Syringes cause heroin deaths - ban them.
A Knife and fork cause food poisoning - ban them.
Glass bottles cause road death - ban them.
Rolled up $100 bills cause cocaine overdose - ban money.
A couple of new headlines I expect to see from the trash journalists at some stage.
Here we go!!!
MDHHS Healthcare Advisory 8-29-2019:
Severe respiratory pulmonary disease associated with e-cigarette/vaping use
The Michigan Department of Health and Human Services (MDHHS) is currently investigating six cases of severe pulmonary disease associated with e-cigarettes/vaping/dabbing. All cases have been reported in Michigan’s Lower Peninsula and most of the individuals have been hospitalized for severe respiratory illness. The age range of the cases is 19-39 years. As of August 27, 2019, 215 possible cases of severe respiratory disease associated with e-cigarette/vaping use have been reported in 25 states. As a result, MDHHS is providing this update to all hospital emergency departments, healthcare providers, hospitals, medical examiners, clinics and EMS providers. MDHHS is also requesting that providers report patients with severe pulmonary disease associated with e-cigarettes/vaping/dabbing, with or without THC (tetrahydrocannabinol), to their Local Public Health Department.
Clinical presentation:
Symptoms experienced by confirmed cases include cough, shortness of breath, chest pain, fatigue, and fever. Other reported symptoms include weight loss, nausea, abdominal pain, and diarrhea.
In previously reported cases, symptoms generally worsened over a period of days to weeks before hospital admission. Chest radiographs have shown bilateral opacities (often in the lower lobes) and CT images have shown diffuse ground glass opacities. Some cases have improved with systemic steroids; some required endotracheal intubation. Note: a copy of the CDC’s “case classification” criteria is attached, for your information.
Management :
Currently, it is unknown what is causing and contributing to the symptoms. Infectious etiologies should be ruled out, at a minimum by respiratory viral panel and influenza PCR or rapid test information. Further testing may be indicated e.g., urine antigen for Streptococcus pneumoniae and Legionella, sputum cultures if a productive cough, bronchoalveolar lavage (BAL) cultures if done, blood cultures, fungal tests or culture, or HIV-related opportunistic respiratory infection tests, etc. Aggressive supportive care is warranted, and in severe cases, it is recommended that pulmonary and critical care specialists are consulted.
What is being done to prevent this problem? CDC and FDA are working with state partners to investigate all associated cases to determine the etiology of these illnesses.
How can health care providers help with prevention and investigation efforts?
1. Report all patients with severe pulmonary illness associated with use of e-cigarettes, vaping devices, or dabbing devices to the local health department, listed at www.michigan.gov/mdhhs/0,5885,7-339-73970_5461_74040—,00.html
The following information should be reported: patient’s name, date of birth (if unknown, age), city/town of residence (or county if known), reporting provider’s name, phone number, email.
2. If available, please collect and hold all devices or substances used, including electronic nicotine delivery systems, vaping or dabbing devices and substances/solutions, from the patient so that they can be sent for laboratory testing if requested by public health.
If Local Public Health determines that the devices or substances should be tested, they will contact you and will handle collection and sending of products to the lab.
If you have questions about contacting your local health department, please reach out to your hospital’s Infection Preventionist.
*** This alert is being sent to: Local Public Health, Hospitals, Physicians and Clinics, EMS Roles, Regional Epidemiologists, Medical Examiners, and Regional Healthcare Coalitions ***
Please forward this information to others as applicable.
Thank you,
Michigan Health Alert Network
And a CDC Draft. Both being circulated to emergency response units as well as health care providers.
