Daily news

Hello, everybody. My name is Kseniia. I am one of the SIG of young geriatrician and I will tell you about daily news.

The work our congress will begin today at 14.15 CEST. The main subject of today is COVID19 and geriatrics. As any congress, we will start with an open ceremony and presidential lecture.

The next, we will try to find the answer to an interesting question:

Can lockdown protect our patients? We will learn about Belgium experience. Let's discuss what kind of measures are done in your country? Does it help?

After it, we will learn about Portugues experience with misinformation.

Do you have this problem in your country? How do you handle it? What do you do to minimize or prevent it?

Later, we will learn about a new problem: a mid-term functional decline in older patients with COVID-19. Do you commonly face the same problem in your practice? What do you do to prevent or manage it?

Ageism is a huge problem, and COVID makes it worse. We will learn the Spanish experience. What do you think we can do to change this situation?

Last but not least, will be COVIDOM: follow-up of the COVID-19 patients by telemetry. Do you have it in your country? Does it help you?

And we will finish our 1st day with a round table: Care for older people during

the COVID-19 pandemic-manifestation of ageism?

Do not forget we also have a lecture, "Nutritional challenges and solutions for the management of older adults in the time of COVID-19," from 16.00 to 17.00 CEST.

So let's watch and discuss. Do not hesitate to share your opinion.

Day 1.

The first day is over. What did we learn today?

First Session.

"Ageism in the clinical studies." Unfortunately, age is a common reason to be excluded from the study. Our Bristol college's excellent done review showed that the average age of participants of clinical research with covid19 was below 65 years old. Also, they pay attention to the fact that our patients are commonly presented to the hospital with an atypical clinical picture. If you want to learn more, you can find their paper on PubMed: Lithander FE, Neumann S, Tenison E, Lloyd K, Welsh TJ, Rodrigues JCL, Higgins JPT, Scourfield L, Christensen H, Haunton VJ, Henderson EJ. COVID-19 in older people: a rapid clinical review. Age Ageing. 2020 Jul 1;49(4):501-515. doi: 10.1093/ageing/afaa093. PMID: 32377677; PMCID: PMC7239238.

Does lockdown work? Defiantly yes. Does the mask protect? Yes, Antwerp's experience supports it. If you want to know more about the pros and cons of lockdown, watch the lecture Erika Vlieghe lecture in our meeting room (on Demand).

"Misinformation about COVID-19 may increase the fear and stigma of older people" - isolation of older adults is one of the biggest problems which were created by misinformation. And we learn five steps from Ricardo Mexia how to fight it. My favorite is: if you have credible information - share it. If you are interested to know more about Communicating Risk in Public Health Emergencies, here the link.

thttps://www.who.int/risk-communication/guidance/download/en/.

Second Session.

COVID OLD: a mid-term functional decline in older patients with COVID-19 - the open eyes lecture if you want to look outside the box on the COVID19 and older adults (IMHO, what do you think?). I need to watch Gaetan Gavazzi's lecture one more time to make notes of references.

COVID-19, older adults, and ageism: Mistakes that should never happen again. One of the most challenging things is to accept the mistakes that were made. Prof. Francisco J. Tarazona Santabalbina raised fundamental questions and provided possible solutions to prevent or at least minimize them. The problems he discussed are common: miscommunication or low level of it between different services is universal. But solutions have existed. We need to make a little bit more.

And I totally agree with Marinakots: it is a shocking result, and I think it our responsibility to learn from it and to do our best to prevent it in the future.

COVIDOM: follow-up of the COVID-19 patients by telemetry. The protocol is recommended for patients wich do not meet the criteria to be hospitalized. The questionnaires were sent by SMS or e-mail. And the results of the research are optimistic. We can supervise patients and relife there anxiety. However, I am afraid that in my country (Russia), it would be difficult to use, as our older adults are not very good with new technology. We have skilled older users, but they more exceptions from the rules. How are you older patients with gadgets?

P.S. Few points about nutrition from my colleague Luba, she is also a part of the SIG of young geriatrician and she watched the Satellite sponsored symposia by Abbott today which was dedicated to Nutrition and older patients at the time of COVID pandemic. The very nice opening talk by Dr Atherton showed us the evidence of timely recommended micronutrients such as leucin, vit D and calcium, as well as proper amounts of protein in order to reduce the muscle loss in older patients due to lockdown and self-isolation regimen with low physical activity. The inspiring second talk demonstrated the link between poorer nutritional status, physical activity and frailty at the COVID-time, the take home message is: use all the tools to asses nutritional and physical status of an older patient with COVID-19 to avoid complications.

