among young people, after accidents: > According to the Centers for Disease Control and Prevention (CDC) WISQARS Leading Causes of Death Reports, in 2017: > Suicide was the tenth leading cause of death overall in the United States, claiming the lives of over 47,000 people. > Suicide was the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death among individuals between the ages of 35 and 54. > There were more than twice as many suicides (47,173) in the United States as there were homicides (19,510). Source: https://www.nimh.nih.gov/health/statistics/suicide.shtml https://www.nimh.nih.gov/health/statistics/suicide.shtml (see Table 1 for the statistics)
  - boomboomsubban 6y ago
    >Suicide is not such a rare cause of death. In the U.S., suicide is the second most common form of death among young people, after accidents Death itself is rare for young people. Nothing you've said changes that suicide accounts for about .01% of deaths. It gets discussed far more than other causes as it's preventable, but it's still rare enough that statistics can be misleading.
    - boomboomsubban 6y ago
      Note, I realized I did my math based off the deaths per 100000 number, meaning it's .01% of people commit suicide each year not .01% of deaths. It's still low enough to make statistics misleading, but I called it the wrong thing.
ponker 6y ago
It will be interesting to look at this by the standard Quality Adjusted Life-Years metric, since suicide is more common among young people who have more QALY to lose than typical coronavirus victims.
aaron695 6y ago
This doesn't fit with what would be expected. So we need numbers. The suicides are not expected during lockdown/isolation. It should reduce suicides. They are expected to be economic when people start realising they have lost their jobs and their business have failed and their lives ruined with no way out. This would be more expected at reopen and everyone else is rebuilding, life is very comparative. And why the hell are they asking doctors and not coroners?

83 points by abduhl 6y ago

At what point are more people killing themselves than are getting saved by quarantine orders? No one is seriously making this calculation.

