Big drop reported in Vaping by United States teenagers

Vaping by United States teenagers fell dramatically this year, especially among middle schoolers. Experts think 2019’s outbreak of vaping-related illnesses and deaths may have scared off some kids, but other factors contributed to the drop, including higher age limits and flavor bans. Just under 20 percent of high school students and 5 percent of middle school students were recent users of electronic cigarettes and other vaping products.

That marks a big decline from 2019 that found about 28 percent of high school students and 11 percent of middle school students recently vaped. The number suggests that school children who vape fell by 1.8 million in a year, from 5.4 million to 3.6 million. But even as teen use declined, there is a big bump in use of disposable e-cigarettes. In early 2020, the Food and Drug Administration (FDA) barred flavors from small vaping devices like Juul and others that are mainly used by minors.

The policy did not apply to disposable e-cigarettes, which can still contain sweet, candylike flavors. As long as any flavored e-cigarettes are left on the market, kids will get their hands on them and the government will not solve this crisis. The national survey is conducted at schools each year by the Centers for Disease Control and Prevention (CDC) and usually involves about 20,000 middle and high school students.

The national survey asks students if they had used any vaping or traditional tobacco products in the previous month.

The national survey was cut short this year as schools closed because of the covid pandemic. Federal health officials believe measures like public health media campaigns, price increase, and sales restrictions deserve credit for the vaping decline. The age limit for sales is now 21. But health officials also acknowledge the outbreak probably played a part.

Sales started falling in August when national media coverage of the outbreak intensified. It is possible that some of the heightened awareness could have influenced decline in use. By the time the outbreak was winding down early 2020, more than 2,800 illnesses and 68 deaths had been reported. Most of those who got sick said they vaped solutions containing THC, the ingredient that produces a high in marijuana.

CDC officials gradually focused their investigation on black market THC cartridges, and on a chemical compound called vitamin E acetate that had been added to illicit THC vaping liquids. The teen vaping drop was larger than expected, this does look like a very substantial decrease in a single year and it is very encouraging. Among the likely factors is the general negative publicity surrounding vaping.

Additionally, Juul preemptively pulled all its vaping flavors except menthol and tobacco last fall ahead of federal action.

Researchers have tracked a recent decline in teen smoking to all-time lows, about 6% even as vaping has increased. It will be critical to watch whether teen smoking begins rising again as fewer teens vape. The new figures were disclosed on the same day that all United States vaping manufacturers faced a long-delayed deadline to submit their products for FDA review.

Generally, that means the vaping companies must show that their products help smokers reduce or quit their use of cigarettes and other tobacco products. E-cigarettes first appeared in the United States more than a decade ago and have grown in popularity with minimal federal regulation. In August 2020, looking back to the early days of the covid pandemic, White House covid task force coordinator Doctor Deborah Birx wished the United States had gone into a stricter lockdown.

Birx wished that when the United States went into lockdown in March, it looked like Italy. When Italy locked down, people were not allowed out of their houses without a pass. People in the United States do not react well to that kind of prohibition. In Italy as the virus spread, residents were told to stay home and only leave for essential activities.

Authorities would stop people and check to make sure they had documents that said where and why they were traveling.

In a roundtable discussion hosted by Arkansas Governor Asa Hutchinson, Birx learnt what Americans are willing to do to combat the virus, and that officials must meet people where they are. Birx cited the strategy Arizona has used to reduce the rising number of cases. People were still able to go to malls and restaurants at reduced capacity, but gyms and bars were closed, mask mandates were implemented, and gatherings of more than 10 people were prohibited.

People were interacting, people were out, but people, by just not doing those careful things, were able to drop the cases significantly, probably by more than 80%. That kind of behavioral change is something every American can do. Tens of thousands of lives can be saved if Americans wear masks, and do not have parties in their backyards taking those masks off.

White House senior adviser Jared Kushner disagreed, saying President Donald Trump was “very forward-leaning” when he and the task force issued 15-day guidelines in mid-March. The 15-day guidelines was done at the time to make sure that Americans had enough hospital capacity and supplies, so that it did not end up like Italy, where there were people dying on gurneys in waiting rooms. Kushner complimented the President on the administration’s response to a ventilator shortage, repeating the White House line that no American who needed a ventilator did not get one.

Kushner thought the United States had done much better than Italy with regards to how it handled the covid pandemic initially.

The United States is in the middle phase of the pandemic and the administration is using what it had learned to protect the most vulnerable people, it was rushing resources to nursing homes. Covid had infected more than 5.4 million Americans and killed more than 170,000. The virus was killing more Americans than Alzheimer’s disease, accidents, and diabetes.

