Infectious Disease

Rheumatologists urge EULAR to consider virtual option for 2023 congress

January 27, 2023

7 min read


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Conway, Lane and Calabrese report no relevant financial disclosures. Vollenhoven reports being a EULAR officer.


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The EULAR Congress of Rheumatology is set to return this spring as an in-person, onsite-only event, with no live remote options, for the first time since the beginning of the COVID-19 pandemic.

Although many rheumatologists are eager to make their return to the annual EULAR meeting in an in-person setting, others are voicing frustration with the limiting nature of an event that only offers accommodations and participation for those willing to travel.

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EULAR announced in early October that its 2023 congress would take place as an onsite-only event, scheduled for May 31 to June 3 in Milan.

Meanwhile, the specter of COVID-19 still looms over much of the world — and the world of rheumatology in particular — even as infection figures remain much lower than in their omicron peak 1 year ago. It follows that one key question for a large, onsite-only meeting — and especially one catering to providers who regularly interact with patients back home who are immunocompromised — asks what kind of COVID-19 mitigation measures might be present.

“As a rule, I think every possible safety measure should be put in place,” Richard Conway, MD, a rheumatologist at St. James Hospital, in Dublin, told Healio. “Given that one of the main drivers to going back to on-site only meetings for the organizations has been to save costs, I find it hard to believe that they will invest heavily in mitigation measures.”

When EULAR announced in early October that the 2023 congress would take place as an onsite-only event, scheduled for May 31 to June 3 in Milan, there was not a lot of information regarding safety measures that may be implemented. However, even now information is scant.

Currently at the time of publication, in a FAQ on the meeting website and under the question, “What is the COVID policy at EULAR 2023 Congress?” the site simply states: “EULAR will proceed with a vaccination-required approach for all attendees in order to gain access to the EULAR 2023 congress venue onsite.”

In an email, EULAR press relations indicated that all information on COVID-19 mitigation measures and mandates will be published on the meeting’s website as more guidance is received from the Italian government. This information will also be disseminated by email, the press officer said.

Although real-time participation at EULAR will be limited to participants who travel to Milan, registrants will be able to access on-demand content from the meeting following its conclusion. However, posters, poster tours and the EULAR Expert and Practical Skills sessions will not be included among the on-demand content.

Meanwhile, it remains unclear if there will be alternative options for interested parties, who cannot attend in-person, to access the on-demand content.

‘Too high-risk, too far away or too expensive’

Leonard Calabrese

Nancy Lane

Since the October announcement, rheumatologists including Conway, Leonard H. Calabrese, DO, of the Cleveland Clinic, and Nancy Lane, MD, of the University of California, Davis Health, have voiced their concerns.

“I understand the strong desire to return to live meetings, but I think that it is unfortunate that they are either overlooking or bypassing some of the lessons of virtual meetings that have actually been very positive,” Calabrese said. “I want the meeting to be live. I plan to go to EULAR live. However, for many people it is either too high-risk, too far away or too expensive.”

In order to accommodate interested parties who are unable to travel, Calabrese thinks all major meetings should include some manner of virtual portion.

“I believe that all of our major meetings should be hybrid and include a live venue that is genuinely live,” he said.

Lane echoed the call for hybrid meetings, adding that the move to exclusively in-person meetings may be premature. She also recalled some of her own personal meeting experience from 2022.

“I saw that EULAR was going to do an in person only meeting and I’m not sure it’s the right choice yet,” Lane told Healio. “I went to the [American Society for Bone and Mineral Research] meeting and decided that I would have been better off participating in a hybrid meeting and watching it online.”

Meanwhile, Conway has been following the conversation surrounding EULAR’s announcement on social media, and expressed concern about the direction other major meetings might take.

“I also hope that other organizations do not follow a similar pattern, and I am concerned from some of the comments on social media that the American College of Rheumatology may be intending to follow EULAR in this decision,” Conway said.

In addition to the trials involved with traveling to in-person meetings for some rheumatologists and other health care professionals, such meetings also raises questions about patient care after the meeting ends — especially concerning patients who are immunocompromised.

In cases where physical attendance at a meeting is a requisite to participating, experts say it is imperative that health care workers and providers act responsibly when they return to their practices. This includes masking, testing and waiting the proper amount of time before seeing patients.

Regarding patient representatives, who are often present at major medical meetings, Conway worries the in-person format will ultimately keep them away.

“There are potential safety implications for immunocompromised individuals attending onsite, both in terms of travel and at the meeting itself,” Conway said. “The even bigger concern for me is that many immunocompromised people may decide not to travel due to these issues and we risk losing their valuable, indeed essential, input.