mehrdadn 6y ago
> At what point are more people killing themselves than are getting saved by quarantine orders? No one is seriously making this calculation. >> Doctors at John Muir Medical Center in Walnut Creek say they have seen more deaths by suicide during this quarantine period than deaths from the COVID-19 virus. Looks like some people are, and it made the news.
- deathgrips 6y ago
  No one in the CDC or state health departments seem to be taking this into account. They're only optimizing for one variable: number of infected and number of covid19 deaths.
  - mehrdadn 6y ago
    You say that as if we've known this since January or something... and as if you have inside knowledge of what those people are investigating right now. Do you? The news on this has just come out. Maybe give them a chance to react before judging?
    - deathgrips 6y ago
      >You say that as if we've known this since January or something Yes, who could have possibly known about covid19 in January? [0] >and as if you have inside knowledge of what those people are investigating right now. Do you? The news on this has just come out. Maybe give them a chance to react before judging? It doesn't take a genius to figure out that forcing people to stay at home, to socially distance themselves from their social support network, and to quit earning a living would have a significant impact on their mental health and a dangerous impact on the mental health of those with mood disorders. Every doctor has been educated on mental illnesses. The CDC had chances to make the right choices in January. It had chances to make the right choices in February. It had chances to make the right choices in March. How long until you think we can judge the CDC? [0] (https://www.reuters.com/article/us-health-coronavirus-testing-specialrep/special-report-how-korea-trounced-u-s-in-race-to-test-people-for-coronavirus-idUSKBN2153BW https://www.reuters.com/article/us-health-coronavirus-testin...)
      - mehrdadn 6y ago
        Come on dude. "Known this" in my sentence was not referring to "the existence of COVID-19" but rather "the fact that we would start seeing more suicides than disease deaths today". The right choice was shutting things down. The only question was how long it needs to keep going, which people were still trying to figure out. Now this event might give them more information that might help them figure it out. If you're reasonable you'll give them a chance to see if they'll take it into account. You know full well much of the rest of the executive didn't show remotely as much competence as the CDC about the disease itself for months despite being repeatedly warned even after the outbreak had already occurred, and now you're lashing out at the CDC for not having predicted when the first side effects would start to occur in some cities within 1 day of when you heard the news? Sheesh.
        deathgrips 6y ago
        >The right choice was shutting things down . . . You know full well much of the rest of the executive didn't show remotely as much competence as the CDC about the disease itself for months despite being repeatedly warned even after the outbreak had already occurred This is some "we have always been at war with Eastasia" doublethink. The CDC told people for a long, long time that masks were harmful and using them was stupid. The CDC shut down private and university covid19 testing in Washington. > and now you're lashing out at the CDC for not having predicted when the first side effects would start to occur in some cities within 1 day of when you heard the news? Ask your doctor if job loss and isolation from friends and family is a risk factor for suicide. I talked to a doctor back in early March who predicted that more people would die from suicides than from covid19.
        makomk 6y ago
        We don't know that was the right choice at all. This is a new, untested pandemic response that hasn't been used before, essentially a planet-scale experiment with everyone's futures: https://www.nytimes.com/2020/04/22/us/politics/social-distancing-coronavirus.html https://www.nytimes.com/2020/04/22/us/politics/social-distan... It had some definite opposition from experts when it was developed, and seems to have won out for political reasons.
    - ponker 6y ago
      No, 3+ weeks ago it was obvious that we did “flatten the curve,” healthcare systems would not collapse, NYC would not need 30,000 ventilators, and that is when the stay at home orders should have been lifted. We’re not going to burrow underground until we have a vaccine, so the time is long overdue to start restoring our mental health and economic well being. Those at high risk can isolate further, but the general population has delivered what was asked of it.
      - ardy42 6y ago
        > No, 3+ weeks ago it was obvious that we did “flatten the curve,” healthcare systems would not collapse, NYC would not need 30,000 ventilators, and that is when the stay at home orders should have been lifted. That doesn't make any sense. You're basically advocating for stopping treatment as soon as progress is seen, not when the treatment is successful. It'd be like an oncologist saying: > Good news! Your tumor is starting to respond to the chemo, and we've seen a reduction in its rate of growth, so we're going discontinue treatment. The stay at home orders shouldn't be lifted when the curve is flattened, but when the capability is known to exist to keep it flat without the orders.
        ponker 6y ago
        That assumes we go to pre-lockdown behaviors when the order is lifted. Data show that this is not true, that social distancing and work from home started before the orders and will continue after they are lifted. Lifting them allows people to make their own choices.
  - DanBC 6y ago
    No, the CDC will be working hard to understand the rise in rates of death by suicide. Counting death is hard, and counting suicide death in the US is particularly hard because of the regional variations in use of medical examiners and coroners and the cultural drive in some areas to say that a death by suicide was accidental. Here's a link to a CDC page: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm > Finally, the estimates of excess deaths reported here may not be due to COVID-19, either directly or indirectly. Upward trends in other causes of death (e.g., suicide, drug overdose, heart disease) may contribute to excess deaths in some jurisdictions. Future analyses of cause-specific excess mortality may provide additional information about these patterns.
ibejoeb 6y ago
It's going to be impossible to track, but surely the financial ruin the governments have compelled people to endure is going to kill many, many thousands of people. It's also not politically advantageous to even consider it, let alone talk about it. In a year, when nobody cares anymore, and people are killing themselves, it will never come back to haunt the policy makers that provoked it all.
- TeMPOraL 6y ago
  If only many, many thousands of people die due to economic issues, that's still a huge win over what the virus would have done if left to run through the country at full speed. Economic problems would've happened anyway. Global supply chains were already in disarray even before March, as China essentially lost two months of manufacturing output, container ships stopped sailing, and the whole chain was pushed into oscillations it'll take a year or more to recover from (affectionately known as the "bullwhip effect"). Airlines and hotels were done the moment the virus landed in Italy - at this point everyone with half a brain started to cancel any trip they could cancel, weeks before governments in Europe got a clue and started locking down their borders. The only way the government could've saved restaurants, nail salons, et al. from suffering similar fate would be by suppressing all information about the virus and going to full denial mode. Otherwise, the customer base would've mostly evaporated anyway, lockdown or no lockdown, and you'd still have rolling shutdowns as place after place had to be quarantined for 2+ weeks after some employee or customer was found sick. With hotels and restaurants barely surviving on fumes, the pressure on the food supply chain would've been only little worse than it is with these places shut down. Anyway, it's not like the governments around the world started to shut down their countries because they were bored, and wanted to stir things up. They actually dragged their feet for weeks after people following the evolution of the virus started stocking up, limiting interactions, pushing for WFH and practicing social distancing.
  - noobaccount 6y ago
    I immediately know two things about you: 1. You don’t live alone. 2. You have a job. I think we’re all a little short on empathy these days.
deleted 6y ago
[deleted]
jazzyjackson 6y ago
It is the same conflation as "the lockdown hurts the economy"/"an out of control pandemic hurts the economy" Maybe being told to stay indoors spikes hopelessness, or it could be that living in a country with an out of control pandemic with no end in sight spikes hopelessness. There's a lot of factors that make the world a stressful, bleak looking place besides stay at home orders.
- makomk 6y ago
  We have other pandemics that we could probably test this hypothesis with, but I suspect that it would be more accurate to say that how we see this particular pandemic is what causes both the massive economic damage and the feelings of hopelessness, suicides, etc. Businesses are losing customers not because the government imposed a lockdown, but because people think they can stop the pandemic and avoid death by staying away. Though there's probably not going to be much enthusiasm from the media towards exploring this idea, since it puts the economic damage etc squarely on their heads.
  - TeMPOraL 6y ago
    > Businesses are losing customers not because the government imposed a lockdown, but because people think they can stop the pandemic and avoid death by staying away. Though there's probably not going to be much enthusiasm from the media towards exploring this idea, since it puts the economic damage etc squarely on their heads. Perhaps let's first explore the question whether they were right. Epidemiology 101 seems to say they absolutely were. The less people interact in close quarters, the less a sickness spread. I have a feeling we're forgetting here that there's an actual virus on the loose. The pandemic isn't a media construct, it's not a mass hysteria. So I think we should also entertain the option that a virus spreading fast through our communities is also responsible for some of the economic damage.
    - noobaccount 6y ago
      Maybe we overreacted just a little bit. Some of these people might’ve just needed a friend.
raziel2p 6y ago
maybe let's focus less on the lockdown as the cause of this, and more on the awful social security and mental health services. lockdown/quarantine doesn't suddenly turn normal people suicidal, it just escalates already existing economic hardships or mental problems. also, should be obvious, but we cannot know how many more people would've died if there was no lockdown, so comparing numbers as they are today is really dumb.

