
Suicides on the rise amid stay-at-home order, Bay Area medical professionals say - abduhl
https://abc7news.com/suicide-covid-19-coronavirus-rates-during-pandemic-death-by/6201962/
======
SimplyUnknown
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-
zelfdod...](https://nos.nl/artikel/2334626-tot-20-procent-minder-zelfdodingen-
in-coronatijd.html)

~~~
mattigames
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...](https://www.theguardian.com/world/2020/may/14/japan-suicides-
fall-sharply-as-covid-19-lockdown-causes-shift-in-stress-factors)

~~~
PopeDotNinja
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.

------
deathgrips
>"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
> 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)

------
jlangenauer
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
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
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
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
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.

~~~
pmiller2
"Quantified to some extent," yes, but not as rigorously as the effects of
SARS-Cov-2. Basic epidemiological models tell us that we at least 60% or so of
the population to be immune in order to reach herd immunity. Based on an
infection fatality rate of 0.5% and a US population of about 328M, you
multiply that out to get an order of magnitude estimate of ~1M dead, whereas
during the Great Depression (probably our closest comparison point to what's
going on now), as well as the recessions of 1921 and 1938, life expectancy
actually increased; the only cause of death that increased was suicide [0].

There are things we don't know about this virus, such as what exactly the
residual effects are on survivors, whether and for how long infection can
provide immunity, what the role of vitamin D is, and many other things, but
those uncertainties largely don't matter to epidemiological models at this
point. We can simply run best and worst case type scenarios to get an idea
what we're dealing with if we're thinking solely about the death rate. And,
even if we underestimate the death rate, if there are severe and long-lasting
aftereffects, that only compounds the need to do something to stop the virus.

IMO, the "knowns" surrounding economic correlations with decreased life
expectancy are far, far more unknown than those surrounding a very contagious
virus that kills people.

And, as I have said before, to much controversy, if a science-based, public
health response to a public health crisis cripples the economy, that's a sign
that _our economic system is broken_ , not that we're overreacting to save
lives, just to doom people to economic misery.

\---

[0]:
[https://www.pnas.org/content/106/41/17290](https://www.pnas.org/content/106/41/17290)

~~~
jxramos
I guess that's the thing with me and epidemiological models. I think for the
bulk of Americans, maybe even people around the world, these models haven't
really entered into everyday life with the ramifications of their accuracy.
It's more convincing to know that economics have looked retroactively at past
events and ran correlations to partly explain lived experiences. Past
performance is no guarantee of future performance as the saying goes, and I"m
not sure who actively tracks the next economic declines to continue to test
whatever correlation models people have come up with to predict negative side
effects on people's lives, but presumably they've landed roughly well enough
patterns to predict something reliably, maybe not though.

But the more urgent predictions at this point come from epidemiologists. And I
wonder have epidemiologists had a good track record at predicting previous
outbreaks accurately, say SARS, ebola, whatever, 20th and 21st century stuff?
As of today we're two orders of magnitude off from those worst case scenario
of millions of deaths in the US I thought were surely coming. I guess another
question is how long were these millions of deaths expected to arrive, in 12
months, 18 months?

That's a good point, how fragile or robust should an economy be expected to be
to wait things out. The fact that lots of companies operate off debt probably
doesn't bode well for them weathering any significant storm. Can't build a
house on sand and expect it to stand as the saying goes.

~~~
DanBC
> As of today we're two orders of magnitude off from those worst case scenario
> of millions of deaths in the US I thought were surely coming

Epidemiologists gave a range of outcomes, taking into account what they know
at the time, and what measures are or could be in place.

The millions of death outcome is if no lockdown measures are put in place and
people don't social distance.

------
mattigames
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...](https://www.theguardian.com/world/2020/may/14/japan-suicides-
fall-sharply-as-covid-19-lockdown-causes-shift-in-stress-factors)

~~~
closeparen
"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.

~~~
TeMPOraL
It's not the same. Unlike with water and thirst, "when I don't have social
interaction, I feel despair" is not true for many people, and for those for
whom it is, it really depends on what they consider "social interaction" and
how much they really "don't have" it.

You could do a rough ordering of quality of social interactions, lowest to
highest: no interaction, text messages, IMs, phone calls, video calls, face to
face meetings. Most people these days have access to _at least_ phone calls,
and my guess is that more than 50% can do video calls with most of their
social circle. It's not perfect. Drinking rain water instead of a hot tea
isn't ideal either - though it will sustain your life.

Point being, it was expected that limiting people's meatspace interactions
will cause psychological pressure to build up, but the extent and seriousness
of it is far from obvious.

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

Damn.

------
miguelmota
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
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
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
Really cool, thanks for the link!

------
boomboomsubban
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
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
>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
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.

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