“I would have concerns about COVID-19 or other infectious diseases taking advantage of these settings, particularly with immunocompromised individuals in attendance,” he added.

Personal decisions

As onsite meetings become more common following the height of the COVID-19 pandemic, those who are considering in-person attendance will need to weigh their choices, Lane said.

“I think people will make decisions and if they want to just learn some information they will want online, hybrid meetings,” Lane said. “If people decide they want to interact with people and enjoy the camaraderie then they will go to in-person meetings.

“I think right now people are still concerned about catching COVID at these meetings and we do not know yet if there will be a surge this winter,” she added. “So it’ll be a personal decision, however I personally won’t go to as many meetings as I have in the past.”

That said, as more people begin seeing the pandemic as something firmly within the confines of the rearview window, the number of those who feel comfortable attending in-person will likely continue to rise.

“More and more people are feeling comfortable in going to congresses,” Ronald van Vollenhoven, MD, PhD, of the Amsterdam Rheumatology and Immunology Center, and chair-elect of the EULAR research committee, told Healio.

Vollenhoven estimates the 2023 congress will attract more participants than the previous year’s, but will likely fail to reach the historic highs the meeting has seen in the pre-pandemic past.

In addition, he argued that hybrid formats have garnered little success for larger meetings, which may have pushed them to return to traditional in-person gatherings.

“My own personal view is that the hybrid has not worked so well for the large congresses, so I have a great deal of understanding for choosing to do it the old-fashioned way,” Vollenhoven said.

That said, he added that much could potentially change regarding the COVID-19 pandemic, and recommended safety measures, between now and May.

“I think it will be difficult right now to predict what is specifically going to be recommended at that time,” Vollenhoven said. “It is very difficult to predict what COVID may look like on an international scale more than 6 months into the future.”

However, regardless of any recommended mitigations, the potential for attendees to get sick remains a factor. As such, prospective attendees should consider the possibility of developing COVID-19, or another illness, when making their decision.

“We do know that after attending large meetings, conventions and congresses, there is definitely a number of people who come down with COVID-19,” Vollenhoven said. “That is very bad for themselves, but you can say, you know, they have chosen their options.

“There is a risk they can bring this to the patient care setting, and I would have to say that this is actually a consideration,” he added.

The virtual future

Among the many impacts the COVID-19 pandemic has had on the field of medicine has been the — to some, overdue — movement to make meetings more accessible for potential attendees who might not be able to travel, for whatever reason.

“One of the small silver linings of the pandemic years has been the development of comprehensive virtual meeting offerings,” Conway said. “These have improved access for a number of groups, including those from low-income countries and those with young children, which disproportionately affects female physicians, as well as trainees and the immunocompromised.”

Improved access to new research has been just one factor that has underscored the potential benefits of virtual and hybrid meetings.

“I think that people who are underserved or have low resources should be able to take advantage of selected parts of the meeting,” Calabrese said.

For organizers, the main argument against hybrid meetings — those offering both in-person and remote options — is often the cost involved in putting on, essentially, two meetings at once. However, an alternative option is to offer pared-down experiences in a virtual format, Calabrese said. Key discussions and plenary sessions would likely be simple enough to record and broadcast for free, he added.

“I truly hope that EULAR will reconsider this decision and at least consider a slimmed down virtual option,” Conway said. “I would strongly encourage this to focus on the novel science — the oral abstract and poster presentations.

“Virtual meetings and their social media interactions have also been an amazing educational development, really maximizing the learning opportunities of such events,” he added.

However, besides the added cost in running them, remote and hybrid meetings arguably also suffer from reduced personal interactions among the participants.

“In my opinion, for the large congresses, the hybrid format has been difficult and disappointing,” Vollenhoven said.

Conway, meanwhile, counters that technology — particularly social media — has fostered and maintained a sense of community among physicians and other health care workers during meetings in which people have been unable to gather in person. In these instances, social media played a large role in networking.

“Networking is an interesting one, and many people have spoken about the loss of face-to-face networking as a big loss in the virtual era,” Conway said. “This ignores the great value that exists in virtual networking over platforms such as Twitter.”

“I would argue that the virtual option facilitates those rheumatologists and trainees who have traditionally struggled with the face-to-face networking model,” he added.

In the end, Conway predicts that a lack of a virtual component will result in stifled conversation and debate on social media.

“We are going to lose a hugely valuable educational resource due to this decision,” Conway said. “The discussions and debates over social media have been a real added benefit to those meetings that have occurred in a virtual or hybrid format.”


Welcome message from the EULAR president. Accessed Oct. 27, 2022.


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