miguelmota 6y ago

Isolation paradox: Isolating will help you be less susceptible to illness. Isolation is known to cause higher levels of loneliness, depression, fear, anxiety and weaker immune system increasing susceptibility to illness.

deathgrips 6y ago
It's not really a paradox because it's understood. Isolation signals to your body that you are being excluded from your tribe or low on the social ladder, which means your world is now more threatening than it used to be, so you need to use more energy to be hyper-vigilant and responsive to stressors.
- postsantum 6y ago
  Social status alters immune regulation and response to infection in macaques https://science.sciencemag.org/content/354/6315/1041.full https://science.sciencemag.org/content/354/6315/1041.full
  - deathgrips 6y ago
    Really cool, thanks for the link!

deathgrips 6y ago

>"We all share a concern for the health of our community whether that is COVID-19, mental health, intentional violence or other issues. We continue to actively work with our Behavioral Health Center, County Health and community organizations to increase awareness of mental health issues and provide resources to anyone in need. If you are in a crisis and need help immediately, please call 211 or 800-833-2900 or text 'HOPE' to 20121 now. We are all in this together, and ask the community to please reach out to anyone who you think might be in need during this challenging time. Thank you." Translation: we will do nothing to help you after isolating you from your support networks. Call us when you want to kill yourself.

theWhores 6y ago
> Call us when you want to kill yourself. (and what we'll do is have you arrested via ambulance, throw you in jail or a medical ward like a drunk, and not much else, unless you have insurance)

mattigames 6y ago

For an opposite example in Japan the stay-at-home order actually reduced the number of suicides[0]. Maybe mental health treatments being so expensive in the US plays a large role in this and the quarantine is just the trigger. [0] https://www.theguardian.com/world/2020/may/14/japan-suicides-fall-sharply-as-covid-19-lockdown-causes-shift-in-stress-factors https://www.theguardian.com/world/2020/may/14/japan-suicides...

