The mystery vaping illness that has killed more than 50 Americans has peaked authorities say ー but medical professionals caution that there's still cause for concern over the health effects of vaping.
"The outbreak is getting better. The level of new cases is greatly reduced and has been declining from a peak in September," said Dr. Anne Schuchat, Principal Deputy Director of the Centers for Disease Control. "Unfortunately despite this improvement we have new issues of concern to share this week."
Over the course of months of investigation into the illness, local authorities in partnership with CDC have narrowed in on a cause for the vaping illness that has sickened 2,506 and killed 54: thickening agent vitamin E acetate. On a Friday call with media, Schuchat reaffirmed that CDC believes "vitamin E acetate has caused the EVALI syndrome in the vast majority of patients."
The additive, which has accepted uses in topical products and as a dietary supplement, burst onto the scene as a thickening agent for THC vape products sometime in 2019, judging by the sharp spike in hospitalizations this year. For some time, the public wondered whether the vape crisis was actually a common syndrome that only recently earned recognition, but the CDC on Friday confirmed the illnesses are a "new phenomenon."
Officials say the crisis, which kicked off sometime in July, peaked in September and has dropped off since, but that vape users shouldn't get too comfortable yet. Health professionals still do not know the exact mechanism of harm of vitamin E acetate, and they suspect there may be more than one cause of e-cigarette, or vaping, product use-associated lung injury (EVALI). Since September, regulators have been recommending people avoid THC vaping products, especially those acquired informally ー or from family, friends, or illicit dealers. They haven't loosened their stance concerning products purchased from licensed retail shops in states where cannabis is legal, but on Friday, Schuchat admitted that there are protections in place in licensed cannabis markets.
"The vast majority of individuals report getting products informally," Schuchat said. "That doesn't mean that there are not individual pretty well-documented episodes where the report is pretty clear the person got a product from a licensed dispensary, but it does sound like there's a lot more protection involved with the way dispensaries are regulated than with the illicit market."
Furthermore, regulators have responded quickly to CDC's fundings. Authorities in states like Colorado, Ohio, Oregon, and Washington have taken steps to prohibit vitamin E acetate in vape products. Even outside of the realm of EVALI, there is still much that health professionals don't know about the long term effects of using THC or nicotine vape products. CDC officials warned that there are likely other substances in vape products that are capable of causing lung injury ー and health professionals agree.
Dr. Gary Kohn, a pulmonologist at Summit Medical Group in New Jersey, knows first hand the devastation that EVALI can cause. He treated an EVALI patient. Vaping will not be safe, Kohn emphasized, even once authorities get to the bottom of the vape crisis.
"Physicians know that your lungs like air, unpolluted air. As soon as you vape or you inhale products that are not air, you are putting your lungs at risk. Right now, the focus is on the e-cigarettes and the vaping of THC products, but it wasn't that long ago that there were discussions about hookah bars. At the end of the day, your body was built for air, not for smoke, vapor, or any of those type of products," he said.
There is still much to learn about vaping and the ongoing acute illness, EVALI, but authorities are making progress. And at least for now, authorities say the worst is likely over.