Clinical Editor's Corner: Kern

Is It Time to Restart Live Cardiology Meetings? The Scottsdale Interventional Forum Experience Shows How.

Morton J. Kern, MD, MSCAI, FACC, FAHA

Clinical Editor; Chief of Cardiology, Long Beach VA Medical Center, Long Beach, California; Professor of Medicine, University of California, Irvine Medical Center, Orange, California

Morton J. Kern, MD, MSCAI, FACC, FAHA

Clinical Editor; Chief of Cardiology, Long Beach VA Medical Center, Long Beach, California; Professor of Medicine, University of California, Irvine Medical Center, Orange, California

Join Morton Kern, MD, with guest panelists David Rizik, MD, and Kirk Garratt, MD, on Thurs 6/17 at 12pm ET for a 30-minute discussion of this column. Register for a reminder here.

This May 2021, the Centers for Disease Control (CDC) announced that if we are vaccinated, we can take off our masks both outdoors and indoors, but should continue to be respectful of those at risk (children, those with medical issues at risk) and keep protective measures in place for the near future. The vaccinated, asymptomatic person may still harbor virus and potentially transmit it. It is our hope and prayer that COVID-19 rapidly fades away and its variants are addressed by our current vaccines, permitting full re-opening of our lives.

In this month’s Catheterization and Cardiovascular Interventions, Drs. Rizik, Rao, Stone, Burke, Hermiller, and O’Neill describe the conduct and outcomes of the Scottsdale Interventional Forum (SIF) as the first live interventional cardiology meeting of 2021.1 I had the honor of participating and can attest to the meeting’s efforts to protect all attendees, hotel staff, and guests while providing top-notch educational presentations between live demonstrations of percutaneous coronary intervention (PCI) and structural heart interventions. A fellows-in-training and nursing symposia were also part of the program. It was a masterful accomplishment and certainly worthy of review as a template for live meetings going forward.

How Was It Done?

In 2020, the springtime live SIF meeting was converted to a virtual meeting in keeping with the CDC requirements during the pandemic. The meeting organizers, including Drs. Rizik, Hermiller, and Reisman, began planning for the following year’s March 2021 meeting, anticipating that some degree of vaccination and effective safeguards would permit a live program. Many discussions among the proposed faculty and local community participants helped determine the final format. The Herculean efforts made to protect the attendees paid off. There were 430 on-site participants (physicians, nurses, ancillary healthcare providers, SIF production crew, meeting planners, event organizers, industry support, and other personnel), including faculty. Of these 430 participants, 128 (29%) were from out of state, needing to travel to the venue. Importantly, to provide proof of concept regarding COVID-19 precautions effectiveness, all 430 on-site SIF participants were contacted after the meeting to determine whether anyone became sick. There were no participants reporting illness and there was a 100% response rate. Equally important, the hotel’s human resource department performed daily tracking following the SIF 2021 meeting, and confirmed that none of their 213 employees had new symptoms or tested positive for COVID-19 within 30 days following SIF.

As one might expect from the fervor surrounding the need to be vaccinated, 286 individuals (67%) were fully vaccinated with an additional 11 persons (2.5%) having received one of the two required doses. Of the 144 not vaccinated, many had not yet qualified for the vaccine. The number of those declining vaccination is unknown. No participant or hotel staff involved with SIF 2021 contracted COVID-19.

CDC Recommendations for Live Meetings

The CDC’s website provides “Guidance for Organizing Large Events and Gatherings”, updated Apr. 27, 2021.2 Following is a synopsis of the report. The CDC continues to recommend avoiding large events and gatherings. Currently, CDC does not provide numbers to define small and large events.

Large gatherings bring together many people from multiple households in a private or public space. Large gatherings are often planned events with many guests and invitations. They sometimes involve lodging, event staff, security, tickets, and long-distance travel. CDC’s large events guidance applies to conferences, trade shows, sporting events, festivals, concerts, or large weddings and parties.

Small gatherings are informal in nature and may occur with family and friends you regularly socialize with, often at someone’s residence (like Sunday dinner). They typically do not involve long distance travel. Small gathering guidance might be appropriate for social gatherings that are more intimate with close friends and family, such as small holiday parties, family dinners, and small special celebrations.

Event planners should work with state and local health officials to implement this guidance, adjusting to meet the unique needs and circumstances of the local community. This guidance is meant to supplement — not replace — any state, local, territorial, or tribal health and safety laws, rules, and regulations with which gatherings must comply.

Risk Factors to Consider for Live Meetings

Several factors can contribute to the likelihood of attendees getting and spreading COVID-19 at large events. Table 1 lists several factors that will create higher or lower amounts of risk for contracting illness. The safety measures used by SIF 2021 are listed on Table 2, and met or exceeded recommendations from the CDC.

The CDC recommended that organizers should continue to assess, based on current conditions, whether to postpone or cancel large events and gatherings, or significantly reduce the number of attendees for events. If organizers are unable to put safety measures in place during large events and gatherings, they may choose instead to host a virtual event.

The SIF organizers followed and implemented CDC guidelines. The results were highly successful events, although they were still spaced out [I mean that in a good way – MK] meetings, returning almost to a pre-pandemic experience.

The Bottom Line

It is exciting to think that we’re almost back. While hospital personnel likely will continue to follow safety recommendations of masks, heightened hand washing, and screening, the remainder of workplaces, schools, and public gatherings will almost be back to normal. It also seems reasonable when planning medical conferences that (1) meeting organizers account for the regional seroprevalence of SARS-CoV-2, including the emergence of “variant” strains, and (2) consider mandating participant “proof of vaccination.”

We are all witness to one of history’s most devastating natural events. The resiliency of our country’s men and women, and the innovation of scientists to keep us alive and well, have made a life-and-death difference. I know I speak for my colleagues working in cath labs around the country and the world when I say a heartfelt “thank you” to all who work to protect us. 

Addendum: How Important Will Online Meeting Options Be as We Return to In-Person Learning?

During the pandemic year, we learned that educational opportunities through Zoom and other online platforms were effective, but lonely.  Online learning will remain a large part of educational meeting formats, including in-person meetings, as it permits those not physically present to be part of the live meeting segments remotely. As described for SIF, the live meeting, however, is a more complete experience of not just didactic lectures, but also of the personal touch and small but poignant moments which make learning at live meetings richer. Online learning is here to stay, but in different degrees for different meeting sizes, content, and goals. 

Disclosures: Dr. Morton Kern reports he is a consultant for Abiomed, Abbott Vascular, Philips Volcano, ACIST Medical, and Opsens Inc.

Dr. Kern can be contacted at mortonkern2007@gmail.com.

On Twitter @drmortkern

References
  1. Rizik DG, Rao SV, Stone GW, Burke RF, Hermiller JB, O’Neill WW. Re-instituting a live cardiology meeting without symptomatic COVID-19 transmission. Catheter Cardiovasc Interv. 2021 May 13. doi: 10.1002/ccd.29748. Epub ahead of print.
  2. Centers for Disease Control. Guidance for Organizing Large Events and Gatherings. Accessed May 20, 2021. https://www.cdc.gov/coronavirus/2019-ncov/community/large-events/considerations-for-events-gatherings.html