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Honest question that you may know the answer to: Out of all patients with reported data (THC use included), what percentage include urinalysis screenings to determine (with certainty) which substances are being used?
Outbreak investigations -whether foodborne or vape product related- are hard. Requires input from/ cooperation by patient, family, physician, lab, local & state health department, and sometimes coroner. @CDCgov is giving the best advice it can based on the data it has/ gets.
I understand your question, and the honest answer is that CDC can’t compel any of 
folks to get a urinalysis or any other test, and even if they could, it would still require an index of suspicion. Local docs aren’t gonna urine test everyone who comes in w cold/ flu symptoms.
And even when urinalysis is done, there are different tests that are better or worse at detecting substances/ metabolites. Long story short, a good history - which is dependent on patient and physician- is the best we have in most cases. Hard to establish “certainty.”
And thank you @JeromeAdamsMD, I do sincerely appreciate your response, even though you're a Nats fan and I was rooting for the Astros all last week.
The @CDCgov cant require that doctors perform urinalysis but it can addnit to the recommendations for treating people presenting with EVALI.
It was added to the recommendations for physicians a few weeks ago.
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