ROME -- It seemed like a great idea: cardiologists from around the world meeting for 5 days in Rome -- the eternal city -- but the devil was in the details.
The European Society of Cardiology's annual congress is the largest gathering of cardiologists, cardiology researchers, and industry in the world, drawing more than 30,000 each August to cities such as Barcelona, Amsterdam, Vienna, Munich, Paris, and London.
But Rome?
This was a new venue for ESC and one that many thought would be especially appealing.
Not so fast.
Unlike many European cities, the convention center in Rome, Fiera de Roma, is not easily accessible by public transportation.
This became obvious even to the uninitiated by a careful reading of the Congress program: "When you pick up your badge and congress material, you will receive your complimentary 10 single journey tickets, included in your registration fee. They will enable you to travel to/from the Congress Centre, Fiera di Roma. These tickets can be used on metro, buses and trams [emphasis added] within the Rome city limits, ending at Fiera di Roma."
It did require "metro, buses, and trams" -- and more, for many attendees -- to get to the meeting. Many public transportation systems would be strained by an influx of more than 30,000 visitors, but Rome's system fractured.
"Public transportation in Rome is challenging at best, but in August half the cab drivers are on holiday," Evanston, Ill., cardiologist Ted Feldman, MD, said. "I booked a hotel close to the train line that goes to the convention center. Best case: 10 minute walk to the train station, 10-20 minute wait for train, 20-minute train ride, the 20-minute walk to the immense convention center.
"Sunday had a limited train schedule; Monday a fire on the train line closed the train. Result: 2-hour trip each way in more than 90 degree [heat and] humidity."
American Heart Association spokesperson Robert Harrington, MD, noted that "unfortunately 'this story' is detracting from the science being presented and the beauty of Rome. But the transportation system doesn't seem capable of matching the meeting attendees needs. At almost every meeting I attend or colleague that I see, the initial topic of conversation is 'how did you get here? How long did it take?'"
Duke's E. Magnus Ohman, MD, told MedPage Today, "This has been the worst organized ESC meeting in decades.... Lack of public transportation and difficulty in combining bus, metro and bus services left one unable to time any event."
And Then There Was Security
About a week before the scheduled meeting, the ESC announced a surprise visitor for the final day of the meeting: Pope Francis.
At an opening press conference ESC President Fausto Jose Pinto, MD, PhD, noted that there would be special security screening for the papal visit on Wednesday. But on Sunday, the police arrived with barricades and metal detectors, creating more problems.
"Without any prior notification, and contrary to all previous discussions with the Italian police, security checks were imposed at the Fiera Roma entrance," said Mike Morrissey, ESC chief operating officer, in an emailed apology to all attendees.
Morrissey said the security would be removed for Monday and Tuesday, but it didn't work out that way.
"You are packed into a train with 400 people, then you finally get here and you are funneled to an escalator that is wide enough for two people, so the line snakes on," said Cleveland Clinic cardiologist Venu Menon, MD, "and then you finally get there and there is security! Another long line and long wait."
The Comedy
"A comic aspect was the 'Japanese style' cramming of the local train so that delegates were packed like sardines in 90 degree heat for 30 minutes to leave the convention center," said Ohman. "Unfortunately, several hundred were left behind on the platform looking forward to their experience as the next train was coming in 30 minutes. The longest transit time recorded was 2 hours and 10 minutes by a colleague. A meeting in Rome requires stamina !"
By Monday, many were abandoning public transportation and joining the taxi line, where the average wait was 2 hours.
One doctor tweeted: "Patient lost to follow-up? Check taxi line at #ESCCongress2016."
Harrington said the basic problem was that Fiera was too far from downtown Rome where many ancillary meetings -- such as meetings for clinical trialists -- were held. (It's about 15 miles from the city center, near the main airport, and in fact consists of repurposed airplane hangars.)
"It is very difficult to go back and forth several times/day. In the AM on both Saturday and Sunday, there were just no cabs available. I finally took an Uber and paid surge prices so as to not miss obligations at Fiera. On Saturday afternoon, I waited for more than 45 minutes in the congress center taxi line. But I have heard stories of people waiting for 2 hours," Harrington said in an email.
"Crazy. Even the cab drivers were complaining how difficult it was to drop off passengers and pick up new passengers as the two areas are completely separated. Fortunately, I missed the early Sunday security screen fiasco as I didn't arrive at Fiera until approximately 10 am that day," Harrington concluded.
But, it was Rome, a city that everyone described as "magical."
And former American College of Cardiology president Kim Williams, MD, said there was a benefit to meeting in the sprawling and remote Fiera: "[It] just helped my daily steps."
For more of MedPage Today's ESC meeting coverage, click here.