EuGMS Congress and COVID-19

Professor Finbarr C Martin is Past-President, EuGMS (2020-21), Emeritus Geriatrician and Professor of Medical Gerontology, Guys and St Thomas’ NHS Trust and King’s College London.

Question: Is it a Congress or a giant Petri dish?!!

Answer: the European Geriatric Medicine Society has postponed the 16th annual Congress in Athens from October 2020 for one year.

Do put October 11-13th in your calendar now for 2021 in Athens. As a result, the Congresses in London 2021 and Helsinki 2022 have each now moved one year onwards. However, this year’s dates, October 7-9th 2020, will be put to good use as we are providing: COVID-19 in Europe: A Virtual Congress.

What’s not to talk about? The ecosystem around COVID-19 has now taken in almost every issue about older people that is of concern to us geriatricians. Biomedical, clinical, social, political, and ethical considerations are impacting daily practice and regularly making the national news. On the positive side, there has been much rapid adaptation and innovation in health and social care practice and organisation, often supported by local communities. On the other hand, much of this support has been in lieu of coordinated national support. Lives have been at risk, and sometimes unnecessarily.

The clinical course of the illness, the treatments and variable efficacies, and potential for vaccines will all be on the agenda in response to questions such as these. Will vaccines protect frail older people? Will therapies for the oft-fatal hyperimmune response benefit older patients? And does the research to answer these questions include older people?

The use and abuse of prediction tools, along with potential scarcity of resources, has prompted accusations of ageism both in healthcare and the general discourse in society and the media. Hopefully, as data emerges, we will better understand the factors explaining the much higher death rates in older people, and whether our tools capture them sufficiently to be clinically applicable to individuals.

It will be instructive to see how the use of IT for symptom tracking, health prevention messaging and overcoming social isolation has enabled or excluded older people, and what initiatives have been successful in overcoming the previously lower access and uptake for this cohort. Data collected at a large scale on symptoms has already been instructive to demonstrate differences in clinical presentation, and reviewing data from across Europe will add to this understanding.

In most countries across Europe, the care home sector has been badly hit but only latterly gained political and policy attention. There is plenty to ponder, and hopefully data to analyse, about the best approach to the many challenges of providing personalised but also safe care in the face of the clinical, environmental and psychological realities of the pandemic. Similarly, palliative and end of life care have faced severe practical obstacles. What have we learnt?

How has primary and community care responded to this unique situation? What have been, and will be, the new rehabilitation needs of COVID survivors? It will be fascinating to compare the national policies and their implementation in different healthcare systems. Can we learn what actually helped stem the pandemic and reduce mortality and promote recovery of function? Where the need for urgent action has highlighted systematic deficiencies, are there signs of renewed commitment to the aims of universal healthcare to which all EuGMS member countries governments are (officially) committed?

MEANWHILE, what has EuGMS been up to? We are spoilt in the UK by the fantastic work of BGS office and officers, but most of the other 32 countries don’t have the resources or body of expertise available here. Therefore, early on, EuGMS published a guidance statement on older people and COVID-19, pointing out upfront the potential specific issues, and the risks of ageist responses. It has contributed to the WHO guidance on care homes as well as producing guidance of its own. A multinational comparative observational study on post-acute organisation of care and trajectories of functional recovery, led by the Geriatric Rehabilitation special interest group, is just getting started, and early findings will be available at the virtual Congress.

On the EuGMS website the EuGMS COVID-19 taskforce has collated key resources produced by others, such as global and Europe datasets, scientific articles and policy guidance from many European countries including those from BGS, to help to share best practice.

COVID-19 has brought a most unwelcome change to 2020. However, it also presents an opportunity to project geriatric medicine as a holistic and progressive force for good in healthcare.

The EuGMS Congress will reflect this broad scope, and foster a spirit of international collaboration and sharing at a time where this seems under increasing strain.