Dear clients and friends: Given your interest in health and medicine, we would like to share with you our collection of the most interesting perspectives on our industry's trends and developments. We are happy to share them with you — and hope you share your thoughts with us.

1. The CPHO Will See You Now

Fortune floats the idea of a new role at every company: the Chief Public Health Officer. The argument starts with COVID, but reaches beyond:

With no quick or easy end to the pandemic (nor a host of other public health problems) in sight, figures from both the business and public health worlds say it’s time to bridge the gulf that has traditionally separated the two sectors. Some, including Michelle Williams, dean of the Harvard School of Public Health, envision a world where public health considerations are regularly integrated into business plans and where maybe even a new brand of executive, a chief public health officer, has a seat at the table.

A CPHO would create opportunities for pharma to build innovative partnerships and reach both employees and consumers.

2. The CPHO Requests that You Log Off

Yet the need for better public health information and strategies faces a formidable foe: Facebook. The Atlantic examines how the social media platform “warps reality” about basic public health understanding. Here, two groups – for and against reopening – both go off the rails: 

Over time, the rhetoric in each group has become noticeably more dramatic. While Banned from Reopen was once a place to swap dazed stories about the experience of clashing with people who were vehemently anti-science, it is now full of self-righteousness and morbid jokes…Reopen NC has also become even more extreme: While users were initially indignant about lockdown measures and suspicious of the motivations of politicians like Cooper who implemented them, it is now teeming with outright conspiracy theories.

The alternate reality and “fake news” ecosystem of Facebook also complicates pharma’s dogmatic insistence to use social media to reach patients “where they are.”

3. Trials Under Fire

The industry has moved with unprecedented scale and speed to launch 1,200 clinical trials for COVID-19, covering 685,000 participants. But a new analysis from Stat rains on the parade:

One in every six trials was designed to study the malaria drugs hydroxychloroquine or chloroquine, which have been shown to have no benefit in hospitalized patients… Indeed, the analysis found many of the studies are so small — 39% are enrolling or plan to enroll fewer than 100 patients — that they are unlikely to yield clear results. About 38% of the studies have not actually begun enrolling patients.

4. The Secret to Innovation: Opacity

DARPA, the federal agency that develops technology for the US military, is responsible for creating the foundational technologies for the Internet, GPS, bomb-detecting bees, and earthworm robots.Tech and innovation blogger Ben Reinhardt offers a sprawling investigation into how DARPA works. He provides a wealth of counterintuitive gems about innovation, some of which pharma may do well to heed:

Opacity is important to DARPA’s outlier success. Congress and the DoD have little default oversight into how a [program manager] is spending money and running a program. Opacity removes incentives to go for easy wins or to avoid being criticized by external forces. Of course, opacity can also be abused in too many ways to list, so it’s important to ask: How does DARPA incentivize people not to abuse opacity? DARPA’s small size and flat structure enable peer pressure to work in positive ways. Finite tenures either make people want to utterly crush it or not care at all. The former happens when you empower driven program managers.  

5. The Doc Got Doxxed

Loyal readers of HLG’s Pharma Notebook may have noticed our affinity for the blog Slate Star Codex. The anonymous author was a practicing psychiatrist, and she or he offered a regular slate of candid, contrarian, and incendiary insights on mental health and the healthcare system. No more. The New York Times profiled the blog, discovered the author’s identity, said they would expose it, and now the blog is done. The author pens a goodbye:

I have a lot of reasons for staying pseudonymous. First, I’m a psychiatrist, and psychiatrists are kind of obsessive about preventing their patients from knowing anything about who they are outside of work…I think it’s plausible that if I became a national news figure under my real name, my patients – who run the gamut from far-left to far-right – wouldn’t be able to engage with me in a normal therapeutic way. I also worry that my clinic would decide I am more of a liability than an asset and let me go, which would leave hundreds of patients in a dangerous situation as we tried to transition their care…When I expressed these fears to the reporter, he said that it was New York Timespolicy to include real names, and he couldn’t change that.

This is a loss, especially for an industry that stands nearly alone in respecting and protecting privacy.