Severe Pulmonary Disease Associated with E-cigarette Use Outbreak Case Definition (CDC) - August 26, 2019
Confirmed Using an e-cigarette (“vaping”) or dabbing* in 90 days prior to symptom onset AND Pulmonary infiltrate, such as opacities on plain film chest radiograph or ground-glass opacities on chest CT AND Absence of pulmonary infection on initial work-up: Minimum criteria include negative respiratory viral panel, influenza PCR or rapid test if local epidemiology supports testing. All other clinically indicated respiratory ID testing (e.g., urine Antigen for Streptococcus pneumoniae and Legionella, sputum culture if productive cough, bronchoalveolar lavage (BAL) culture if done, blood culture, HIV-related opportunistic respiratory infections if appropriate) must be negative AND No evidence in medical record of alternative plausible diagnoses (e.g., cardiac, rheumatologic or neoplastic process). Probable Using an e-cigarette (“vaping”) or dabbing* in 90 days prior to symptom onset AND Pulmonary infiltrate, such as opacities on plain film chest radiograph or ground-glass opacities on chest CT AND Infection identified via culture or PCR, but clinical team** believes this is not the sole cause of the underlying respiratory disease process OR Minimum criteria to rule out pulmonary infection not met (testing not performed) and clinical team** believes this is not the sole cause of the underlying respiratory disease process
AND No evidence in medical record of alternative plausible diagnoses (e.g., cardiac, rheumatologic or neoplastic process).
Footnotes * Using an electronic device (e.g., electronic nicotine delivery system (ENDS), electronic cigarette, e-cigarette, vaporizer, vape(s), vape pen, dab pen, or other device) or dabbing to inhale substances (e.g., nicotine, marijuana, THC, THC concentrates, CBD, synthetic cannabinoids, flavorings, or other substances). **Clinical team caring for the patient.
Well, I knew I would get good information and discussion about this news…thanks
Interesting information. Can’t manage to find either the Michigan document (on state), or the CDC (draft) criteria on CDC or HHS, sites. Link(s) would be nice, if handy. Did find this CDC Aug 30, 2019 publishing:
Was provided to me by a fireman friend. His chief is distributing them to his staff. They were provided via pdf.
That’s what got me, they are tying it to general vaping, not THC vaping. They just want to blanket anything they think they can.
Back in high school I hated THC. I was the designated driver on our friday and saturday night cruises, kids these days don’t know what driving in town on weekends even means.
However if I could find some THC that actually put me to sleep without all those stupid side effects, I would consider it now. I hated the feeling it gave me, kind of like put me in my own head high. All the medicine I take to sleep is pretty bad.
Not all cannabis is the same. These days there are some stupendously strong strains that can even make a regular user feel sick. You just have to find the right kind for you. This is one of the reasons why legalization is necessary, so that people can get proper advice on what to buy.
There is stuff that makes you high as a kite, energizes you or put you to sleep. The first time(s) you try, it’s possible that you don’t feel anything or much stronger than with others. Try and get some good info before you try and be careful with edibles, they’re difficult to dose if you’re not familiar with the product.
One reasonable thing the CDC said…
People who use vape should not buy products off the street, modify e-cigarette products or add any substances that are not intended by the manufacturer, the CDC and FDA said.
At least that doesn’t immediately paint vaping itself as bad.
They think they have problems now, lol. Make it illegal and let the black market take over. I flushed my last bag of pot at 24 because I had no idea what I was getting. Everything from oregano to PCP. Don’t eat the brown acid, lol. Fuck that.
Indeed, those who stuck with Clear Light, Orange Sunshine, and Columbian Red/Gold fared much better. 
--------------------------- Ganesha ----------------------------
Ganesh Chaturthi, also known as Vinayaka Chaturthi or Vinayaka Chavithi is a Hindu festival celebrating the birth of Ganesha (September 2, 2019). Ganesh is widely revered as the remover of obstacles, the patron of arts and sciences and the deva of intellect and wisdom. As the god of beginnings, he is honoured at the start of rites and ceremonies.
Every breath, every sigh, every song, every enchantment, every dream, every prayer is a gem of creation.
Fragrant things there now are in the earth, whether roots, or herbage, or woods,
or essences which distil from fruit and flower grew and thrived in that land.
With such blessings the earth freely furnished them.