Thank you, prof Benetos, prof Petrovic and Mary Ni Lochlainn for the opening ceremony.

See you all tomorrow. Please, do not be shy; share your thoughts. And do not forget to wear masks.

8/10/2020

Hello, everybody! How are you today?

Today is the second day of our journey.

There are three live channels today. The main topic is inpatient (including ICU) and outpatient management of our older patients. The sponsored symposiums will tell us about nutrition and vaccination.

I will not be able to watch all of them at the same time. If you learn something interesting, feel free to share it.

Also, do not forget, we have multiple pre-recording symposiums on-demand section. Have you watched them?

P.S. If you have any comments or suggestions on my work, please, express it. (It's my first experience as a blogger).

08/10/2020 18.00

Good evening!

I decided to be constant and stay on Live channel 1.

Antiviral treatment and COVID19. One of the most challenging questions of the last months: evidence-based medication for COVID19.

Prof. Callens updates our knowledge. Hydroxychloroquine and azitromycin do not work and even dangerous. Remdesivir benefits the patients on an early stage of disease or oxygen (does not work on if the patient is in ICU). Do not mix Hydroxychloroquine and Remdesivir due to drug-drug interaction. Good news: numerous new potential agents nowadays tested against COVID 19. Hopefully, soon we will have definitive treatment.

Convalescent plasma - controversial results, unfortunately.

What about Trump's medication - monoclonal AB REGN-COV2 - maybe it better than convalescent plasma, but definitely more expensive. As a result, we still do not have enough information to answer the central question of how good is it.

Unfortianly, we do not have "1 pill" for COVID19, and it looks like we will not have. We should treat the patient and try to prevent complications.

Organization of intrahospital care for COVID19 patients. The Belgium experience during the first wave. One out of four patients were above 65 years old, 12% were admitted to ICU, and the mortality rate was 21%.Prof. Braeckel told about changes that were done during the epidemic to optimize management. One of the most interesting (again for me) is a multidisciplinary team that discussed patients three times a day. What was done in your hospital to optimize management? Was it helpful? Did you have something that does not work?

If you want to learn more about different experiences all over Europe, there a pre-recorded lecture on-demand section: DIFFERENT APPROACH IN THE MANAGEMENT OF COVID-19 OLDER PATIENTS A TESTIMONY OF THE EuGMS MEMBER COUNTRIES & GLOBAL EUROPE INITIATIVE (GEI) SESSION ON COVID-19 - GEI SESSION: "Prevention and treatment - COVID-19 patients from community to hospitalization across the GEI countries"

COVID in Italian-hospitals. Prof. Mazzeti talked about the Italian experience. There was interesting data about how the characteristics of the patients how died were changing over time. Moreover, the professor shared their experience when they converted the hotel into a hospital. Did you need to do the same in your country?

If you want to learn more about the Gemelli hospital work, here the links for there publications: https://jamanetwork.com/journals/jama/fullarticle/2768351

Clinical frailty score.

Frailty is a worsening prognostic factor of the patients with COVID19. Clinical frailty score is an easy and reliable tool to diagnose the frailty.

Do you use it during your practice? Does it affect management?

Have you ever heard about COVID-GRAM? If no, here is the link to learn something new: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2766086

"Coordination between geriatrics wards and nursing homes."

Prof. Peromingo talked about what we can do to protect the nursing homes from becoming an epidemic center.

"HOW OLDER PERSONS PERCEIVED DECISIONS TAKEN DURING THE CRISIS."

There was a very emotional lecture from Eduardo Rodriguez-Rovira. It sounds like anti-utopia: "Older adults above 80 years old or from nursing home not admitted to ICU", "70 corpses were found in their homes in Madrid, they were older adults who lived alone". Unfortunately, it was. We need to remember it, to be able to prevent it in the future.

"Try to a confined virus, not a people." Eduardo Rodriguez-Rovira.

I think we all have something to think about tonight.

Have you watched other lectures? What can you suggest?

Have everybody found their e-posters and oral presentation?

What do you think about congress? Please, share your thoughts.

See you tomorrow.

09/10/2020 10.55

Hello!!!

Today is the last, but definitely not the least important day of our congress. The live presentation will start at 15.00 CEST. Again, three live channels, and one of them sponsored.

On the Congres' website, you can see the sign "SIG" that stay for Special Interests Groups, the full list of them you can find on the official website: http://www.eugms.org/research-cooperation/special-interest-groups.html. Do not hesitate to become a part of one of them. It is an excellent opportunity to meet new people, expand your knowledge, participate in international scientific projects, or become a speaker on the congress as my SIG "Young Geriatricians" friends Marian Dejaeger from Belgium and Cristina Udina Argilaga from Spain. You can see them tonight from 17.00 to 17.30 CEST on the second life channel.

