What are your threshold criteria for attending a meeting this year?
Click here to read the Cover Story, "Forecast hazy for future in-person ophthalmology meetings."
Skip a year
Major ophthalmology meetings are a great source of renewing friendships, catching up on the latest information and techniques, and seeing the new toys we all love to use. It is a big part of each year and critical for our professional organizations for all the same reasons, as well as paying the bills for all the work they do. I get it: Canceling a big meeting is, well, a big deal. I have never missed an American Academy of Ophthalmology meeting in 45 years. It has been like part of the landscape, as locked into my thinking as the changes of the seasons. So, I fully understand the forces that are pushing the decision to keep this meeting open even though the Association for Research in Vision and Ophthalmology and the American Society of Cataract and Refractive Surgery, correctly in my opinion, canceled their meetings with equally strong reasons why they would want to keep those meetings going.
With 98% or so of the population uninfected and no good treatment or vaccine at this time, the only reason to hold a large meeting is if it can be safely carried out. We know the four core rules by heart at this time: 1) no one who is symptomatic attends, 2) social distancing, 3) all wear face masks and 4) wash hands carefully and often. Sounds easy enough, so why not attend the AAO meeting this fall? I just wish it were so simple, and I can think of many reasons why this is not a good idea. The key concern in checking viral spread is minimizing exposure. Travel to a major meeting means a lot of people on airplanes where social distancing is often not occurring as the airlines cut flights and more are crowded. We have all heard horror stories of flights plenty crowded and many letting masks slip and, despite screening, plenty of coughing going on. So, this is exposure point one and includes the airports on both ends.
Once you run the airport gauntlet, then there are hotel check-ins, restaurants, transportation to the meetings and then the meetings themselves. We may mean well, and I see a good talk, but what I am seeing in stores and public places now is that reality means social distancing and always wearing masks soon become laughable. Yes, there are places that try and police this, but humans are social animals, and it is like herding cats. Hey, ophthalmologists are professionals and will surely do better. I would hope so, but there is a reason why with society opening many states have limited group functions to 20 or 50. You just compound the odds of exposure the larger the groups get.
So, maybe we will be a lot better with this pandemic in the fall. Do not count on it. Most experts I trust in expect it will likely be worse with a second surge expected. Maybe an effective vaccine by then? Sorry, but not going to happen. Maybe by early 2021 but not this fall. In fact, I think it is highly likely AAO will be canceled by edict anyway after a whole lot of planning and effort has gone into the meeting. It is just hard to see from a public health viewpoint that this makes much sense. All I know who are planning on going I am encouraging not to go, and if they plan on it, make sure reservations can be canceled without penalty, as that is going to be the likely outcome.
There is just so much we do not know at this time. We are getting mixed messages about disease spread by asymptomatic patients or the percentage of cases that are totally asymptomatic. We do know that risk for death goes up dramatically if you are male (check), older than 65 years (check) and have some underlying diseases (sadly three checks for me). So, sounds like a lot of baby boomers I know to me and a big chunk of AAO membership. This certainly fits me to a T and certainly high-risk individuals should not go, and I would hope the AAO makes this clear. Still, I know very high-risk people who are feeling obligated to attend, and that worries me a lot.
So, hypothetically, let’s say 100 people get this virus from attending, 20 are hospitalized and six die. No one knows, but this is not an unreasonable scenario if 10,000 people attend. Probably on the conservative side, actually, but just a guess. So, if a crazy person stormed into our annual meeting and shot 20 people and killed six, would we take this lightly? I think not, but the risk may be similar. The smart decision in my opinion is no major meetings until we get an effective vaccine in place. We can skip a year just fine, and why run the risk? In conclusion, I think it is clear I am not going. No way, no how.
Randall J. Olson, MD, is an OSN Cataract Surgery Board Member.
