Large, in-person medical conferences can be risky in the Omicron era. Yet, proponents say these risks can be mitigated, and resuming in-person learning and networking are necessary to advance medicine and support a profession at its breaking point.
Before the pandemic, medical conferences were like the Super Bowl for health-care professionals – annual events to learn, network and socialize. Now they are making a long-awaited comeback, but not without risks to attendees and their communities.
In May, a number of attendees at the American Urologic Association meeting tested positive for COVID-19 following the event in New Orleans. The same was true for the Society for Academic Emergency Medicine meeting, also taking place in New Orleans over the same weekend amidst a rise in cases in the United States.
This risk was not lost on conference attendee Lauren Westafer, “By day two, you started hearing about people testing positive.”
Westafer, an emergency physician and researcher from Springfield, Mass., was nervous about her first in-person conference but was motivated to both attend and avoid acquiring COVID-19.
“You could end up with a whole department you are unable to staff if half go and get sick,” says Westafer. “I had to work shifts, but I also needed to protect my family.”
To avoid COVID-19, Westafer planned ahead, but acknowledged it was still possible she could return with an infection.
“I researched masks. I wanted something breathable and that fit behind my ears so that I wouldn’t be compelled to take it off. I also tested myself each day and before arriving home.”
Weeks since the meeting and not testing positive, Westafer has no regrets.
“I didn’t realize how hungry I was for the human connection, for the information, the inspiration and the innovation. Our departments are getting crushed with crowding and very sick patients. Morale is very low. To hear this is not just happening where I work and to troubleshoot how to make it better … This made me feel like I was part of a larger community.”
Andrew Helmers, a pediatric critical care physician in Toronto whose research is in bioethics and medical professionalism, says the resumption of in-person medical conferences marks an uncomfortable transition period for the health-care profession.
Helmers says there are challenges unique to patient-facing providers who attend gatherings, such as staffing implications and potentially exposing vulnerable patients; like him, many doctors and nurses have witnessed the severe effects of COVID-19.
He also says health-care providers are in a state of limbo when it comes to attending social events in the pandemic, even with restrictions lifted.
“In residency training programs in particular, there has been an absence of socializing outside of work in spite of what happens outside of work not being the purview of the hospital or the program,” Helmers says. “There is a hidden curriculum in terms of discouraging participation in case they get sick and the schedule gets disrupted.”
Along the same lines, Westafer adds, “We have this expectation for emergency doctors and residents to live an austere life that the rest of people are not living. It is unreasonable to hold emergency docs to an unhuman standard.”
Like Westafer, Helmers says there are intangible benefits of in-person conferences that bolster the attendee and the profession. “There is something to be said about having a face-to-face sit down and heart-to-heart discussion with someone who is traveling that same road with you in health care.”
If these people got sick at the conference, it would risk closure of small emergency departments across the province.
Amna Karabegovic, an emergency physician in Toronto and organizer of the Emergency Medicine Update conference in May, recalls the heavy weight of the decision to hold the conference in-person.
“By January, we knew we had a more transmissible variant and the majority of our audience were community emergency physicians who work in Ontario. If these people got sick at the conference, it would risk closure of small emergency departments across the province.”
EM Update decided on a hybrid version, hosting 250 emergency department health-care providers in-person for a three-day conference in downtown Toronto and 500 attending virtually, without any word of cases resulting from conference attendance.
Factors such as the need for hands-on learning ultimately made the organizers offer an in-person option. Roughly a third of conference programs were workshops that prepare emergency providers for infrequently encountered emergencies, such as needing to insert a chest tube or manage a difficult airway.
But for in-person attendees, safety was the top priority, says Karabegovic.
“It was fully masked and fully vaccinated. We cancelled the organized social events and our plated lunch. We created boxed lunches so that attendees could eat outside or wherever they felt comfortable. We also did not allow any food or drink in any of the meeting rooms, and we had volunteers to remind people about masking.”
The virtual content streamed simultaneously, and Karabegovic says they had to pivot quickly when two speakers were unable to attend because of household contacts with COVID-19.
“We livestreamed them from their home as if they were on stage, and the only thing that was lost was the ability to go up to them after. There was zero negative feedback.”
It took a lot of dry runs, says Karabegovic, who acknowledges the increased organizational complexity in hybrid conferences, as well as higher costs and more technical support.
Westafer hopes to see future conference organizers take some responsibility for attendees’ safety and says, “As you get your badge, provide a few test kits and advise testing every morning. Rather than squeeze balls or USB flash drives, give out a stash of high-quality masks.”
Helmers and Westafer also say departments need to take steps to make in-person attendance at professional meetings feasible, such as incentivizing back-up call schedules in the wake of illness or equitably limiting the number of attendees from any one department.
“Departments and programs have a prerogative to ensure patient care can be delivered in the wake of any given conference,” Helmers says. “In this transition period, it may be a hard balance to strike.”