I also want to remind you that we have prerecorded lectures. Some of them do not cover COVID-topic; they about general geriatrics challenges.

Thank you very much for Marinakots for sharing with us the second live channels news yesterday. 

If you want to say something, sharing your thoughts, ideas, suggestions, do it.

See you tonight.

09/10/2020 19.00

Good evening.

As yesterday, I decided to stay on channel 1.

COVID-19 pandemic: do not leave delirium behind.

It was an outstanding lecture on delirium in the era of COVID19. This condition extremely common in older patients with COVID19. Some leader opinion strongly believes that it should be put in the list of the most common symptoms of COVID19^ right after SOB.

A few links of the recent publication on the topic which were discussed during the presentation : 

https://pubmed.ncbi.nlm.nih.gov/32491022/

https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-02882-x

https://www.bmj.com/content/369/bmj.m1985

https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.16803

https://academic.oup.com/biomedgerontology/advance-article/doi/10.1093/gerona/glaa209/5897028

"The COVID19 pandemic in nursing homes".

Jean-Marie Robine looked on COVID19 from an epidemiological point of view. From 25 to 50% of people who died due to COVID19 - died in nursing homes. 

One of the first wave's critical lessons is that we need to protect nursing homes, as they have one of the most vulnerable populations.

"Social Media, Ageism, and Older Adults during the COVID-19 pandemic."

"Life of older adults less valuable." One of the relatively spread statements in social media during the COVID19 era. When I was a medical student, I was asked whose life I will sacrifice the good or a bad person if they are brought simultaneously, and I am only one available doctor. I was an enthusiastic medical student before ICU rotation and the answer at that time was: at first, I will help the person who looks the sickest. COVID19 rephrased the question who would you safe young or old? Luckily, for me, it's still a theoretical question, we have enough ventilators in my hospital, and we had not had to choose whose life is more valuable. However, I know that this was a real-life question for some of you, and I know you did your best to save as much life as possible.

October the first is an international day of older persons, and one of the WHO initiative for this day is "Take a Stand Against Ageism." What do you think each of us can do to stand against ageism? 

Some links from the presentation.

https://covid19.elsevierpure.com/it/publications/coronavirus-ageism-and-twitter-an-evaluation-of-tweets-about-olde

https://www.docwirenews.com/abstracts/modern-senicide-in-the-face-of-a-pandemic-an-examination-of-public-discourse-and-sentiment-about-older-adults-and-covid-19-using-machine-learning-2/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7499682/

"Biology of aging in the context of COVID-19" by Luigi Ferrucci. Just a few words wonderful academic-based lectures about what makes our patients so vulnerable to infections. 

"THE ROLE OF A SCIENTIST IN THE COMMUNICATION DURING COVID-19 PANDEMIC".

So, what is the role of science? 

1. To build & maintain trust

2. Recognition of uncertainties & communication

3. Coordination

4. Transperansy

5. Stay up against fake news.

A few more evidence that lock-down is a useful measurement to prevent the spreading of infection.

More than 50% of people do not believe that the government could stop the virus from spreading. Her the link to NEJM to a paper -Dying in a Leadership Vacuum. https://www.nejm.org/doi/full/10.1056/NEJMe2029812

Meanwhile at Channel 2 was held a YGI-session, dedicated to young geriatricians experience at the time of the pandemic. Two speakers from Belgium and Spain presented their situation and what has been learned during the crisis.

We are delighted with an excellent start and waiting for new YGI-activities and new meetings.

The closing ceremony, as usual, started with the EAMA presentation. EAMA is a European Academy for Medicine of Aging ( https://www.eama.eu/en). 

Congratulations EUGMS award winners:

Laura Blomaard, Leiden University, Tne Netherlands

Urszula Klosinska, SWPS University, Poland

Richard Dodds, Newcastle University, UK

Kazuko Obayashi, Nihon Fukushi University, Japan

Thank you to prof Benetos, prof Petrovic, prof Ellul, and Marina Kotsani for the closing ceremony.

So, the EUGMS e-congrees 2020 is over. But you can watch lectures up to the end of November 2020.

Hopefully, we will meet next year in Athens and will discuss news in real life in the hall with free coffee.

Please be careful, wearing a mask and find time to take a rest!

See you next year!

PS. If you have any suggestions, ideas, or want to talk, the blog will work continuously.

Please do check our Facebook and Twitter activity.

Sincerely,

yours Kseniia.