Young adulthood is the summer of life, and one could forgive adults between the ages of 18 and 35 for feeling even more “COVID fatigue” than the rest of the population. The restrictions and physical distancing we have all adopted to navigate this uncertain time have gutted the core of young adults’ social lives: shuttering bars, canceling concerts, and turning restaurants into sterile, oddly empty cafeterias. But a new surge in COVID-19 infections may combine with renewed vape pen injuries to bury young Nevadans in health problems this coming summer.
COVID: Not Just Your Grandparents’ Disease
Early reports about the novel coronavirus, which causes the disease known as COVID-19, indicated that young people were largely invulnerable to the infection but could still pass it to older adults and more vulnerable members of society. [1] Although young adults were in the hearts of academic years, in the swing of new careers, and looking forward to spring and summer nuptials, they largely heeded the social call for physical distancing and broad shutdowns of many nonessential businesses and sectors at high risk for spreading the infection.
Not everyone was on board, as photos of crowded beaches in the southeast United States showed during Spring Break in late March and early April. [2] Then the idea that COVID did not cause serious illness in younger adults began to crumble as New York suffered a massive outbreak that claimed thousands of lives, including those of young, healthy people. [3] Researchers began to detect signs of strokes and bizarre blood clots in younger adults that seemed to be COVID-linked. [4]
And now, as many states lurch aggressively toward “reopening” and a return to the social and economic activities we abruptly abandoned three-odd months ago, younger adults are carrying a heavy burden with the disease. Infections in people under age 35 make up the majority of new infections in some regions, and the share of infections in these age cohorts has doubled in many places. [5] There are many factors behind this new trend, but part of the equation is surely the same sense of invincibility that also exposes young adults to vape pen injury risks.
Remember That Epidemic?
It seems like ancient history now, but before every day’s headlines were filled with updates on the global coronavirus pandemic, much of the news coverage in the public-health space was focused on vape pen injuries. In mid-December 2019, the Southern Nevada Health District – which serves the larger Las Vegas metropolitan area – warned of an “outbreak” of lung injuries associated with the use of electronic cigarettes (also known as e-cigarettes, e-cigs, vapes, or vape pens). The District reported that there had been six cases of what it termed “electronic, or vaping, product use associated lung injury,” or EVALI, in Clark County. (Clark County includes the cities of Henderson, Las Vegas, and North Las Vegas among others, and it is the most populous of Nevada’s 16 counties. [6])
The District urged anyone who “developed a severe respiratory illness that is not associated with other viral infections such as influenza” to contact their healthcare providers. What we know now is that a new respiratory illness was just beginning to spread throughout the globe during this time, and that illness (COVID-19) is difficult to distinguish from influenza; both infections are, in turn, hard to distinguish from some e-cigarette injuries. Some of the symptoms of vaping injuries include:
- Fever or chills
- Cough
- Nausea or vomiting
- Diarrhea
- Shortness of breath
- Chest pain
- Stomach cramps
- Weight loss
Anyone who has been vigilant about the signs of coronavirus infection will see how similar the symptoms of e-cig injuries are to the signs of COVID-19:
- Fever or chills
- Cough
- Shortness of breath
- Nausea or vomiting
- Diarrhea
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose [7]
Fearing an “epidemic” of vaping injuries, Nevada officials like Attorney General Aaron Ford pushed aggressive measures to identify new e-cig injuries and rein in unregulated vaping products. [8] It is now believed that the source of many of these injuries was an oil used in many unregulated, THC-based vape pens and related products. [9]
An Uncertain Future
If a particular oil additive in a narrow subset of the vape products market truly was responsible for the hundreds of electronic cigarette injuries seen nationwide over the last year, this could open the maker up to a product’s liability case in the State of Nevada as well as the rest of the country. However, there is some promise that modest regulation will control that issue. Executives of vaping companies certainly hope that is the case, and some even think that this summer will prove to be a boom time for them, combining renewed trust in the safety of e-cigarettes with a widespread desire to enjoy outdoor recreation. [10] Add to this that many states are beginning to reopen – including tourism-heavy locales like Nevada’s Las Vegas area and the Reno-Sparks-Tahoe region – and some foresee a big uptick in vaping use.
But questions remain. Will the social experience many vape users look for be muffled by the restrictions of phased reopening? Will not-so-distant memories of vape pen injuries cause young adults to look for another way to take the edge off? Will newfound concern for our pulmonary health lead even more smokers and vapers to find ways to quit? Or will that stubborn “young invincible” spirit prevail, drawing young adults into intimate circles as they pass vape pens from one mouth to another, risking damage to their lungs at the very moment when they should be safeguarding them? Time will tell, but it seems the fierce urgency of youth may carry the day over wiser decisions, possibly causing a spike in new Nevada e-cig injuries.
[1] https://www.theatlantic.com/ideas/archive/2020/03/young-people-are-not-immune-coronavirus/608794
[4] https://www.washingtonpost.com/health/2020/04/24/strokes-coronavirus-young-patients
[6] https://en.wikipedia.org/wiki/List_of_counties_in_Nevada
[7] https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
[9] https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html