Health and medical conferences have been sites of COVID transmission this year. Croakey managing editor Alison Barrett investigates whether enough is being done to minimise the risks for conference participants, and some of the related equity concerns.
Alison Barrett writes:
For over a year, Franklin Women, a social enterprise supporting women in health and medical research, had been planning a networking event to bring women together in person to hear from other inspiring women leading the COVID response in New South Wales.
The event was to be held in person last week but as COVID-19 cases began climbing from the latest Omicron wave, it was with disappointment that the group made the decision to move the event online.
Franklin Women founder Dr Melina Georgousakis acknowledged that it was a tough decision, telling Croakey that the value of their events comes from being able to network and connect in person.
However, seeing reports on Twitter of COVID transmission at conferences and predictions that cases would peak around the time of the event, Georgousakis told Croakey it made her nervous knowing that there was a chance that people may get sick from their event.
“You’re making them choose between these amazing career opportunities and really putting themselves and their family at risk of COVID,” Georgousakis said.
Croakey is aware of a number of health and medical conferences held this year where participants have contracted COVID.
Professor Marie Bismark, a public health physician, psychiatry registrar, health lawyer, company director and researcher, has attended several conferences during 2022. She told Croakey that she has been made aware of people catching COVID-19 at about half of the Australian conferences she has attended.
Attending conferences in Aotearoa/New Zealand as well as Australia, Bismark said she has been “surprised how few people are wearing masks” at health and medical conferences in Australia.
Bismark, acknowledging that she does not “want to give the impression that [she’s] perfect with [her] mask wearing”, has made personal decisions to attend conferences in a high-quality mask and not attend conference dinners and other social events to minimise her COVID risk.
Bismark said: “I really worry about people coming out to an event, and then potentially taking COVID home to unvaccinated children, older family members, or vulnerable patients.”
She has noticed that delegates in New Zealand tend to be masking more than delegates in Australia. Bismark told Croakey she has not heard the same stories about COVID transmission at the conferences she has attended in New Zealand as in Australia.
Nicole Lee, Director of People with Disability Australia, traveled from her home in rural Victoria to Sydney to present at a conference in June and ended up in hospital for two days due to COVID-19 after attending the conference.
While unsure if she caught the virus at the conference or en route, Lee told Croakey that she felt the organisers did everything they could within the guidelines and bounds of government mandates at the time.
Lee told Croakey that free rapid antigen tests, masks and hand sanitiser were provided at the conference she attended, in addition to messages about staying home if unwell.
Personal responsibility
Without clear guidelines or regulations from governments, it came down to each individual to make their own decision whether to wear a mask or attend the conference if unwell, Lee told Croakey.
Lee said she was one of a handful of conference participants who wore a high-quality mask. She decided to leave the event early one day when she became uncomfortable about the low levels of mask-wearing.
Lee was anxious before getting to the conference. “It was such a shock coming from Melbourne, that’s a bit of a mix of mask wearing and many people still working from home and the shops are mostly empty, to busy shops in Sydney with streets full of people not taking any COVID precautions,” including in airports and taxis, she told Croakey.
These reports and observations raise questions about the level of safety measures being considered or implemented at health and medical industry conferences, particularly during times of high COVID-19 transmission.
Striking a balance
As Georgousakis noted, Franklin Women made the decision for their members, and said that it was also important for conference and event organisers to enable their members to make easy decisions. This is in line with the public health adage of making “healthy choices the easy choices”.
Acknowledging that financial costs may discourage people from not attending an event if unwell, Franklin Women offer full refunds at all their events if people are not able to attend due illness.
Still in the planning stages of the Australasian Association of Bioethics and Health Law conference, co-chair Dr Rebekah McWhirter told Croakey the organisers are continuing to review and “be responsive” to any changes in COVID incidence and also government policies.
McWhirter said the Association’s members are really looking forward to gathering in person, the first time in three years.
While being guided by public health regulations in lutruwita/Tasmania, where the conference will be held in November, McWhirter said that if case numbers are high leading into the conference, they will make decisions that they feel appropriate to keep their delegates safe, such as considering mandating masks for attendance.
“We would obviously be endeavouring to strike the right balance so that we’re not inadvertently causing any burdens on people that aren’t warranted by the risks. Or, you know, putting people at risk unnecessarily when we could take easy actions to reduce that risk,” McWhirter said.
However, she said it was challenging with circumstances “changing all the time” and never having enough information at the right time to make the right decision.
The Bioethics and Health Law Conference will be hybrid, which enables people who may be cautious about attending in-person events to participate, McWhirter said.
A hybrid event also enables people to attend who may not be able to afford in-person attendance, which likely requires travel, and meant the conference could also invite an international expert to speak at the event virtually, she said.
With academic institutions decreasing conference funding during the pandemic, virtual and hybrid events mean you are able to hear from international experts without the extra costs, according to McWhirter.
Equity matters
Bismark said virtual options are great for people who may not feel confident that “adequate protections” are being taken at conferences. However, these people will miss out on the benefits from social and in-person interactions.
“They’re such valuable professional experiences, and I find that a lot of the benefit of conferences comes from speaking with people informally, rather than just the formal sessions,” Bismark said.
It is possible that more people may attend conferences in person if they were confident of good air quality at the venue, universal mask wearing and opportunities for breaks to be taken outside, according to Bismark.
In addition to considering mask requirements, McWhirter is considering ventilation at the venue and options for eating outside.
McWhirter said it is challenging organising events this year due to the significant costs involved in cancelling within a certain timeframe of the event. Given conference and event venues have suffered financially over the past two years, they may be less able to provide refunds.
Leadership
Bismark told Croakey that more leadership is required from the top – for example, if organisation leaders wore masks, then that would encourage more delegates to follow suit.
“There are these real cultural norms and I think a lot of people take the cues from senior members of the profession,” Bismark said.
Some delegates are quite conscious of minimising their risk of catching COVID, according to Bismark and she has noticed in addition to wearing masks, some delegates take CO2 monitors with them to get an idea of air quality at venues.
But, she said: “They’re definitely in the minority, which really surprises me when you think that we’re talking about clinicians, so people who’ve been at the frontlines of the pandemic response and people who are in leadership roles.”
Making conferences safer
Bismark suggested: “Make it easy for people to do the right thing” by providing free high-quality masks and have options for eating and networking outdoors.
She also recommended that senior members of health and medical organisations play a role in modelling COVID-safe behaviours.
Bismark also suggested that conference organisers consider air quality by asking venues what they are doing to manage air quality and ventilation, in addition to case identification and contact tracing – critical in infectious disease control.
It is challenging for conference organisers to implement measures beyond those that are government-mandated or recommended, according to Lee.
Providing a hybrid conference is an equitable option for both cost and for people who do not feel comfortable or are unable to attend in person.
Further reading
Ten simple rules to host an inclusive {virtual} conference, by Rocio Joo and colleagues in Plos Computational Biology
The irony and ignominy of medical conferences as superspreader events, by Anand Swaminathan, Jessica Smith and Esther Choo in Stat News
From Twitter
See thread by Dr Nicole Lee Schroeder, a researcher on disability history.
Some comments were made on Twitter about COVID safety at the Public Health Association of Australia’s recent Communicable Diseases and Immunisation Conference, and concerns have also been raised about health and scientific conferences in other countries. Many people have also shared masked-up selfies from various events and conferences.
Croakey thanks and acknowledges donors to our public interest journalism funding pool who have helped support this post.
