Oncology Has Lessons to Learn From the COVID-19 Pandemic

Jill Gilbert, MD

The coronavirus disease 2019 (COVID-19) pandemic has forever changed our world. We must remember the heavy societal burden this virus has wrought, including lives lost, the significant and debilitating late effects for survivors, and the mental health crisis for survivors, caregivers, and the general population. What are the lasting effects of more than 12 months of isolation, economic downturn, family separation, and, in some cases, forced family quarantine? The world is paying attention and these areas are all topics of intense, ongoing investigation as we grapple with the collective human toll of this unprecedented event in our lifetimes.

As an oncologist, I compare this great effort to rapidly understand the viral epidemiology, prevention, treatment, health disparities, and late effects of infection with the field of cancer discovery. As hematologists-oncologists, our field has always been defined by discovery. We have witnessed huge advances in drug discovery and applied these to cancer treatment.

However, these milestones have taken decades to achieve, and governmental financial investment in the National Institutes of Health/National Cancer Institute can be sidelined depending on presidential or congressional budget priorities. Although COVID-19 discovery and translation have occurred at an incredibly rapid pace, this cancer care provider wonders whether we can take the lessons learned from the pandemic and apply them to our world. What are the lessons that we can glean from this experience? Although much has been written about the new paradigm for rapid drug discovery and translation into tangible clinical use, I want to focus on the other significant lessons that we should take from the pandemic experience.

Public Engagement Matters

According to the International Agency for Research on Cancer, incidence of cancer was at 17 million worldwide in 2018 with 9.5 million reported deaths. In contrast, the Johns Hopkins Coronavirus Center recorded 110 million cases of COVID-19 with 2.44 million reported deaths worldwide as of February 18. Thus, even though the reported COVID-19 cases significantly outnumbered new cancer cases, the cancer death toll remains significantly higher. Do not misunderstand. This statement is not to diminish the horrific impact that COVID-19 has on our population.

However, compared with the pandemic story, which realized unprecedented advances in little more than 12 months, cancer discovery remains comparably slow. Appropriately, the public’s emotions concerning COVID-19 are running high and raw. Except for relatively small factions, the public outpouring of support and, frankly, demand for a COVID-19 “win” has bolstered the rapidity of translatable discovery.

In contrast, while almost everyone has been touched by cancer, public engagement and lobbying efforts have in some ways become “white noise.” The urgency to stop cancer has always been present, but the general public’s sensitivity and involvement in demanding rapid discovery and treatment advances have been mired in special-interest lobbying efforts that have undercut the cancer messaging by creating factions whose own financial interests overshadow the primary issue at hand: the need to curtail the human toll of the disease.

All too often, what the public hears is the ongoing squabbling of siblings, all of whom believe that their needs are most important. When the public tunes out, the lobbyists—for big pharma, for the insurance industry, for tobacco—move in. What we are forget-ting is that we, the public, are the ultimate lobbyists because we vote. The COVID-19 experience has demonstrated that public opinion, public passion, pressure on lawmakers, and ongoing large-scale public engagement can positively alter the trajectory of treatment gains.

Although governmental COVID-19 messaging has at times been opaque, the absence of diversionary messaging from financially motivated factions has allowed the public to serve as the ultimate lobbyists to demand change and rapid results. Although outliers exist, the majority has made it clear that personal responsibility and accountability of elected officials matter. How did this COVID-19 grassroots, public campaign gain strength, and what are the pointers that we can apply to cancer discovery?

Consider the following:

• Social media works if we use it appropriately. Create and post relevant content that does not focus on you or your research, but on the issue at hand. Credible expertise helps, but so does the humble and regular sharing of content.
• Be consistent and create a sense of “Team Anti-Cancer” versus anti-(insert lobbying interest here). Keep your eye and conversation on the prize: fighting cancer. Although lobbying interests may interfere with the ultimate fight against cancer, our North Star is fighting the disease, not one another.
• Ongoing real-time conversation within a community is important for building public consensus and for creating buzz around a topic.
• Hold elected officials accountable to us for fighting cancer, and not to industries whose motives are mired in financial self-considerations.
• Think of recent social media trends that garnered viral (forgive the pun) support and raised substantial funds and awareness for great causes. How can we apply this to cancer? Do you remember the ice bucket challenge? An independent research organization reported that donations from the 2014 ALS Ice Bucket Challenge enabled the ALS Association to increase its annual funding for research by over 187% and substantially increased worldwide awareness for amyotrophic lateral sclerosis.
• In fact, the CEO of the ALS Association noted, “Five years after the ice bucket challenge soaked the world, the pace of discovery has increased tremendously, bringing ALS researchers closer than they have ever been to real breakthroughs in diagnosing, treating, and eventually curing this disease.” Moreover, the association’s clinical trial network saw a 50% expansion.¹

The pandemic continues to upend life as we know it. But as a survivor of Hurricane Katrina, I can honestly say that even horrible events can translate into some societal wins. Recognize the power that you have in shaping your life and our world.

Reference

1. Ice bucket challenge dramatically accelerated the fight against ALS. News release. ALS Association. June 4, 2019. Accessed February 15, 2021. https://www.als.org/stories-news/ice-bucket-challenge-dramati-cally-accelerated-fight-against-als