-Plato, Critias
A bit of more specific information regarding the single patient who (for unknown reasons) died in Illinois:
Last week, a patient in her 30s who had recently vaped died in Illinois, and public health officials said they are still waiting for toxicology and other tests to determine the cause of death. …
… “We know some of this is associated with T.H.C.,” said Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration. “I think this is probably going to be associated with illegal products,” Dr. Gottlieb said. “It’s not like the major manufacturers have suddenly changed their ingredients,” he said. “It’s probably something new that has been introduced into the market by an illegal manufacturer, either a new flavor or a new way to emulsify T.H.C. that is causing these injuries.” …
… The Food and Drug Administration is analyzing about 80 samples received from patients, but has not made the results public.
Source: https://www.nytimes.com/2019/08/30/health/vaping-e-cigarettes-marijuana-cdc.html
It seems somewhat odd that Gottlieb (no longer heading the FDA) would be making public statements on the FDA’s behalf. They probably would like him to take some of the public “heat” around “vaping” issues - though he can’t really speak in an official capacity for FDA. (Perhaps) a bit of “blame-projection” and “Gottlieb guilt”. By allowing Gottlieb to make non-binding public statements, the FDA remains free to “change the story” later
Jacob Sullum at Reason Magazine has been writing about these recent events, and related subjects:
(Aug 19, 2019): “Blaming Breathing Problems on ‘Vaping’ Is Like Blaming Food Poisoning on Eating”
(August 30, 2019): “Federal Investigators Think Black-Market Vaping Products, Not Legal E-Cigarettes, Are to Blame for Respiratory Illnesses”
By lumping e-cigarettes in with tobacco products, the FDA and CDC may hope to scare kids away from them. But the message to current smokers - that they might as well keep puffing away, since all these nicotine sources are essentially the same - is potentially deadly. … The CDC now grudgingly accepts that smokers who switch to vaping are better off, but it still worries that nonsmokers will take up vaping. To deter them, the CDC inflates the risk posed by e-cigarettes, which also deters smokers from switching, even though that decision could save their lives. The only way out of this conundrum is one the CDC never seems to consider: Instead of slanting information in the hope of manipulating people’s behavior, why not tell them the truth and let them make their own decisions?
(August 31, 2019): " FDA Lies About Vaping While the CDC Inches Toward the Truth"
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Referenced in 2nd article (above), a new post (by the previously quoted on this thread) Dr Michael Siegel:
The more than 200 cases of severe lung illness that have been reported in 22 states is indeed an important public health concern. But it is misleading, alarmist, and irresponsible to tell the public that these cases are being caused by retail e-cigarette products generally. Moreover, it is damaging misinformation because it does nothing to prevent further cases from occurring. The attribution for these cases is so broad that it is tantamount to giving no advice at all. Scaring people into believing that any vaping could cause you to die of respiratory failure is not only untrue, but it is not going to result in any change in behavior because it is far too vague. …
… As a trained epidemiologist, it was immediately clear to me that these cases are not being caused by vaping products generally because these products have been on the market for years without any significant problems and because the reports are clustered in specific geographic areas. Now that further information is available, it is clear that the majority of the observed cases are associated with the use of THC oils that were obtained from unlicensed sellers. It is also likely that cases occurring among people using nicotine-containing e-liquids without THC are due to a contaminant that is appearing in products being sold on the black market, not in retail stores. …
… Here, we need to start telling the public the truth. However much physicians or anti-nicotine groups may not like it, the truth is that the outbreak we are seeing is not due to the risks of using standard vaping products. It appears much more likely that the outbreak is mostly, if not completely attributable to illicit products–especially THC extracts–that are being sold by unlicensed sellers on the black market. Unless people are provided with this specific information, they will not take action to avoid the products that could put them at risk.
(August 30, 2019): “Boston Pulmonologist Provides Misinformation About the Cause of Severe Lung Disease Associated with ‘Vaping’”
.
