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As we continue to cope with and adapt to a COVID-19 pandemic that is not quite over and that is still seemingly a global crisis on every front, we look to Amanda Gorman’s poem, “An Ode We Owe,” for wisdom and insight. 

Amanda read her piece during the opening of the 77th Session of the U.N. General Assembly in New York, challenging everyone to be aware and not to ignore the clear and present dangers we face as citizens of the earth. 

As a side note, I have written about Amanda in a previous blog, when she released her poem “New Day’s Lyric” in January 2022—it set the tone for the kind of resilience we needed at that time, to move forward. She is truly a remarkable poet as I was particularly struck by her emphasis on the need to believe in a positive future. 

Amanda also read her poem “The Hill We Climb” during President Joe Biden’s inauguration in March 2021. If you want to read more of her poetry, you can find Amanda’s books here. 

In an interview with the Associated Press, Amanda said that she hopes listeners to her poem can garner this takeaway: “That while issues of hunger and poverty and illiteracy can feel Goliath and are so huge, it’s not necessarily that these issues are too large to be conquered. But they’re too large to be stepped away from.”


‘An Ode We Owe’                     

How can I ask you to do good,
When we’ve barely withstood
Our greatest threats yet:
The depths of death, despair and disparity,
Atrocities across cities, towns & countries,
Lives lost, climactic costs.
Exhausted, angered, we are endangered,
Not because of our numbers,
But because of our numbness. We’re strangers
To one another’s perils and pain,
Unaware that the welfare of the public
And the planet share a name–
–Equality
Doesn’t mean being the exact same,
But enacting a vast aim:
The good of the world to its highest capability.
The wise believe that our people without power
Leaves our planet without possibility.
Therefore, though poverty is a poor existence,
Complicity is a poorer excuse.
We must go the distance,
Though this battle is hard and huge,
Though this fight we did not choose,
For preserving the earth isn’t a battle too large
To win, but a blessing too large to lose.
This is the most pressing truth:
That Our people have only one planet to call home
And our planet has only one people to call its own.
We can either divide and be conquered by the few,
Or we can decide to conquer the future,
And say that today a new dawn we wrote,
Say that as long as we have humanity,
We will forever have hope.
Together, we won’t just be the generation
That tries but the generation that triumphs;
Let us see a legacy
Where tomorrow is not driven
By the human condition,
But by our human conviction.
And while hope alone can’t save us now,
With it we can brave the now,
Because our hardest change hinges
On our darkest challenges.
Thus may our crisis be our cry, our crossroad,
The oldest ode we owe each other.
We chime it, for the climate,
For our communities.
We shall respect and protect
Every part of this planet,
Hand it to every heart on this earth,
Until no one’s worth is rendered
By the race, gender, class, or identity
They were born. This morn let it be sworn
That we are one one human kin,
Grounded not just by the griefs
We bear, but by the good we begin.
To anyone out there:
I only ask that you care before it’s too late,
That you live aware and awake,
That you lead with love in hours of hate.
I challenge you to heed this call,
I dare you to shape our fate.
Above all, I dare you to do good
So that the world might be great

 
The poem begins with a question: “How can I ask you to do good?” then quickly moves into key issues that we are presently facing—the interconnectedness of climate change, poverty, hunger, inequality, and the impact of hate. 

Amanda’s poetry draws attention to Sustainable Development Goals (SDGs)—an important aspect of potential solutions. 

When asked by the Associated Press why she decided to touch on SDGs, Amanda responded: “I actually think that there [are] swaths of the population which [have] yet to be engaged or kind of told or activated around the Sustainable Development Goals. So much of what I like to do in the poem is making sure that we raise awareness around these issues and show that these goals do exist.” 

It is so powerful to hear her simple suggestion—that working together instead of going against each other can solve our problems. 

Global Messaging on Health

Global health inequalities are a central part of numerous key issues. For myeloma patients it is helpful to think about the future course of the global COVID-19 pandemic, and how inequalities affect so many aspects of myeloma care. 



Is the Pandemic Really Over? 