The United States had averaged more than 1,000 covid deaths per day. Covid became the third cause of death in the United States, ahead of accidents, injuries, lung disease, diabetes, Alzheimer’s, and many other causes. Heart disease and cancer were the leading causes of death in the United States. The rate of deaths from covid was also much greater in the United States than in many other countries.

Americans were eight times more likely to get killed by covid than were Europeans. Just as more students headed back to school, health experts were worried about a disturbing trend: decreasing testing combined with high test positivity rates. In other words, covid was still spreading rampantly, but there were less testing to find and isolate cases. The number of tests performed each day in the United States dropped by an average of 68,000 compared to the daily rate in late July.

Fifteen states conducted fewer tests: Alaska, Arizona, Colorado, Idaho, Louisiana, Minnesota, Mississippi, Montana, New Mexico, Nevada, North Carolina, Rhode Island, Utah, Washington, and Wisconsin.

Yet test positivity rates were still higher than the recommended 5% in more than 30 states. The testing situation was not good in the United States. It was not picking up people who are contagious. It was probably missing 8 out of 10 people who are contagious. Any decrease in testing was worrisome because the testing situation was not already doing well.

And if the testing situation did not pick people out of a crowd who were contagious, then the epidemic spread. This epidemic was still spreading widely. Medical experts say there could be several reasons that testing was decreasing. One of the reasons was that supplies were not being shipped to places that could test. It was part of a strategy not to count how many people were infected.

Another reason was that people might be less motivated to get tested, knowing it can take several days or longer to get results. And major delays caould make some tests “borderline useless”. Medical analyst Doctor Kent Sepkowitz was worried some states may be taking cues from Trump who said, “when you do more testing, you find more cases,” which might make the United States “look bad”.

Sepkowitz, an infection control expert at Memorial Sloan Kettering Cancer Center in New York, noted that several states that have touted decreased case counts also had some of the highest test positivity rates, an indicator that the virus was spreading.

So even as the rates were worsening, many states had decided to reduce their efforts to find cases. As a result, by looking less, they were finding fewer cases and sure enough, the case numbers had gone down. Florida had seen six consecutive weeks of decline in test positivity rates. And the number of patients hospitalized with covid declined by nearly 40% since peaking July 22nd 2020.

The number of ICU patients was down 30% since July 18th 2020. Florida Governor Ron DeSantis thought the downward trends across the state were durable and was going to continue to work hard to be able to see those good trends. One of the measures Florida took to blunt the number of cases was closing bars in late June 2020. Halsey Beshears, Florida’s top business regulator, is reviewing feedback and ideas from his meetings with bar and brewery owners from across the state, but no timeline for the reopening of bars has been set.

While no time frame for reopening is certain, Beshears understood the urgency advocated by business owners in recent meetings. While medical experts hope a vaccine will be publicly available in 2021, researchers have encountered a problem: not enough Black and Latino volunteers have signed up for clinical trials. Of the 350,000 people who had registered online, 10% are Black or Latino.

That was not nearly enough, as trial participants were supposed to reflect the population that was affected.

Research showed more than half of United States covid cases had been among Black and Latino people. Much of the distrust stemmed from a history of medical atrocities against minorities. In the 1800s, Doctor Marion Sims experimented on slaves and performed surgeries without their consent and without anesthesia. From 1932 to 1972, Black men were subjects in the Tuskegee syphilis study without their knowledge or consent and were not offered penicillin to treat their disease.

And from the 1940s until the 1970s, researchers in several studies exposed hundreds of subjects, mostly Black people, to dangerous amounts of radiation. Health officials were trying to gain the trust of minority communities and recruit more diverse volunteers for Phase 3 covid vaccine trials. So far, phases 1 and 2 had shown the vaccine to be safe. Some volunteers experienced fever and muscle aches, but they felt better after a day or two.

The good news: A new saliva test could give Americans a quick way of learning if they have covid, and if they need to isolate to help prevent the spread. Researchers from the Yale School of Public Health created the SalivaDirect test, which received emergency use authorization from the FDA. If cheap alternatives like SalivaDirect can be implemented across the country, the United States might finally get a handle on the pandemic, even before a vaccine.

Unlike some other tests that require specialized supplies, the SalivaDirect test did not require a specific swab or collection device.

SalivaDirect could also be used with reagents from multiple vendors. Yale simplified the test so that it only cost a couple of dollars for reagents, and expected that labs will only charge about $10 per sample. Researchers said the new test could produce results in less than three hours, and the accuracy was on par with results from traditional nasal swabbing.

SalivaDirect tests could become publicly available.