Remember the Oprah Winfrey-endorsed bestseller The Power of Now.  It’s sold more than two million copies worldwide and has been translated into more than 30 foreign languages. The author intended to pen a spiritual self-help guide to help us discover our purpose of being – to confront the challenges of the moment – and conflicts – of “living in the now.” 

Perhaps all we heard from the title and the take away is “I want it now.” When it comes to science and public health, that’s a mega problem. When do I want it? Now!

Clinical Trials Usually Take Years.  Enter Operation Warp Speed

How long do or should clinical trials take – well, it depends – but often years. Science takes time. It demands rigor and objectivity. It’s not a “now” pursuit. It’s why so many potential medicines fail to advance through clinical stages to our medicine chests as physicians and patients work diligently to evaluate their safety, effectiveness and long-term risks in observational studies. 

For example, the research into drugs to reduce life-threatening high cholesterol spans decades.  Many think of the incredible drugs now available as generic, which fueled continued research. Few think of the game-changing Framingham Heart Study or the groundbreaking and Nobel Prize-level work of scientists Drs. Michael Brown and Joseph Goldstein. There is beauty to science.  In the famed Academy Award-winning movie The Agony and the Ecstasy with Charlton Heston, as Michelangelo and Rex Harrison playing Pope Julius II, Heston’s character is constantly asked by Harrison, when will the Sistine Chapel ceiling be completed.  The artist replies: “When it’s done.”  That’s science!

It’s possible that COVID threw science – the purity of the art of discovery to improve humanity’s lot – out with the peer-review bathwater.  Everyone is at fault in some way. Government agencies, elected officials, public health champions, media, and, yes, the public are all part of the now movement.  We all wanted a biomedical elixir to ward off the virus NOW! We have been conditioned to get what we want quickly.  We order online at Grub Hub or Amazon, and within hours – a day tops – a vehicle pulls up to our doorstep.  NOW!

Now, how about COVID? We expected salvation at warp speed.  Companies no longer wait to share data at peer-review forums or in top-notch journals.  When the public cries out, we send out a press release. We expect answers from pharma, the White House and CDC immediately. We moved to evaluate, approve and move to rally people to access the COVID vaccines a mere 13 months after trial initiation. The mRNA vaccine became the first FDA-approved COVID-19 vaccine on August 23, 2021.  That’s the equivalent of now when it comes to drug development.

It Takes Years to Develop a Vaccine – NOW?

In comparison, the usual vaccine development timeline is five to 10 years and sometimes longer to determine if a product is safe and efficacious in clinical trials, completes the required regulatory approval processes, and a manufacturer has a sufficient quantity of vaccine doses for public access.  COVID broke the previous record of four years set by the development of a mumps vaccine in the 1960s.

But there are reasons we were able to go fast. The infectious disease community is collaborative. There are previous models of engagement, We have technologies that enable us to screen options that didn’t exist in the 1960s. It’s impossible to compare apples to apples or oranges. The times have changed. Science can move faster; however, objectivity and peer review remain musts.

Don’t point the finger of blame at any one institution or segment of the process.  Everyone created and bought into this urge for now!  We were frightened for our survival, mental health and economies.  The White House was responding to public pressure.  Events changed rapidly, and so did the news flow.  Media leaped into the fray to bring out their wagons of consulting experts aboard, with varied opinions to keep eyes glued to screens. Researchers slept at lab benches to sustain the world – to ward off the – then-deadly pandemic. 

We cannot forget that while we criticize the scientific process and unknown long-term effects of these vaccines, the “power of now” drives decisions and actions.  We cannot forget that the ERs were filling up, and people were dying at the start of the pandemic.  We were scared, and fear ignited non-reflective action. Countless public health challenges were pressing – addiction, poverty, isolation and more. We needed a response. Sometimes the process is imperfect. Let’s not forget to evaluate how all this impacted science and apply the learnings in the future.

Tech as a Scientific Accelerator

Technology has become the gas pedal for science.  AI, AR, machine learning, and big data are all variations of the same concept, but technology does enable scientists to move rapidly. The urgency to offer hope tips the hat to companies being permitted to update the public via news releases and later share detailed information in a peer-review setting. Industry scientists yearn to help sustain lives. Everyone had good intentions. However, we need to find better balance and return to a culture that encourages objective reflection and third-party (even uncensored) pushback,

The Power of Now was geared to get us to think beyond the moment.  To consider who we are and our purpose in the world.  However, like most things, we commercialize good ideas. COVID left too many casualties – most important among them precious people and, yes – scientific exchange.  Now is a competitive advantage – often a first-to-market must.  However, science is a reflective task accelerated by technology. 

Let’s Open the Door to the Power of Options

The Power of Now has given way to the Power of Options, a concept shared by David Noble and Carol Kauffman in the recent issue of HBR. Scientists remain societal leaders.  Scientists are curious and explorers.  We must encourage scientists to create their life-saving magic in coordination with the checks and balances of their peer-review culture.