In early June, the American Society of Clinical Oncology held its 2022 Annual Meeting (#ASCO22) in Chicago. This was the first in-person annual meeting since the pandemic began.  While attendance was smaller than usual, McCormick Place (the largest convention center in North America) still hosted 30,000 oncology-related clinicians, researchers, healthcare professionals, patients, and advocates from all over the world. 

To address the risk of COVID-19 transmission, attendees were required to prove they were fully vaccinated against COVID-19. Attendees also were required to have a negative COVID-19 test, and COVID tests were readily available during the conference. Masking was recommended – “ASCO expects all attendees to be masked indoors at our meeting when not eating, drinking, or presenting.”

I am a cancer research advocate living with incurable lung cancer for over eleven years. I started attending ASCO Annual Meetings in 2014. It’s wonderful to gather with other cancer patient advocates, network with oncology professionals, and learn about the newest research for my disease.  I would have loved to attend in person this year, but I didn’t.  I chose to attend virtually during the pandemic because my radiation-scarred lungs are prone to infection (I’ve had pneumonia more than once since my diagnosis), and lung cancer patients are at increased risk of death from COVID-19.  However, I had a window into the happenings at McCormick Place via the #ASCO22 hashtag on Twitter, as well as texts and messaging from friends who were there.

Many attendees tweeted pictures of colleagues reunited after a long, trying absence. The pandemic has been especially tough on medical professionals.  They needed the joy that reconnection brings.  I don’t begrudge them that.

However, those images generated a different emotion for me. After speaking with several friends in the lung cancer patient advocate community, I’ve learned I’m not alone in my feelings.

I’m pissed that the ASCO community appears to have given so little value to the safety of people who have cancer. Here’s why.

RISK OF COVID-19 TRANSMISSION AT #ASCO22 WAS KNOWN BEFOREHAND TO BE HIGH

COVID-19 transmission was deemed high in Chicago by the city’s COVID Dashboard in the weeks leading up to #ASCO22.  Omicron variants were on the rise and deemed very transmissible. With tens of thousands in attendance, chances of encountering someone infected with COVID were NOT low. Although omicron symptoms seem generally less severe, people are still dying from it–especially people with underlying conditions, like cancer. Others have lingering side effects.

Several medical professionals who attended the smaller 2022 American Association of Cancer Research (#AACR22) Annual Meeting in New Orleans last April tested positive for COVID-19 a few days after the meeting.  Masks were not required at AACR, and few masks were seen in surrounding hotels, restaurants, and public transportation. By the start date of the much larger ASCO meeting two months later, community transmission of COVID was much higher.  The likelihood someone at #ASCO22 would become infected was a virtual given.

MASKS WERE EXPECTED, BUT NOT REQUIRED

While ASCO expected masks to be worn, masking was not required nor enforced.  On the second day of the conference, a tweet observed that perhaps 50% of attendees were wearing masks.  Other tweets showed some attendees gathered for selfies and group pictures in session rooms and hallways wearing no masks.  Others reported people at ancillary events and hosted parties that included food were frequently unmasked.

ONLY ONE COVID-19 TEST WAS REQUIRED, AND RESULTS WERE NOT CHECKED

ASCO 2022 required a COVID-19 test “within 48 hours of the time they entered any of the session rooms or exhibit hall.”  This allowed international attendees with long flights to test after they arrived at McCormick Place.  However, testing relied on the honor system:  no one verified nor recorded test results.  Both rapid and PCR tests were readily available throughout the conference for those who wished to test again, but no system was available for posting results.  One doctor who planned to attend tested negative for COVID the day before travel.  To be extra safe, they tested just before leaving for the airport.  That second test was positive. As a result, she chose not to attend the conference.

It’s unlikely everyone was equally diligent with testing. How many people arrived at the conference unknowingly positive?

ONCOLOGY PROFESSIONALS, YOUR PATIENTS WANT YOU TO SET THE EXAMPLE

Oncology is a medical field that’s evidence based and highly dependent on data.  Good results demonstrated in clinical trial data are essential to getting new cancer drugs approved by regulators and available to patients.  One would think oncology professionals would be the first to follow the data when it comes to protecting their patients from COVID-19. People who have cancer expect our doctors, nurses, and other clinical professionals to set and maintain a high bar.

So many patient advocates typically attend ASCO that the meeting offers a Patient Advocate Lounge as well as patient-focused programs. Many of these advocates have active cancer. Before the meeting, both patient advocates and doctors pleaded with ASCO to make masking a requirement to reduce the risk of spreading of COVID to patients who attended ASCO, and to healthcare providers at ASCO who would be seeing patients in clinic when they returned home. ASCO refused. The letter has since been taken down, but is mentioned in this article.

Lung cancer patient and research advocate Jill Feldman had the honor of being invited to speak in an ASCO education session. Including patients on ASCO panels is still rare, and Jill takes the responsibility of representing the patient voice seriously.  She chose to forego in-person ASCO except for the session in which she was speaking because she had significant COVID anxiety — she’d been hospitalized for the virus last December. She lives near Chicago, so she didn’t have to fly or stay in a hotel.  She wore an N95 mask, except for her time on the podium.  A tweeted picture of the audience in her session (since deleted) showed many faces and few masks. Despite Jill sharing her anxiety about possible COVID exposure at the end of her talk, some ASCO attendees approached her afterwards to chat without wearing masks. 

On the day after the five-day meeting ended, two tweets by Tatiana Prowell, MD, reported ASCO22 attendees were already testing positive for COVID.

I am grateful for the oncology professionals who are caring for me.  I am glad they feel renewed by their experience at #ASCO22. I appreciate those who were careful to stay masked while at the conference.

Still, I am angry about the apparent disregard for people who have cancer that was demonstrated by ASCO as a community and the oncology profession as a whole. Many #ASCO22 attendees were unmasked while hugging, sitting shoulder-to-shoulder in sessions, chatting while in noisy food courts, catching up over Exhibit Hall lattes, and networking at after-hours parties.  I wonder how many of them (or the people they were near) were in clinic the next day sharing their ASCO joy and COVID with immunocompromised patients.

A fellow lung cancer advocate and virtual #ASCO22 attendee tweeted her decision not to attend in person.  Her choice was widely applauded: in five days, her tweet received almost 2000 likes, 200+ retweets, and dozens of “thank you” responses.

C’mon, ASCO community, you can do better.  Cancer patients expect – no, REQUIRE – you to set a high bar.  Step up.