President Joe Biden’s assertion that the pandemic is over in a Sunday Broadcast of 60 Minutes has drawn some backlash from a flood of experts. 
 
According to NPR, public health experts say that his declaration “could complicate the administration’s effort to battle COVID-19” especially with public health officials “trying to convince Americans to get a new [omicron] booster shot.” 

Adding to that, data from the Centers for Disease Control and Prevention (CDC) show that nearly 400 Americans are still dying from COVID-19 each day. 

Professor of Molecular Medicine at Scripps Research Eric J. Topol had this to say in his op-ed column in the L.A. Times: “Well into our third year of battling COVID-19, we all wish that were true. But unfortunately, that is a fantasy right now. All the data tell us the virus is not contained. Far too many people are dying and suffering. And new, worrisome variants on the horizon.”

Washington Correspondent for New York Times Sheryl Gay Stolberg reported on patients’ reactions to the president’s statement, with most of them saying that Pres. Biden “was being insensitive at best.”

Experts echoed the same apprehensions: the still concerning daily number of COVID-19 deaths and the emergence of new variants that would likely cause another surge in the months ahead. 

It is also noted that we no longer have reliable data about the number of cases since results of home testing are not being recorded. The best estimate is that the number of cases are five times higher than what is being officially reported.

We should take a step back like Amanda Gorman and consider a more global perspective on COVID-19—it continues to be a daunting crisis worldwide. Global vaccination strategies and public health measures to prevent new variants from emerging are still sorely lacking to this day. They are still major to-dos at the global level. As an example, China is still having enormous difficulties in enforcing its zero-COVID policy. 

However, with Pres. Biden’s declaration, it seems that Pandemic Oversight’s work is done. 

For myeloma patients, this means that they are left to fend for themselves in terms of establishing their own guidelines and protecting themselves from COVID-19 as much as possible. 

I would still recommend continued vigilance, as I have done in my previous blogs.

The IMF’s COVID-19 page remains a reliable resource for news updates and guidelines on vaccines, boosters, the pre-exposure prophylaxis Evusheld™ to boost antibody levels, and the antiviral Paxlovid™ if a COVID-19 infection occurs. Best-quality masks are still highly recommended in all situations where there is a risk of exposure. 

Myeloma Care 2022-2026


For the next 5 years, we will continue to see a rapid evolution in standards of care (SOC)

The recommended triplet of VRd (bortezomib, lenalidomide, and dexamethasone) may be replaced by the Quadruplet of daratumumab (dara) or isatuximab plus VRd or VTd (bortezomib, thalidomide, and dexamethasone) if Revlimid® is not available. 

For non-transplant patients, dara-Rd (daratumumab plus lenalidomide and dexamethasone) is a strong standard of care where available. These regimens produce long first remissions in the 5-year range.



The many new exciting immune therapies offer major back at the time of relapse or if introduced earlier in the disease. Both CAR T-cell therapy (requiring individual bioengineering preparation) and bispecific or T-cell engagers offer powerful off-the-shelf therapies to extend remissions and overall survival substantially.



Equity and Access

Central issues with myeloma therapies are equitable access and coordinated efforts to improve outcomes. Currently, there are about 30-40 countries where modern therapies for myeloma patients are available. However, costs limit full access even in these countries.

For example, there is little hope that any of the newer drugs could ever be bought and distributed at the government level in Latin America and Africa—they are just too expensive. 

The IMF is focused on new efforts to enhance standard of care access to both testing and treatments on a global level.



The Bottom Line: Amanda’s Powerful Words


Amanda’s poem is a CALL TO ACTION that everyone must heed. For SGDs, it is only through mobilizing that we can succeed in saving our planet and in achieving a truly sustainable future. I hope the UN members took her message to heart. 
 


Image of Dr. Brian G.M. DurieProfessor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels, Dr. Brian G.M. Durie is the Chairman of the Board and Chief Scientific Officer of the IMF. Dr. Durie is also the Chairman of the International Myeloma Working Group (IMWG)—a consortium of more than 250 myeloma experts from around the world—and leads the IMF’s Black Swan Research Initiative® (BSRI). 

 

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