Out in the World Again

Margaret Tempero
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I hope that when you read this, we are still out in the world and have not retreated back “under our rocks.” This time it feels like a sure thing—perhaps not the end of the pandemic, but at least the end of serious illness for most. As I write this, I am scheduled for my second booster and the University of California San Francisco has just lifted the mask mandate for nonclinical areas. I am staring at the “Coronoavirus Worldometer” data for the United States over the past 2 years, relishing the decline in deaths from a peak of more than 4,000 a day in January 2021 to less than 300 a day at the end of March 2022.

There are signs that others see the end of this as well. On April 1, we received a communication from our health system to cease seeing new patients residing in other states via telemedicine. As you know, during the beginning of the pandemic and as an emergency measure, we were all given permission to “practice” in states in which we were not licensed. It is a shame that this is ending. For once, patients disadvantaged by residence in remote areas could receive opinions and even have treatment managed by long-distance doctors and their clinical teams.

I know we will be studying this pandemic and our response to it for a long time. There are so many lessons. I am particularly proud of the way providers in cancer care rallied to make sure patients with cancer received the treatment they needed regardless of the strain on the healthcare system. All the top tier medical journals, including JNCCN, published new data promptly and crafted recommendations for providers in a very timely way.

Still, it is sobering to think that we lost more than a million Americans to COVID-19. How different the outcome might have been if everyone followed guidance, wore masks (especially N95 and KN95 masks), and got vaccinated as soon as it was possible to do so. I am still baffled by the fact that, while we managed to produce possibly the safest and most effective vaccines ever created, so many people delayed or refused to be vaccinated.

We still have a challenge ahead. Many of our patients, especially those with hematologic malignancies, cannot mount immunity with vaccination. These patients will need continued precautions and preventive measures. But at least we know what to do.

There are also challenges in returning to “normal.” What is normal, anyway? Virtual meetings are convenient even when you are physically on site. As for remote work, I rather like padding down the hall in my slippers to tune into the first meeting of the day. I know we are headed for some ongoing hybrid workplace models, but exactly how this will evolve is still a mystery to me.

I will leave you with one final thought: Virtual meetings are good for managing the business in our world. But I believe true creativity and growth can only happen when people mingle and work together—in person!


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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