~~~
ibejoeb
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
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
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.

~~~
TeMPOraL
Huh.

Point taken. Thank you for reminding me. You're correct in both guesses, and I
do sometimes forget that I'm not suffering through the worst of it.

~~~
exmadscientist
And:

3\. You and your loved ones are not dealing with mental illnesses that were
under control before the lockdown, but losing control during and after it.

This thing is _really hard_ on some people.

(The above is _not_ intended to castigate you or drag you through the mud.
Just a reminder that everyone's a little different.)

~~~
TeMPOraL
That's a good point too, but honestly, the continued lockdown is getting to us
too. Probably not enough to qualify for treatment, but enough to be mindful of
our own mental states. But I know many others have it much worse.

------
DXA9zE
Japan, like the Netherlands, was not "locked down"

~~~
the-dude
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
Are you being arrested and criminally charged in Japan for being outside?

Japan is not locked down. California is locked down.

~~~
watwut
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
It is not illegal to go outside in California either. Walking, running,
bicycling, etc. are encouraged.

~~~
ibejoeb
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.

~~~
mattigames
A lot of those terrified people did indeed die; exactly 1 every 4000 people
(in the US), plus a lot more will die in the following months, not to mention
the ones that "recover" but thanks to permanent damage to their lungs and
other organs will die in the next few years due complications from it, so
please let's not talk like those fears are unfounded.

~~~
mikem170
1 in 4000 is not a lot, as deadly pandemics go.

I'm not aware of numbers on permanent lung damage. Too much of the news seems
to be fear-mongering anecdotes when we could really use all the objective
facts we can get.

~~~
mattigames
Permanent damage will only be calculated months or years from now, because
x-rays and every other machine to investigate that has a slightly more
important job right now, so any decision will probably have to be taken before
we get the "objective facts" you want.

You can call it fear mongering or whatever you want but the statistics show
1.3% death rate of infected in the us[0], meaning approx. 1 every 100 people
with the virus is dying, and the white house estimates a max of 240.000 deaths
before this ends[1], you could still say 1 every 2000 is not a lot, and then
you may realize how important any number of deaths is its completely
subjective based on your own perceived value of human lives, maybe even 3999
deaths every 4000 is not much for some people because logically speaking the
surviving people can repopulate the planet, and maybe in such case we should
be really worried about not injecting any fear mongering into that 1 person
that will survive.

[0]
[https://www.google.com/amp/s/medicalxpress.com/news/2020-05-...](https://www.google.com/amp/s/medicalxpress.com/news/2020-05-covid-
death.amp)

[1]
[https://www.washingtonpost.com/world/2020/03/31/coronavirus-...](https://www.washingtonpost.com/world/2020/03/31/coronavirus-
latest-news/ñ)

~~~
mikem170
The news is full of scary anecdotes, because that gets clicks. People are
rightfully starved for information, the data is fuzzy, incomplete, and
complicated, the situation is unusual, has evolved, became politicized
unfortunately, etc.

I'd like to think you and I could agree in general to a broad set of known
facts, and certain ranges of predictions, a set of possible outcomes, etc. But
I think we'd still disagree on how to proceed! That's the part I'm curious to
talk about. I don't mean to be argumentative with any of this or quibble over
details, just trying to share my line of thinking, and curious about yours.

I can agree with the predicted 240k deaths in the U.S. you quoted, I guess
that would be about 1 in 1375 people in a country of 330 million. I end up
comparing those odds to the 863 of every 100k people how in any given year
[1], which is 1 in 115, or almost 12 in 1375. These numbers vary by age, but
the averages serve as decent enough discussion points when we talk about a
large population in aggregate, which is how I look at this.

I'd feel differently if it were easier/possible to save those 1 in 1375 people
who will die from covid, but it's not. The lockdowns were successful keeping
hospitals from being overwhelmed (something I supported), but there is zero
indication that we can stop this with lockdowns, quarantines, or contact
tracing at this point. There are too many infected people. The odds are that
there will not be a vaccine for many years, either.