Not before the fall
I am itching to spend time with my ophthalmology friends and family. Regardless of content or need, I cannot see myself traveling to a meeting until early fall at the earliest, though. Everyone is on high alert to see how the disease spread continues to unfold as moratoriums lift and our nation continues to open back up. There are still so many unknowns related to travel with airports, airlines, hotel and meeting space occupancy, and potential new clusters of disease spread. We may have travel restrictions placed upon us from our own workplace, including a self-quarantine process upon return from travel for nonessential work. This, in addition to the need to sustain financial viability, will frame my willingness to travel to a work meeting.
While virtual Zoom meetings have served as a good alternative, meetings will need to become more creative, and this will require infusion with live and more interactive components. I do not know if pre-meeting COVID testing will hold much value because the act of traveling alone may be the biggest risk to each of us for disease spread. If invited as a faculty member, I would prefer a potential hybrid approach in which the faculty panel could be together with social distancing observed, while employing a virtual audience approach. I would be willing to attend a meeting if the meeting rooms allowed for sufficient distancing between each attendee. While the threshold of total attendees would depend on the occupancy of the room size, I do not have a sense for what my personal threshold would be for a total number of attendees around me. At this point, I would prefer a small meeting approach, and round table or small group discussions would be more ideal (20 to 50 per gathering). I think I would almost prefer to go to less popular, less populated cities where exposure overall could be mitigated.
Lastly, the level of preparedness of the meeting organizers will need to be transparent. Meeting information such as venue details, total number of attendees and virtual options will color my decision about attending a meeting, even though these were considerations that I did not give a second thought to before SARS-CoV-2.
Elizabeth Yeu, MD, is OSN Cornea/External Disease Section Editor.
AAO is the question
The decision to attend a live meeting or not this year was made for me in most cases by the meeting organizers. Pretty much all the meetings I had been invited to present at or participate in for 2020 since March have either been postponed or gone virtual due to the pandemic. In addition, my medical school has instituted a travel ban for international meetings and a freeze on the professional account, which means any travel to a meeting will have to come out of my pocket. All of this is disappointing because this was to be the “Year of the Eye,” 2020, a meaningful year for ophthalmology, and I was to speak in Egypt, Ireland, South Korea, England, India and Saudi Arabia, in addition to various national and regional meetings.
Currently, the only meeting I need to make any decision to attend in person is the annual meeting of the American Academy of Ophthalmology in November in Las Vegas. If this meeting does go as currently planned as a live meeting, I plan on attending. Because I am chairing the Retina Subspecialty Day program this year, I feel it is important for me to attend. Furthermore, I believe AAO and the convention center will take as much precaution as possible to make it as safe an environment as possible for the attendees.
I would expect all to wear masks, plenty of hand sanitizers everywhere, distancing of chairs in the audience with limited seating, plexiglass windows at counters, cleaning of kiosks, mouse, podiums, and microphones after each use, social distancing and congregating out in the open space rather than indoors, if possible. I want to avoid congested elevators, so I will be taking the stairs often or wait for an empty elevator. I do not expect any buffet lunch but possibly a boxed one. The coffee break may need to change. The stay at the hotel, going out to restaurants for meetings and social events, as well as flying, are additional places to give a thought when attending a meeting during this COVID-19 era.
While virtual meetings have been nice and saved time from all the traveling, certain things are best accomplished with in-person meetings. Our individual risks and thresholds vary, resulting in many deciding against attending a live meeting until a foreseeable future. That is to be expected, should be accepted, and the meeting organizers need to plan accordingly. I do not expect any live meeting attendance to reach its pre-COVID level any time soon. This includes meetings planned for early 2021.
It is possible that the AAO meeting may become a virtual or a hybrid meeting this year. Only time will tell during these unpredictable times. However, some are ready for an in-person meeting. I hope everyone will be doing their part and be considerate of each other to keep everyone safe.
Judy E. Kim, MD, is an OSN Retina/Vitreous Board Member.