LAUSR

251 suicides over the two-year period, representing an 8.4% increase in suicides (when compared to the 2018 rate of 48,432). What is especially concerning about our projections is the genuine uncertainty with respect to the labour market post-COVID-19, as well as the tremendous financial uncertainty and decrease in consumer sentiment, all of which are independent and additional contributors to suicide. Moreover, social isolation and quarantine, which are critical viral transmission risk mitigation strategies, are recommended nation-wide. Social isolation is well established as a significant risk factor for suicidality. Multiple studies have reported that government policy response can significantly mitigate the increased risk of suicide due to economic hardship and unfavourable labour market dynamics. For example, in Japan, a 1% per capita increase in local government expenditures was associated with a 0.2% decrease in suicide in the years following the 2008 recession. The Japanese experience was replicated in Europe, wherein government spending, especially on social programs intended to mitigate suicide risk, significantly reduced projected suicides in Denmark. Preventing suicide in the context of the COVID-19-related unemployment and financial insecurity is a critical public health priority. In addition to financial provisions (e.g., tax deferral, wage subsidy), investing in labour market programs that intend to retrain workers is warranted. Furthermore, government support for employers is critical to reduce the massive increase in unemployment and contraction of the labour market. Proactive public-private partnerships that aim to provide psychological first-aid and psychiatric emergency services to persons at imminent risk of suicide are essential. Individual resilience enhancement strategies should be implemented (e.g., exercise, sleep hygiene, structured daily schedule, better diet). Approximately half of suicides in the US are committed with a gun; recommendations surrounding appropriate gun and ammunition storage are warranted. For persons with clinically significant depressive/anxiety symptoms or persons experiencing features of post-traumatic stress disorder or drug/alcohol abuse, timely access to comprehensive treatment should be part of the COVID-19 management strategy.