Medical Meetings and COVID: Is Virtual Just as Risky as In-Person?

Going to a medical meeting in person or attending it virtually may carry roughly the same COVID-19 infection risk, a cross-sectional survey study suggested.

In the week following the Academic Surgical Congress (ASC) in Orlando, where masking was required, rates of COVID infection were not significantly different among 546 attendees who went to the meeting in person and 135 who attended virtually (1.8% vs 1.5%, P=0.83), according to Callisia Clarke, MD, MS, of the Medical College of Wisconsin in Milwaukee, and colleagues, writing in JAMA Network Open.

Precautions were taken both before and during the meeting, which took place February 1-3, immediately after the peak of the Omicron wave. At that time, Florida was recording more than 1,000 weekly infections per 100,000 people.

ASC attendees wore N95 or KN95 masks during the live meeting and were encouraged to self-test for COVID-19 before traveling to the meeting. Seating was spaced out for attendants during conference sessions, and only outdoor catering was available. No social events took place indoors.

“These data suggest that among highly vaccinated clinicians with high risk of occupational exposure, cautious strategies to mitigate COVID-19 transmission during a surge were effective, and in-person meeting attendance posed no greater risk than professional hazards,” the researchers wrote.

Overall, 42% of the 1,617 meeting registrants responded to the survey. Ten people who went to the meeting in person self-reported a positive COVID-19 test in the subsequent week, as did two of those who attended virtually. Four live attendees also reported developing symptoms after the meeting, but did not test.

Of the 681 respondents, 27% were medical students, 34% were trainees, and 33% were attending physicians. All in-person participants were fully vaccinated and almost all (91.6%) had received a booster dose as well. Six survey respondents (4.4%) reported switching from in-person to virtual attendance before the meeting began due to a positive COVID-19 test.

This study “offers some hope for the future of relatively safe in-person meetings,” said Winfried Kern, MD, PhD, of Albert-Ludwigs-University Medical Center in Germany, and Daniel Morgan, MD, MS, of the University of Maryland School of Medicine in Baltimore, writing together in an accompanying editorial.

They pointed out that zero transmission was achieved at a medical conference earlier in the pandemic in Switzerland, with the use of “stringent masking, physical distancing, supervised hand hygiene, and canceling of social events.” During that 2020 meeting, none of 168 attendees were infected during a period of lower community incidence than the current study (65 weekly infections per 100,000).

Still, Kern and Morgan highlighted, “evidence of relative safety in the past does not guarantee safety in the future.” Precautions taken during the event must remain “flexible” and adjustments should be made for levels of community transmission at the time of the event, the duo argued.

They noted that outdoor sporting and cultural events also have lower risks when there are high levels of vaccination, previous COVID-19 infection, a negative lateral flow test within 48 hours of the start of the event, and adequate mask wearing, often together with spaced seating.

“Some physicians have argued conferences need to be extremely low risk to avoid ignominy,” wrote Kern and Morgan. “However, the high levels of in-person physician attendance at medical conferences demonstrate broad support for them.”

But they acknowledged that hybrid conferences will likely become the new standard, as this option offers better access for junior academics and professionals taking a career break due to family, illness, or military service, and for attendees from low- and middle-income countries. What’s more, they added, “reduced traveling will reduce the carbon footprint and energy use.”