ATS 2022: Restoration in the Aftermath of COVID-19

Neil Osterweil

May 10, 2022

SAN FRANCISCO — San Francisco, the City by the Bay, plays host to the American Thoracic Society 2022 International Conference (ATS 2022) beginning Friday and running through May 18.

For the first time in 3 years the meeting will feature in-person sessions (with appropriate COVID-19 precautions, of course), as well as online sessions in the now-familiar hybrid format.

"I am looking forward to seeing people in person, without a square box on a screen around them," said outgoing ATS President Lynn M. Schnapp, MD, chair of the Department of Medicine at the University of Wisconsin School of Medicine and Public Health in Madison.

"I did my fellowship training in San Francisco, so it is a homecoming for me to be there and see the people I trained with. I've been at a variety of different institutions over my career, so I've made great friends all around the country, and ATS is always the time I get to see everybody and catch up. It's been too long," she said in an interview with Medscape Medical News.

HIV-Associated Lung Disease

Beyond the social aspects, Schnapp said she is particularly looking forward to the President's Symposium on Insights into Mechanisms and Future Directions of HIV-Associated Lung disease, to be held Monday at 9:30 AM (all times shown are Pacific Daylight Time).

"In December, we commemorated the first recognition of AIDS, which occurred 40 years ago with the first reports from the CDC, and as a fellow there in the late '80s and '90s, that was the pandemic that dominated my fellowship," she said.

The session will begin with a review of lessons learned over 40 years of HIV care from the ubiquitous Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.

The session will also feature a review of changes in the care of patients with HIV over 40 years, the global burden of the disease, an overview of the spectrum of lung diseases in adults and young people living with HIV, and discussion of the mechanisms that contribute to chronic lung disease in these patients.

"In the early part of the epidemic all we saw were cases of pneumocystis pneumonia and the complications of HIV in the lung. Now with antiretroviral therapies, people are living with HIV long term; it's a chronic disease, so now what we're seeing is an increase in chronic pulmonary diseases — emphysema, pulmonary hypertension, lung cancer," Schnapp said.

Out-of-this-World Speaker

At the opening ceremony Saturday, beginning at 4:30 PM, former NASA astronaut Catherine Grace "Cady" Coleman, PhD, will talk about how she managed isolation and remained connected with others during 6 months on the International Space Station. 

A skilled amateur flutist, Coleman can also claim the distinction of being the only ATS speaker to have played a duet from space, with the earthbound musician Ian Anderson (lead singer of the rock band Jethro Tull), and to appear onstage at the Kennedy Center in Washington, DC with the celebrated Irish band, The Chieftains.

The World Post-COVID

ATS 2022 Committee chair Andrew Halayko, PhD, MSc, professor of physiology and internal medicine at the University of Manitoba in Winnipeg, Canada, previewed for Medscape some of ATS 2022 other keynotes, including a session titled "Restoration in the Aftermath" (Sunday, 8:15 AM). Speakers Rana L. Awdish, MD, MS, from the Henry Ford Health System, Detroit, Michigan, and Megan M. Hosey, PhD, from the Johns Hopkins School of Medicine, Baltimore, Maryland, will use "a really innovative storytelling framework to illustrate how patient and provider narratives can provide a critical foundation for healing."

"This will address stress and burnout, what have we lost and where are we now, and I think this will be a great way to start the conference, because one thing we as researchers and health professionals have lost is the face-to-face meeting that we really came to rely on as part of our career development," Halayko told Medscape Medical News.

On Monday at 8:15 AM, Michael Fiore, MD, MPH, MBA, director of the Center for Tobacco and Intervention at the University of Wisconsin School of Medicine and Public Health, will give a keynote address titled: "Unfinished Business: The Achievable Goal of Eliminating All Tobacco Product Use in the United States by 2030." Fiore will outline the latest federal tobacco guidelines, including the recent recommendation to ban menthol flavoring in cigarettes, as well as the latest research on vaping and lung health.

"He has been a leader in the field of tobacco research for years and has probably saved more lives than just about anyone based on his public health advocacy for tobacco regulations," Schnapp said.

The Inevitable COVID

In addition to the aforementioned keynote session, there will be a plethora of abstract-based sessions, symposia, and mini-symposia focusing on COVID-19 and how it has affected all aspects of pulmonary care and research, including a chaired session next Wednesday May 18 focusing on COVID and burnout.

Myriad other sessions will explore issues related to COVID-19 and cystic fibrosis, health disparities, environmental and occupational lung diseases, and pediatric pulmonary care.

"With respect to COVID, it's woven throughout the conference, but we've moved beyond talking just about the biology of the virus and how it works. We've now moved on to this construct of restoration in the aftermath, how we move on with lessons learned in terms of healthcare delivery," Halayko says.

"As pulmonary and critical care physicians, we've been significantly impacted by COVID on so many levels," Schnapp said.

Questions to be addressed about COVID at ATS 2022 will include: "What are the best strategies to facilitate resilience? What lessons have we learned about how we care for patients with COVID and how we care for ourselves? How can we best support our junior faculty, particularly our women junior faculty who have been disproportionately impacted by COVID because of childcare and school closings while still needing to cover ICUs?" she said.

The Usual Suspects

HIV, COVID-19, tobacco, and other plagues are just part of the many subjects that will be packed into 4 days. Other sessions will focus on basic science, clinical topics in pulmonary medicine, the clinical year in review — a perennial favorite of attendees, Halayko said — as well as sleep medicine and critical care.

Halayko told Medscape that he is especially pleased to see the return of the postgraduate courses that precede the scientific sessions.

"They are both hands-on, and so are the clinically relevant all-day sessions, or didactic sessions, and they cover all topics of relevance to pulmonary and critical care and sleep medicine," he said.

Neil Osterweil, an award-winning medical journalist, is a long-standing and frequent contributor to Medscape.

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