A previously (on August 25, 2019) published post by Dr Michael Siegel (found on the same blog-site):
The advice from health agencies, including the CDC, to avoid using “e-cigarettes” is irresponsible. This is such a broad category of products that it doesn’t really give people any guidance whatsoever in terms of what to avoid. There are millions of people who are vaping nicotine-containing e-liquids and it would not be prudent for these millions of people to return to smoking in order to avoid the risk of this “unknown” and “mysterious” medical condition. Moreover, with such vague advice, no one is likely to change their behavior because they are not being warned about any specific, identifiable risk. …
… Since lipoid pneumonia is caused by oil inhalation, it seems pretty clear that those cases diagnosed as lipoid pneumonia are being caused by the use of e-liquids that are oil-based, not alcohol-based. Most nicotine-containing e-liquids are alcohol-based, meaning that they contain as excipients some combination of propylene glycol and glycerin. These products do not pose a risk of lipoid pneumonia. There are some nicotine-containing e-liquids that are oil-based, and these should absolutely be avoided.
… the CDC and other health groups are providing such generalized and vague advice that it is essentially meaningless. Sadly, the failure of CDC and other health agencies to provide appropriate recommendations is putting kids’ lives at risk. Since there has been no admonition to avoid the use of THC oils, kids are going to continue to use these products. This is why the CDC’s recommendations are irresponsible.
(August 25, 2019): “IN MY VIEW: CDC and Health Groups’ Bias Against E-Cigarettes is Putting Kids’ Lives at Risk”
.
Vitamin E oil appears to have been a common substance associated with the severe and sudden respiratory problems in some of the New York cases, according to state health officials. It is not known how it was used. Vitamin E is sometimes advertised as a supplement in cannabidiol oil, which is not designed for vaping but has been used that way. … called to the intensive care unit to consult on a patient with the severe lung ailment. The patient was in his 20s and a heavy e-cigarette user who also vaped THC. … The regulation and study of the marijuana industry is particularly complex. Even though the federal government still considers cannabis a controlled substance, 33 states now allow it to be sold for either recreational or medicinal purposes or both. Hundreds of cannabis products are sold, legally and illegally, such as THC oil, or cannabis oil with THC.
(New York Times, August 31, 2019): “The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’”
While the specific causes remain unclear, contaminants and adulterants in illegal vapes look like the most likely explanation.
Despite attempts to blame recent reports of respiratory illnesses among vapers on legal e-cigarettes, investigators are increasingly inclined to think the real problem is hazardous chemicals in black-market THC and nicotine products.
The Washington Post reports that “state and federal health authorities are focusing on the role of contaminants or counterfeit substances as a likely cause of vaping-related lung illnesses.” They “are narrowing the possible culprits to adulterants in vaping products purported to have THC…as well as adulterants in nicotine vaping products.”
This is what the Gooberment does. It’s called job security. Create a problem that doesn’t exist then solve it at the expense of the people. All while convincing the people that the Gooberment saved them.
Schtepping with the CDC “Uninformed Sevices”. We cut it twice, Chairman Trump, … but it’s still too short !
From the (airhead) US Sturgeon General’s Boss (Admiral Brett P. Giroir, Assistant Secretary for Health):
https://twitter.com/HHS_ASH/status/1149334372488818690
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Duty bound Uninformed Medical Officers duly power-chugging the Collective Therapeutic State Kool Aid:
We must trust the checks-and-balances of our chain-of-command to protect
and guide us. This strengthens our relationships with our co-workers, our
superiors, our agencies, and ultimately with the Commissioned Corps.
Back when I was in high school (the stone tablet/pre-internet days) we did a locally published study that proved that mother’s milk led to heroin addiction.
Causality has yet to be definitively established - however, strong correlations have been found by numerous researchers to exist between being born and all-cause mortality. The hypothesis has its detractors, however as some numerical analysts point out that reincarnation would reverse such cause and effect relationships. Others accuse such numerical analysts of merely seeking to create and rhetorically justify the existence of permanently funded academic research grants on the taxpayers’ dime. It has indeed long been well known, and largely accepted, that the only things which are definitively assured are death, taxes, dentists, and the bombastic and bellicose ravings of moral nannies ostensibly seeking to “save humankind from themselves”.
Worry not, however, as in the grand tradition of perennial and pervasive oxymoronic “military intelligence”,
“U.S. Unleashes Military to Fight Fake News, Disinformation”, led by our Psychopath in Chief Donald Rump.
