From the Desk of Dr. Louis M. Weiner

You can’t predict the future. A year ago, we headed into the holiday season to spend time with friends and loved ones. We had patients to see, experiments to do, clinical trials to plan and execute. We traveled all over the world, jammed like sardines in large, winged, jet-propelled metal cylinders — I believe they were called airplanes. We scorned videoconferences and relished the opportunity to connect with colleagues at large international meetings. We even went to restaurants, concerts, plays and movie theaters! With friends!

The economy was booming, and this fact alone augured well for the triumph of the president in the 2020 election. Paper towels and toilet paper were plentiful. We didn’t know Instacart from Instagram. George Floyd was still alive. My father was too, though I was certain we were going to lose him (we did not). Nearly 300,000 unsuspecting American souls did not imagine that their lives would end in 2020, prone, in an ICU, isolated from their loved ones. You can’t predict the future.

What a year this has been. I can’t wait for it to end. COVID-19 continues to surge around the country, and while there is light at the end of the tunnel, I view the FDA authorization of the Pfizer vaccine as the pandemic equivalent of D-Day. Victory now appears to be inevitable, but much suffering and death await until the war ends, hopefully by sometime this summer.

Whenever the pandemic ends, we will not immediately spring back to “normal,” whatever that is. The aftershocks — the lingering grief and resentments, the impact on our society, our children, our businesses, and of course on our ability to conduct cancer research and cancer care, are likely to be profound and unpredictable. As if that were not enough, the aftermath of the elections points to government gridlock at best, and I shudder to contemplate the worst.

But, in 2020 I also saw the best — the energy of Americans dedicated to the electoral process, the unbelievable commitment and courage of colleagues on the front lines of the pandemic, the astonishing work that led to an approved vaccine in less than one year and the immense decency and charity of countless Americans in very dark moments. Indeed, what a year this has been.

You can’t predict the future. Virtually every expectation I had for 2020 was wrong. I have no clue as to what 2021 will bring. I do know that it will be an important and interesting year, and I continue to feel so lucky to work with each and every one of you, knowing that together, we will accomplish great things. I know that for many of us, this holiday season will be lonelier than usual, but I do hope you find peace, joy and connection with the people you love.

This is my last blog for 2020. I wish you a Merry Christmas, Happy Chanukah, Happy Kwanzaa and a Happy New Year.

If we can hang in there for only a few more months, we will get through this nightmare.

Please, please, stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

On March 6, I spoke at the home of Liz Shepard and Terry Straub at the 2020 Lombardi Gala kickoff reception, as we prepared to celebrate the cancer center’s 50th anniversary this past October. Our spirits were high, and we looked forward to the coming year with great anticipation. I was asked to make some remarks and to include comments regarding the novel coronavirus that was beginning spread like wildfire. I reassured the 30 or so attendees that while the virus was dangerous, it was nothing compared to cancer. We left this intimate indoor event, with hugs and kisses all around, filled with ambition and eager to get to work.

My bad. One week later, we were in lockdown. Here we are, about 10 months later. Indoor gatherings like that reception rightly would be considered irresponsible and life-threatening. Last week, deaths from the virus exceeded the numbers of deaths from heart disease or cancer. More than 280,000 Americans have died since that evening, and it appears inevitable that the eventual toll will approach or surpass 500,000 lives. By the end of December, we will have easily exceeded total American combat deaths in World War II, and by March the coronavirus death toll in this country will have blown past the total number of American combat deaths in World War I, World War II and the Civil War. With just a bit more bad luck, we’ll add the Korean and Vietnam wars’ combat deaths to those totals, and will approach or surpass the number of deaths caused by the Spanish Influenza pandemic of 1918-1919. I know we have a much larger population now than a century ago, but we also have the benefits of modern medicine that were not available back then. So, where did I go wrong?

Clearly, I underestimated the especially grim biology of this virus. Even with ideal management, many people would have died during the current pandemic. However, I have no doubt that more effective policy and coordination would have lessened the horror considerably. With the advantage of hindsight, we now know that rigorous social distancing was able to substantially reduce the impact of the pandemic on infections, hospitalizations and death this past spring and summer. This happened at significant costs to our economy, to be sure. But lives were saved.

I don’t think the problem lies with the health care system, which has responded heroically and has optimized critical care measures to reduce death rates, develop some effective therapeutics and, hopefully, introduce effective vaccines with breathtaking efficiency and speed. I am in awe of colleagues who have redirected their efforts to combat this killer, and who have risked their own lives, again and again, to offer care and comfort to those in need. I am inspired by the countless acts of kindness and generosity that have eased the burden of the pandemic for so many of us.

Tragically, the rise of the pandemic during an election season politically weaponized policy decisions that led to a functional absence of strategic national planning. Such planning and leadership would have led to coherent policies and, more importantly, widely accepted expectations regarding sensible social distancing and responsible behaviors. Massive logistical mobilization, a historic American capability, would have assured access to needed equipment, PPE and supplies in a manner that benefited all Americans. Policies to protect our most vulnerable citizens, including the elderly and historically disadvantaged minorities, could have minimized disparities in access to prevention and care. Many still would have died, but many more who died still would be alive. This could have been a great American moment, where we came together to battle a deadly foe.

So, after a bittersweet Zoom Thanksgiving, and the prospect of more months of social isolation before vaccines are widely implemented and the pandemic recedes, I am left to ponder the future. What will 2021 bring? Certainly, this is a moment for somber reflection, and my blind optimism of March seems so terribly naive. However, I find myself feeling more optimism than despair (perhaps my training as a medical oncologist has conditioned me in that regard). Effective policy is on the horizon, and with any luck, social resistance to such efforts will gradually recede over time. I truly believe that the vaccines are game-changing; even if we don’t achieve herd immunity, the people who are immunized are likely to be protected, and that will reduce community spread by the summer of 2021. I expect to celebrate next Thanksgiving at a large, joyous family dinner.

Having proven that my predictions are about as accurate as those of Carnac the Magnificent (if you don’t know who he was, you can look it up), I will understand if you are skeptical about my optimism, but hope you agree that these aspirations have merit.

Meanwhile, we will light the candles for the first night of Chanukah this week on a family Zoom, watching our grandchildren open gifts in two dimensions. It’s not like being together, but it will have to do.

For those of you who also celebrate Chanukah, Chag Sameach, and spin the dreidel with hope for the coming year.

Have a good week. Stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.