Rashelle Bernal never expected she’d end up in the hospital because she vaped. But that’s what happened a few weeks ago; Bernal may be part of a nationwide outbreak of a severe lung-illness that’s sickened more than 500 people. So far, eight people have died across the country, and Kentucky officials say there’s one confirmed case and two probable ones in the commonwealth. They’re investigating a dozen more.
Bernal moved to Louisville about a month ago from California. There, she sometimes smoked cigarettes and marijuana. But Bernal said she’s pretty health conscious, and she heard that vaping was a safer alternative.
“I got really started trying to do it in the last year to try something different, I guess a safer alternative is what we were told,” Bernal said. “But it doesn’t seem like that wasn’t the case in my situation.”
Bernal said she wasn’t a regular vaper back in California, and she bought her vapes at a retail e-cigarette store. When she moved to Louisville, she started vaping more frequently. She was living away from family and friends for the first time in her life and it was stressful, so Bernal vaped to help her cope.
“It became like, something I would do on the hour, just like instinctively,” she said.
Soon after that regular habit took hold, Bernal started getting winded, nauseous and felt like there was an elephant on her chest.
“I got to the point where I thought I had the flu,” Bernal said. “And then to the point where I couldn’t eat anymore, I started vomiting after I had anything, couldn’t keep down water.”
So she went to the emergency room. One of her doctors, Ehab Haj Ali, said that at first, he thought she might have pneumonia. But that was ruled out through tests.
“All the workups were negative, and the only links we could find was vaping,” Ali said.
At that point, Bernal was having a really hard time breathing. Ali said Bernal was put into a coma and put on a ventilator.
Bernal doesn’t remember that. All she remembers is waking up, and being very confused about what happened. Her family in California flew to Louisville to care for her and she’s now home recovering. But she can’t move around without a walker. She can’t braid her daughters hair, let alone her own. It’s all part of the recovery from being in a coma for a week.
“My big thing is that I wouldn’t want another family or another parent, you know, just to see their kid on a ventilator,” Bernal said.
The Long Game
Sts. Mary and Elizabeth Hospital didn’t respond to inquiries about whether Bernal has been reported to the state as a possible vaping-related case. But Ali said her symptoms line up with what the Centers for Disease Control and Prevention is pointing to: a rapid onset of coughing, significant breathing difficulties, nausea, vomiting and diarrhea.
The Centers for Disease Control and Prevention on Thursday said there are now more than 500 cases of this vaping-related lung illness across the U.S. Eight people have died. And there are still a lot of unknowns about the commonalities between these cases: health officials say some people report vaping a THC-containing product, others used black market products and some say they bought regular nicotine vapes sold in retail stores.
Health experts say this outbreak might have gone on for awhile, but doctors only recently started connecting the dots.
But the thing about the outbreak of lung illnesses is that it’s only part of a larger question about vaping: what will the long-term health effects be? Deborah Buckles, the program director at Indiana University’s Simon Cancer Center Tobacco Treatment Program, said though there are claims that vapes are safer than cigarettes, that’s not proven.
“It’s going to be 2027 at the earliest before we really know what the long-term effects are,” Buckles said. “So for us to say that these are safer at this point is not accurate. We don’t know that yet.”
Greg Conley, president of the American Vaping Association, pointed to a paper from the Royal College of Physicians in England that said vaping is safer than smoking cigarettes, and can be used to stop smoking.
“And that smokers who make that switch get back similar benefits that they do if they quit nicotine smoking altogether,” Conley said.
He and others in the vaping industry are frustrated federal officials have told people to stop vaping altogether because of the outbreak. Conley calls that irresponsible.
“Vaping remains a far less hazardous option for smokers,” Conley said.
There is some evidence that e-cigarettes are effective at helping people quit smoking cigarettes. But one study in the New England Journal of Medicine found vapes were effective when combined with behavioral support from a professional in person. That study also found that a high percentage of people who quit smoking cigarettes with vaping, kept vaping. Those study authors said that could be problematic because there are unknown long-term health risks.
Youth Vaping And Safety
Conley did say that people who’ve never smoked a cigarette should not start vaping. And research shows that vaping use is rising among youth. This week a study was released showing more than one in four seniors in high school nationwide vape, which doubled from 2017.
One of the reasons for those increasing rates are vape flavors — like bubble gum, strawberry and banana nut bread — that appeal to young people. And the vaping industry has recently come under fire from federal officials who found these companies were marketing to teens and other young people.
President Donald Trump has said the government may put a ban on flavored vapes. The Food and Drug Administration also will soon require vaping companies to submit pre-market applications. But Deborah Buckles at IU said the vaping companies knew what they were doing in marketing to teens.
“The FDA can regulate the marketing, the flavoring, the how these products are sold, where they're sold, what flavors can or cannot be used. However, they've been very slow to do that,” Buckles said. “And, unfortunately, the industry did in fact, know what they were doing, and knew that if they could get kids addicted quickly enough, before there was too much FDA regulation, that they'd have users for life. And that's exactly what's happened.”
Until now, there’s not been much regulation on vapes. But soon the FDA will ask vaping companies to submit what are basically risk-benefit applications. Companies will have to show evidence that the products are safe, if they do help people quit smoking and if those benefits outweigh the risk of teens starting to vape.
Meanwhile, Rashelle Bernal is still recovering from her hospital stay. Her doctor says she would have died had she not gone to the hospital.
“Now I’m part of a statistic,” she said.
Bernal is expecting to eventually hear from health officials to find out if she’s part of the outbreak. In the meanwhile, she says she hopes her story serves as a cautionary tale.
