The autumn congress of the Swiss Society of General Internal Medicine (SGAIM) took place on 17. and September 18, the largest medical congress since the nationwide lockdown took place away from virtual platforms with 700 participants. In beautiful summer weather and under strict protective measures, physicians and congress partners met at the Palazzo dei Congressi in Lugano. Without aperitifs, but with mask. The Secretary General, Dr. med. Lars Clarfeld, draws a positive résumé.
The SGAIM organized this year’s autumn congress under the motto “Medicine in Motion” and was pleased to welcome a large number of visitors. The limited number of participants was reached within a very short time and workshops, updates and presentations were actively attended by representatives of all language regions.
Lunch in the fresh air
In addition to a general obligation to wear a mask and the storage of visitor data, the protection concept also provided for a ban on consumption in the congress building. Apéros and lunches during the lectures therefore had to be dispensed with. Instead, the organizers relied on lunch packages, which could be eaten outside. While fresh air at lunchtime certainly has its benefits in summer temperatures, this approach may be more difficult to implement in the coming seasons.
To continue to minimize the risk of infection, participant registration was moved to the outside area. So it wasn’t just the disinfectant dispensers everywhere that showed the great efforts made to ensure the safest possible congress attendance. But how effective and feasible did the protection concept prove to be? Where were the difficulties? And is the physical staging of more medical congresses realistic in the near future? We talked about these and other questions with the Secretary General of the SGAIM, Lars Clarfeld, MD, on September 28, 2020.
Dr. Clarfeld, the 4th Fall Congress of the SGAIM was, after all, one of the first medical congresses to be held on site again after the lockdown. What, then, were the decisive reasons for you to carry it out physically?
First of all, it is important for me to mention that the safety of the participants has always been our top priority. For us, one of the main reasons for holding it in this form was our members’ desire for networking. Furthermore, our format would have been difficult to implement electronically with many parallel events.
Following the postponement of our 5th Spring Congress until next year, we have decided that continuing education cannot be permanently paused. If an end to the current situation had been foreseeable in a few months, a postponement could have been considered. Realistically speaking, however, the issue of COVID-19 is likely to keep us just as busy in 2021. For us, it was simply not an option not to offer a congress for two years or to have only an electronic congress during that time. Therefore, we have examined possibilities to hold our congress under safe conditions in the current situation.
What measures has the SGAIM taken to counter the risk of infection?
A key element for safety, as in other events, was the strict mask-wearing requirement. As an exception, only the speakers could speak without a mask in the large rooms with sufficient distance from the audience. Food posed a bigger problem for us. You can’t go two days without feeding visitors. On the other hand, drinking coffee together and wearing a mask are not compatible. So, although it was extremely difficult for us, especially since socializing is an essential part of such conventions, we did away with coffee breaks and imposed a ban on consumption in the entire indoor area. Instead, there were water bottles for all participants and lunch packages. It was important to us to be able to enforce the protection concept safely and to keep the incentive to come together without a mask as low as possible.
How was the acceptance of these measures?
It was very good. We had anticipated more problems, especially with food. As far as I know, however, there has not been a single incident on this occasion. The obligation to wear masks was also very well respected. 99% of the participants wore the mask correctly. In my role as security officer, I was present at the congress and here and there I saw someone who was not wearing the mask correctly. We then approached these people, with only one discussion. The whole team was instructed to address visitors in case of violations, which worked very well. Overall, our consistency in enforcement was well received, as the same rules applied to everyone. We have received a lot of positive feedback on this.
In your estimation, were there any critical incidents during the congress regarding risk of infection?
No, not as far as I know. People really behaved in a very exemplary way. Even in the toilet area, I didn’t see anyone without a mask. One or the other has slid the mask down while talking on the phone, which seems to be a common reflex. In most cases, a hand signal was enough to get the participant to put the mouth and nose protection back on correctly. So far, there have also been no reports of contagions at Congress. Also, to my knowledge, there was no one who participated with COVID-19 infection.
Did you encounter any particular challenges that you hadn’t anticipated?
The big challenge was uncertainty. The stress level in the preparation was certainly twice as high as at a “normal” congress. There’s the constant question of how the pandemic will develop, whether there will be new regulations and so on. We had to cope with this situation for the first time when organizing our specialist examination in June. We had developed an exemplary concept for a huge hall in Basel with 32,000 m2. The minimum distance could be maintained without any problems and there was also a mask requirement here as well as staggered entry times. Then two or three weeks before the event came the restriction to 300 participants. It would have been possible to adapt the concept to the new regulations, but in our opinion it would have worsened safety on site. Fortunately, we were then able to obtain an exemption from the canton of Basel. Even the clarification of responsibilities is sometimes complex. In addition to this uncertainty up to the last minute, we had the special situation at the fall congress that we carried out the congress registration in-house for the first time, which presented an additional challenge.