TeMPOraL 6y ago
That, or access to said services - which usually depends on the job you have, and many Americans suddenly found themselves without one. A blogger/psychiatrist shares some examples of how this plays out in general: https://slatestarcodex.com/2020/04/24/employer-provided-health-insurance-delenda-est/ https://slatestarcodex.com/2020/04/24/employer-provided-heal... Relevant in particular are all those examples following the pattern of "$something happened, had to switch insurance, now I can no longer see the doctor that helped me over the years, and the new one starts from scratch/does something that essentially cancels the effects of years of therapy". Now throw in the pandemic, and I can easily imagine this starting to be reflected in suicide rates.
closeparen 6y ago
"When I don't drink water, I feel thirst" is a not a medical problem for your doctor to fix, it is a description of how humans work. "When I don't have social interaction, I feel despair" is the same. The healthcare system can at best poke the parameters of these systems around the margins. It's not going to eliminate human needs.
- mattigames 6y ago
  I would like to see some numbers on that, in general people that are mentally strong are less likely to succumb to suicide when isolation hits, and would explain why other countries such as Netherlands and Japan are seeing a _decline_ of suicide rates, decades of being unable to afford mental health are probably a factor in that; I admid there is a good chance it's not as big of a factor like I imagine, and accumulated stress factors seen only in America are to blame.

holler 6y ago

> "I mean we've seen a year's worth of suicide attempts in the last four weeks.” Damn.

SimplyUnknown 6y ago

Funnily enough, yesterday an article appeared[1] claiming the number of suicides in the Netherlands has dropped up to 20 percent. Cause as of yet unknown. Also unclear whether this effect is temporary. One hypothesis the article states is that in normal life people's sensory inputs are overwhelmed and cause anxiety. The sudden calmness the lockdown introduced might have a positive effect. This is, however, in contrast with the paired increased loneliness. [1] https://nos.nl/artikel/2334626-tot-20-procent-minder-zelfdodingen-in-coronatijd.html https://nos.nl/artikel/2334626-tot-20-procent-minder-zelfdod...

mattigames 6y ago
Similar suicide rate decline happened in Japan, decline of work stress factors (e.g. commuting, office, boss) are suspected as the cause. https://www.theguardian.com/world/2020/may/14/japan-suicides-fall-sharply-as-covid-19-lockdown-causes-shift-in-stress-factors https://www.theguardian.com/world/2020/may/14/japan-suicides...
- PopeDotNinja 6y ago
  I wonder what the effects of mass working from home would do for Japanese culture. The concept of salary person sleeping at their desk until it's time to leave is a foreign concept to me. I'd have a hard time believing it if I hadn't heard about it so much.
theWhores 6y ago
Probably because business in Amsterdam is down. With all the whores and drug addicts out of business, the profile for deaths of despair likely hinges that much on one single municipality/metro area.
svaha1728 6y ago
In the US the culture is imploding, and 20% are without livelihoods, which might explain the opposite effect.

DXA9zE 6y ago

Note that the Netherlands was not "locked down." Only certain places of business have been suspended, like brothels. People go about their lives as normal.

SimplyUnknown 6y ago
I don't know if you live in the Netherlands, but stating "only certain businesses like brothels have been suspended" is a massive understatement of the impact of the "intelligent lockdown" as it is called. Bars, gyms, schools have been closed for two months now. Only a few restaurants offer take-out and more offer delivery. Dining in is not possible. Work-from-home is default for everyone I know. Nursing homes have only just been allowing visitors again. It is true that the Netherlands was not locked down, but people definitely are not going normal about their lives.
- DXA9zE 6y ago
  > It is true that the Netherlands was not locked down, but people definitely are not going normal about their lives. True, it's even better than normal. Let's not pretend that the extent of California's reaction to the coronavirus is even comparable to that of Netherlands, Japan, etc..
  - SimplyUnknown 6y ago
    > True, it's even better than normal. That's definitely not true. > Let's not pretend that the extent of California's reaction to the coronavirus is even comparable to that of Netherlands, Japan You are right, it's not. But that wasn't the point. But pretending that California is the only one suffering and taking measures while the Netherlands or Japan are not is also out of touch with reality.
    - DXA9zE 6y ago
      To the extent that it's relevant to the article in the OP, it could sure be better than normal for a lot of people. Working from home where previously it was not available, minimum wage being paid for people forced to stay home. It's basically a forced vacation. I'm sure some business owners are unhappy, but frankly I find reduced suicide rate predictable.