Experts say that the most likely outcomes are that this virus decreases in
severity to become another variant of the common cold, or comes up
occasionally making for something like a bad flu year [3]

I feel bad for the tens of millions of folks in the U.S. negatively impacted
by the lockdowns, especially without evidence supporting that lockdowns will
make a long term difference if hospitals are not overwhelmed. I'm afraid the
economic price to pay is going to be terrible for so many people, so many
lives turned upside down, that the economy is going to get a lot worse before
it gets better. Look what happened after the 2008 recession, the protests, the
ascendency of right wing national politicians, civil wars in the middle east,
etc. This looks like it could be worse. I feel horrible about the added debt
being passed to the younger generation for this stuff, why should they pay
with a lower standard of living because collectively we can't save for a rainy
day?

At this point it seems best to me to support hospitals and what we know works,
including helping the vulnerable self-isolate. I don't think it's justified to
force unwilling people into lockdowns unless hospitals are becoming
overwhelmed.

[1]
[http://www.cdc.gov/nchs/fastats/deaths.htm](http://www.cdc.gov/nchs/fastats/deaths.htm)
[2]
[http://www.cdc.gov/nchs/data/dvs/MortFinal2007_Worktable23r....](http://www.cdc.gov/nchs/data/dvs/MortFinal2007_Worktable23r.pdf)
[3] [https://www.statnews.com/2020/02/04/two-scenarios-if-new-
cor...](https://www.statnews.com/2020/02/04/two-scenarios-if-new-coronavirus-
isnt-contained/)

~~~
mattigames
So many falsehoods and dubious claims in your comments for someone claiming to
be basing his opinion on facts: China already injected 100 people with a
vaccine under a trial[0], Oxford will soon inject 10000, both said it will
take months to know if the vaccine truly worked as intended but is nothing
like your claim of "years".

> "[is not] possible to save those 1 in 1375 people who will die from covid"

You know which day of the week surgeries are most successful? Monday, can you
guess why that is? Is because surgeons are most relaxed after a weekend and
are fully rested and ready to fully focus on the procedure at hand, that
should give you a small glimpse to the giant difference between treating 100
people one week and treating 1 person per week in the course of 100 weeks; in
simpler words: The less people are in the hospital the more likely the ones
there will receive plentiful care and monitoring, understanding that isn't
rocket science.

[0] [https://www.livescience.com/coronavirus-vaccine-
adenovirus-c...](https://www.livescience.com/coronavirus-vaccine-adenovirus-
china.html)

[1] [https://www.euronews.com/2020/05/22/coronavirus-more-
than-10...](https://www.euronews.com/2020/05/22/coronavirus-more-
than-10-000-people-to-be-recruited-as-oxford-vaccine-enters-its-next-tria)

~~~
mikem170
What specified falsehoods and dubious claims did you find in my comment?

They oxford trails may fail because they can't find enough infected people,
our of 10k volunteers they are worried they might not have 50 infected people,
less than 20 and the trial is a failure [1]. The numbers show that this is
disappearing, at least this wave.

>The less people are in the hospital the more likely the ones there will
receive plentiful care and monitoring, understanding that isn't rocket
science.

Are you justifying leaving 40 million Americans unemployed, their lives up in
the air, based on the supposed marginal differences between Monday and non-
Monday surgeries? Don't you worry about the damage the lockdowns are causing?
Do we burden younger generations with more debt and a lower future standard of
living when the hospitals are not overcrowded?

I stated my line of thinking, why I went from being scared of the virus in
March to being more scared of the damage from the lockdowns by the end of
April.

What is your line of thinking? Do you worry about the damage the lockdowns are
causing? Do you think the lockdowns are working to eliminate the virus? When
do you think is a good time to stop the lockdowns? Do you think it's fair to
lockdown people who don't feel the way you do?

I'm genuinely curious about why you think the way you do.

[1] [https://www.bloomberg.com/news/articles/2020-05-24/oxford-
un...](https://www.bloomberg.com/news/articles/2020-05-24/oxford-university-
vaccine-trials-run-into-hurdle-telegraph)

------
DXA9zE
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
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
> 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
> 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
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.

------
aaron695
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?

