Starting Over, Again!

Margaret Tempero
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Editor's Note: This editorial was written before the emergence of the omicron variant of COVID-19.

Welcome to 2022! By the time you read this, you have probably already put away all those holiday decorations, sworn off overeating, and promised yourself you’ll exercise more and lose some weight. Oh wait, that’s me! I am sure you kept all the resolutions you made last year, so this year, you can ramp it up. Like resolving to learn a new language or master a new musical instrument. Good for you!

Seriously though, I am struck by how different this new beginning seems compared with last year. In January 2021, we had so much hope. A new, highly effective vaccine had arrived, a vaccine program was rolled out, and I think we were all pretty convinced we could put the COVID-19 pandemic behind us. Unfortunately, however, that isn’t how things worked out. Issues such as vaccine hesitancy and a lack of access to vaccines in less well-developed parts of the world allowed more transmissible variants to emerge, causing new surges and continued hospitalizations and deaths. So instead of recovering from the challenges of COVID-19, we are learning to live with it. This is a “new normal” perhaps.

But for those with a compromised immune system, this is hardly “normal.” In our professional world, virtually all of our patients with hematologic malignancies fall into this category. These patients can’t count on protection from the vaccine. This means they and their families must remain isolated, depending on masks and social distancing to prevent infection. Thankfully, we have therapeutic antibody drugs that can also provide additional protection if complete isolation is impossible. Such protocols are being tested now, so that someday, I hope, a mother living with lymphoma doesn’t have to worry about sending her child to school.

I don’t pretend to be an expert on COVID-19, but I think a key tool going forward will be home testing. One of my brilliant young colleagues at UCSF, Dr. Nina Shah, cares for patients with multiple myeloma, a particularly vulnerable group. As her birthday neared, she wanted a party but didn’t want a breakthrough infection that might put her patients at risk. Her solution: arriving guests were greeted outside with a glass of champagne and a test kit. After the requisite 15-minute wait for results, everyone was invited in, and the party started, safely!

We may not be able to control the actions of others, but we can control our own. We can stay home when we are sick. We can self-test if we notice anything unusual. We can require testing for gatherings of family and friends even if they are asymptomatic. It’s not so difficult.

As we welcome in this New Year, let’s resolve to keep everyone safe. We are blessed that science has triumphed with convenient tests, effective vaccines, and new antiviral drugs. Let’s use them wisely.


Margaret Tempero, MD, is a Professor of Medicine and Director of the UCSF Pancreas Center and editor-in-chief of JNCCN. Her research career has focused on pancreatic ductal adenocarcinoma, especially in the area of investigational therapeutics. Dr. Tempero has served on the ASCO Board of Directors and as ASCO President. She currently serves on the ASCO Conquer Cancer Foundation Board. She codirected the AACR/ASCO Methods in Clinical Cancer Research and taught this course and similar courses in Europe and Australia. She was founding Chair of the NCI Clinical Oncology Study Section and served as a member and Chair of the NCI Board of Scientific Counselors Subcommittee A. She is a member of the Scientific Steering Committee and Chair of the Clinical and Translational Study Section for the Cancer Prevention & Research Institute of Texas. She is or has been on the Scientific Advisory Boards of the Lustgarten Foundation, the Pancreatic Cancer Action Network, the V Foundation, The Alberta Canada Cancer Board, and the EORTC. She served as a member of the Oncology Drug Advisory Committee for the FDA. She has served as Deputy Director and Interim Director for the UNMC Eppley Cancer Center. She is Chief Emeritus of the Division of Medical Oncology at UCSF. She served as the founding Deputy Director and was later Director of Research Programs at the UCSF Helen Diller Family Comprehensive Cancer Center.

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