DXA9zE 6y ago

Japan, like the Netherlands, was not "locked down"

the-dude 6y ago
Do you happen to live there? I do. Lots of shops closed, WFH for large parts of the population. Schools of all sorts closed, sports club closed, severe limits to groups of people. No hairdressing, no driving-school, I could go on. edit: I am talking about NL
- DXA9zE 6y ago
  Are you being arrested and criminally charged in Japan for being outside? Japan is not locked down. California is locked down.
  - deleted 6y ago
    [deleted]
  - watwut 6y ago
    Why was this downvoted? It is true that there is difference between "it is illegal to go outside" and "a lot changed, but you still can go for walk or sport".
    - lern_too_spel 6y ago
      It is not illegal to go outside in California either. Walking, running, bicycling, etc. are encouraged.
      - ibejoeb 6y ago
        None of those things are "encouraged." There are non-stop radio spots telling people to stay home. You've got cheeky stuff like Randy Newman singing lyrics like "get away from me" to the frankly dystopian line from George Takei saying, "Stay in splendid isolation." The are otherwise normal people that are still terrified. Anecdotally, I know people who have had the thing and still won't participate in society because they are convinced that they could die. We've really done a good job of disturbing people, and we're going to see weird fallout from it.

jlangenauer 6y ago

One thing to note is that this article quotes one doctor and one nurse at a single hospital. They have obviously seen more suicide attempts than usual, but we must remember this is a single data point and could just be a statistical anomaly. It would be interesting to know if this phenomenon is repeated elsewhere in California or the US, but without knowing that, we can't draw too many conclusions from this article.

DanBC 6y ago
We can't draw too many conclusions from the article, but a rise in the rate of suicide would not be a surprise. We know that economic uncertainty, isolation, or lack of access to support all increase deaths by suicide.
- jxramos 6y ago
  Yep, it's interesting we're absorbing costs in known areas to unknown costs in unknown areas. I'd say focus on the known, and get more skeptical about the worst case scenarios we're comparing against. As always the "compared to what" question is sometimes not even an entity in reality for comparison but a hypothetical, maybe driven by fear.
  - TeMPOraL 6y ago
    Arguably, we know even less about by how much exactly "economic uncertainty, isolation, or lack of access to support" increases suicide rates than we know about how deadly the virus is.
    - jxramos 6y ago
      I don't know about uncertainty per se or on isolation but I know at least with respect to economic downturns, recessions, and slumps and all the relation has been quantified to some extent by economists or social scientists from what I understand. Not sure how much the increase goes but it's considered a measurable thing apparently and has enough history to sketch out some kind of correlation from what I understand. Known territory in otherwords.

boomboomsubban 6y ago

As the article doesn't provide any of the actual numbers of these events, Walnut Creek has 35 confirmed coronavirus cases. The county has 1155 cases and 33 deaths. Suicides is a rare cause of death, usually around .01%. Unless the actual totals are also mentioned, I'm always skeptical of articles attributing some huge change in the rates to some phenomenon. If my really terrible math is correct, this could he around 10 more suicides over this period, which an overworked medical staff may have played a factor in.

greenyoda 6y ago
Suicide is not such a rare cause of death. In the U.S., suicide is the second most common form of death among young people, after accidents: > According to the Centers for Disease Control and Prevention (CDC) WISQARS Leading Causes of Death Reports, in 2017: > Suicide was the tenth leading cause of death overall in the United States, claiming the lives of over 47,000 people. > Suicide was the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death among individuals between the ages of 35 and 54. > There were more than twice as many suicides (47,173) in the United States as there were homicides (19,510). Source: https://www.nimh.nih.gov/health/statistics/suicide.shtml https://www.nimh.nih.gov/health/statistics/suicide.shtml (see Table 1 for the statistics)
- boomboomsubban 6y ago
  >Suicide is not such a rare cause of death. In the U.S., suicide is the second most common form of death among young people, after accidents Death itself is rare for young people. Nothing you've said changes that suicide accounts for about .01% of deaths. It gets discussed far more than other causes as it's preventable, but it's still rare enough that statistics can be misleading.
  - boomboomsubban 6y ago
    Note, I realized I did my math based off the deaths per 100000 number, meaning it's .01% of people commit suicide each year not .01% of deaths. It's still low enough to make statistics misleading, but I called it the wrong thing.

ponker 6y ago

It will be interesting to look at this by the standard Quality Adjusted Life-Years metric, since suicide is more common among young people who have more QALY to lose than typical coronavirus victims.

aaron695 6y ago

This doesn't fit with what would be expected. So we need numbers. The suicides are not expected during lockdown/isolation. It should reduce suicides. They are expected to be economic when people start realising they have lost their jobs and their business have failed and their lives ruined with no way out. This would be more expected at reopen and everyone else is rebuilding, life is very comparative. And why the hell are they asking doctors and not coroners?