It has been several months since COVID-19 began spreading through the U.S. With the first case of community spread confirmed by the CDC on Feb. 26, 2020, many annual medical meetings fell victim to cancellation in order to preserve the health of their participants. In total, more than 60 conferences were canceled, with the latest being the American Hospital Association Leadership Summit in mid-July, though the majority of the canceled meetings were originally scheduled during March.

While a fraction of the remainder were postponed, the majority opted in to a new type of meeting, one that — despite being around for nearly 20 years — seems to have found its niche: the virtual conference.

But what impact has this electronic experience had on the medical landscape? Who thrives in this new environment? And what does this all mean in a post-pandemic world?

The first aspect to consider is the planning of such events. Again, many conferences had to make the decision to cancel or carry on in the face of COVID-19 in a short amount of time. According to Dr. Brendan Stack, who served on this year’s American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNSF) Annual Meeting Program Committee, the planning process started prior to COVID-19, and included deadlines for submissions and the grading of content. When COVID-19 showed no signs of slowing down, they had only weeks to make the switch to an online conference. 

“After the decision to go virtual,” Dr. Stack said, “we had to figure out the live program versus the on-demand program, and how to balance offerings, so as not to offend our on-demand speakers or diminish the value of on-demand presentation in the future.” 

Already, the immediate challenges for setting up a virtual conference in a short amount of time are obvious. Who will provide a live webcast of the presentation? Who will record speeches beforehand and have them uploaded during the conference?

Other challenges became immediately apparent: what does one do with vendors? What are the hidden costs? According to Dr. Stack, there was, naturally, the added cost of time and money to employ technology in the conference, like the software integration for a virtual transmission or working with a vendor to track and award CME as attendees viewed presentations.

That said, there seemed to be more in savings: the conference did not have to engage in contractual agreements with hotels surrounding the venue, the cost of working with the venue itself disappeared, and some of the costs were covered by insurance. Dr. Stack was, however, careful to note that the “impact of cost [was unclear] for industry partners in terms of savings on physical presence versus efficacy of the marketing” involved with a virtual conference.

When speaking of savings, it’s important to keep the participants in mind. Attendees were not required to buy a plane ticket to attend these virtual conferences or take time away from their practice. Instead, they could watch the presentations from the comfort of their homes. Dr. Stack remarked that most of the presentations — and the meeting in general — were planned with clinicians’ work schedules in mind.

While the lowered cost to attend these conferences and the ability to watch at one’s own convenience are attractive, there are several elements to consider when comparing in-person and virtual conferences. First and foremost: the ability to see other clinicians. When asked about his experience at the 23rd International AIDS Conference, Dr. William Valenti remarked that he missed seeing his colleagues at the meeting. “It was a mixed bag, … it felt informal. I missed speaking to other people and seeing their faces.” As many can attest, the energy of a virtual meeting can be lackluster, especially when it comes time for an open discussion after a presentation. Some attendees have found it difficult to ask questions via chatbox, where questions can be easily lost.

Along the same lines, attending a meeting from home is not without distractions. Laundry needs to be changed, the pets fed, and — nightmarishly — an internet connection can be lost. “In the era of smartphones,” opined Dr. Valenti, “our attention span is not at one hundred percent.” Dr. Valenti did go on to say that despite the lack of undivided attention, he felt more productive.

What else can be lost in virtualization? There’s the experience of the in-person exhibit hall, the time spent networking between presentations, and the swag. Also lost is the chance to explore a new city one might not normally visit, perhaps an international location. Dr. Valenti remarked that, in working “on global issues like HIV or COVID-19, you have to think global, from 10 thousand feet up. The international physical conference conveys that sort of experience. … it is a challenge to get that global experience when you’re sitting in front of a screen.”

On the issue of the global experience, larger conferences normally draw attendees from all over the globe. Surely a conference held entirely online would draw a larger crowd from the global community. According to Dr. Stack, AAO 2020’s international attendance actually saw a decrease. He suggested that two factors could have contributed to this. The first is that timeless rule: location, location, location. The cities chosen to host an annual meeting are typically international gateways. The second possibility is that, in the past, some foreign institutions sponsored travel costs for international conferences. This year, many of those same institutions might have placed a different value on covering the expense of attending a meeting from one’s home office.

So then, was the switch to a virtual conference a success? In short, definitely maybe. Dr. Stack relayed that the committee was reaching out to analysts to review the data. He felt confident that amidst the pandemic, the conference was a success, stating the meeting had “a huge impact on the dissemination of education, with over 30 thousand hours” of material viewed. This was despite the loss of connection between members and missed opportunities for social networking. “That will be the challenge for any virtual meeting going forward.” He further remarked that “this was a superb meeting educationally, but we still need to figure out how to make it a super meeting socially and in terms of connection.”

And now to the question on everyone’s mind: what does this mean for 2021 and beyond? For the AAO, 2021 is a momentous year, marking its 125th Annual Meeting, which, for now, is slated to be held in Los Angeles. Due to its location, Dr. Stack noted the future of the conference would be “up to the California government; we might not know until a few weeks out.” He said that future sessions might become a hybrid event, perhaps staying primarily live but with virtual components. “This situation is forcing us to reassess both our live priorities and broadening our concept of the possibilities for other content dissemination.“ He went on to say that the planning committee aims to maintain the core population of attendees while widening the tent for new participants.

Dr. Valenti largely agreed that the idea of some hybridization between live events and virtualization is here to stay. He remarked that some people don’t have the time to travel to another location unless they have a strong desire to visit the area where the conference is held. “Not everyone can afford to fly off to Mexico for a weekend,” he said. He noted that he’d consider attending a virtual conference again, but just not in such a concentrated experience.

It’s clear that there are definite benefits to hosting a virtual conference, especially in the age of social distancing and lockdowns. The switch to virtual meetings has also caught the attention of #MedTwitter, with participants tweeting their relief of not having to board a plane for a conference. Instead, they can stay home in their pajamas.

What are your thoughts on the switch to a virtual conference? Have you a positive experience? Some constructive suggestions for the organizers? Let us know your thoughts in the comments section!