Overall, the ability to plan is simply much worse at the moment than we are used to. I will return here to the example of catering. Usually you plan on a little less, since there are always cancellations and people who don’t eat at the convention. If the food runs out, however, this is not a major problem, as something can always be added. This option does not exist when lunch bags are issued, as the exact number must be prepared. It must also be kept in mind that participants eat at different times and packages – not too many and not too few – must be withheld accordingly. It really comes down to additional organizational overhead on all fronts. And there are additional costs. Although we didn’t have coffee breaks, the food was more expensive than usual. Another example is the registration, which was held outside for the first time. Extra tents had to be erected. Even seemingly trivial things, such as handing in masks, suddenly present a challenge. We decided there to give boxes in which the masks were distributed. These had to be filled in hours of work. All in all, everything was very elaborate. I have to pay a big compliment to my team.
Since – as you say – you never knew how the situation would develop: Was there a plan B?
An electronic convention as Plan B was up for discussion. But then we decided against it. Relying on both in parallel would have entailed very high costs. For smaller events with only one event lane, this is certainly an option. But with a setup as complex as the one at the Fall Congress, electronic mapping would have been very difficult. We see the need for electronic solutions and also their potential. On the other hand, especially in times when so much is happening electronically, we also see the desire to meet physically once again. Especially in terms of networking, you can’t compare a physical congress with an electronic event.
The congress was booked up extremely quickly. How did you experience the run on seats?
The registration process was quite normal. We rather assumed in advance that there would be fewer registrations due to the pandemic. We were all the more pleased with the great demand. Two weeks before the event we decided to close the registration in order to stay true to our security concept. We definitely wanted to prevent things from getting too tight.
You said that the great demand came as a surprise to you. To what do you attribute the great need among physicians to physically participate in congresses?
Networking is a key reason for attending the congress, in addition to continuing education. The exchange with colleagues, also about other topics not relevant to continuing education, is obviously a great need.
In all this weighing for and against implementation, a decision must be made at some point. When was that time?
When we decided to go this way, I can’t really say anymore. About four to five weeks before, there was the final, definitive decision. This is also a question of fairness to the partners, who in turn also have to plan. At some point, exhibitors must also trigger processes. From then on, for example, when the exhibition stands have been commissioned, it is really difficult to back out. Of course, the whole thing is difficult to predict and plan. In the end, the development in terms of infection figures played into our cards.
On the one hand, the numbers in Ticino were relatively favorable and on the other hand, the whole environment was extremely sensitized. This is very important for a safe execution, which of course includes travel, hotel and so on. We had the feeling of being in a very safe environment.
Were there any cancellations due to COVID-19?
There were very few. Some speakers were videoed in for various reasons and one awardee was unable to attend due to quarantine regulations. Individual participants also cancelled with symptoms of illness, which was of course handled accommodatingly on our part. There were also a few who did not come because of their function and the residual risk that remained. The hospitals’ bans on attending congresses, which were still widespread in the spring, were no longer a major issue at the fall congress.
What do you take away for future conventions?
We have seen that even in times like these it is possible to organize a larger congress. However, the undertaking must not be underestimated under any circumstances. The stress factor is considerably greater, especially due to uncertainty. It is very important to stay true to yourself and never lose sight of the fact that the safety of the participants is paramount.
What we have also seen is that, at least in the medical environment, the acceptance of the measures seems to be very high and they are well implemented. Of course, this is a special group in which it can be assumed in principle that the correct handling of masks and hygiene measures are known.
I think the conduct of any Congress in the current situation is always an individual consideration and dependent on a variety of factors. This includes not only infection rates, but also the regulations in place. If, from the point of view that normal life must go on, it should again be possible to attend football or ice hockey matches, this naturally puts the holding of congresses into perspective. Uncertainty, which is also the biggest challenge, remains until the last moment and each concept must be adapted to the specific venue.
Will the planned SGAIM Spring Congress be held in Basel?
At the moment, I assume so, but of course subject to further pandemic developments. Our will to carry out the congress is great. I can tell you for sure on the day of the opening of the congress whether it will actually take place.
Is there anything you would do differently next time?
In my opinion, our security concept was very reasonable and we would plan it exactly the same way again for the Lugano venue. Of course, the concept is not easily transferable to other venues and numbers of participants, but for the setting at the fall congress we succeeded very well. Clearly, there was a bit of a learning curve, which will hopefully simplify the execution of future congresses. For example, we thought in advance that the information of the participants, which we collected with the registration, would be sufficient. In the course of preparations, however, we realized that the place of work was not sufficient for the cantonal authorities, but that they required the place of residence and telephone number of each visitor for potential tracking. We then had to re-record this information at check-in, which would not happen to us again if we did it again. Other things like mask dispensing required new approaches, but we will implement them the same way again at the next congress.
I would like to thank all participants for the great organization of the congress.
The interview was conducted by Amelie Stüger on September 28, 2020.
HAUSARZT PRAXIS 2020; 15(10): 36-38 (published 10/22/20, ahead of print).
