The Rheumatologist and Medical Education in the Time of COVID-19
I used to be a frequent flyer — for that matter, I used to fly. Life often changes in a blink of an eye and there are few other areas of societal medicine that have changed more than the field of medical education. I would like to take a moment to reflect with you on these changes and offer some thoughts of the good and the bad and perhaps divine a bit on the road ahead.
The changes in general have been tectonic-driven by the recognition that asymptomatic spread of COVID-19 is real, and that social distancing is effective at suppressing an accelerated disease curve. For example, take the study of an apparent “super-spreader” at a Biogen leadership meeting (less than 200 people) in early March during which a single person spread COVID-19 to an official count of 99 persons and then far beyond as attendees boarded planes to return to their respective homes. Such scenarios have served as chilling reminders that live meetings without social distancing carry profound risks.
Just imagine the consequence of the same type of “super-spreader” at EULAR and ACR, merely weaving their way through the poster hall. I am not trying to freak out over this possibility, since clearly cooler heads have prevailed for now and major meetings that I often attend have all been canceled, postponed or reconfigured. The Conference on Retroviral and Opportunistic Infections (CROI), a major infectious disease meeting in early March, was among the first to be canceled and among the first to go virtual. The possibility of a live EULAR conference in June — which I was to attend — is gone, but I look forward to seeing their virtual platform.
Additionally, the Federation of Clinical Immunology Societies (FOCIS), a great immunology meeting that Cassie and I were to attend together in San Francisco in June, which keeps us abreast of the happenings in the world of immune-related adverse events, has now been pushed back to the fall. Many other popular meetings, such as the Congress of Clinical Rheumatology, have now been pushed back until fall but whether any of these meetings in a live and traditional format will actually take place this year remains to be seen.
What will help make these organizers make these decisions? Science hopefully will drive much of this complex process as we increase our understanding of the prevalence of COVID-19 in the general population combined with a more granular understanding of the nature of viral spread and the effectiveness of immunity. This latter point is far from clear and of vital importance. For many of us a certain age — and commensurate COVID-19 risk — the question will be as to both whether and when getting on a plane the next time will be worth it.
We at Cleveland Clinic are in full preparation mode for ACR with abstracts ready to be launched, displays in the making and satellite conferences in the planning. The only real question is whether the conference will be live, virtual or both?
Let me close by looking on the positive side of this issue. By that I don’t mean that sooner or later live meetings will resume because they will at some point; rather, let’s reflect on what advances in education are already being felt in this virtual era. We are all getting pretty hip at Zoom and Skype and every other video conferencing platform, and I am really impressed by how many people are attending presentations in the evening and on weekends. I don’t know what everyone is doing but they are certainly registering, and the presentations have been great.
Repurposing meetings like CROI by CME entities has been invaluable to me and I see much more repurposing of large meetings in boutique ways that will offer condensed and interpretive distillates by trusted key opinion leaders on both large and small areas of interest. New platforms, gamification and interactive formats all will serve to enhance the experience — and, best of all, you don’t have to dress up or dress at all if your camera is off. Finally, virtual meetings are a forum that blends well with my ultra-persona of ‘Wine and The Rheumatologist’ as I now get to learn while drinking really good wine from my cellar. That’s my take — please send me yours through Twitter at @LCalabreseDO or email me at firstname.lastname@example.org.
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- Leonard H. Calabrese, DO, is the Chief Medical Editor, Healio Rheumatology, and Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer Chair of Clinical Immunology at the Cleveland Clinic.
Disclosures: Calabrese reports consulting relationships with AbbVie, Centecor Biopharmaceutical, Crescendo Bioscience, GlaxoSmithKline, Horizon Pharma, Janssen Pharmaceuticals, Pfizer, Regeneron Pharmaceuticals and UCB.