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Elevating Healthcare Professionals and Available Resources - The Latest on COVID-19 and Pain

One year into the COVID-19 pandemic, new research is emerging that provides insight into acute pain implications in the onset of COVID- 19 infection and the complications and long-term impact of the disease on chronic pain. This complimentary virtual course will explore, through nine sessions over three days, various aspects of COVID-19, from the role of the healthcare provider, review of the current science on management, through to the understanding of the patient’s journey and their decisions in self-management. The event will unite the pain community in education, exchange of novel ideas, and promote engagement across care communities on the complexities of pain and COVID-19. 25. 5 CE/CME credits will be available.

Learning Objectives for Program:

Sessions

Date and Time: 19 May 2021, 10:00 – 11:30 (Eastern Time)

Moderator: Ian Gilron (Canada)

Speakers: Lars Christian Lund (Denmark), Valeria Martinez (France)

Description: Acute and novel pain syndromes emerging during acute and early post-acute COVID-19 onset are complex and varied. Evidence is accumulating regarding their nature and pathophysiological mechanisms as the pandemic progresses.

In the early stages of the pandemic, there was conflicting science on safety in the use of NSAIDS and other OTC medications during the onset of symptoms without clear scientific evidence. This will be discussed with myths debunked. In addition, there are many whose use of prescribed medication has changed to OTC as a result of changes in their ability to consult their doctors and/or their ability to access prescription and non-pharmacological treatments.

Apart from pain symptoms at the onset of the viral infection, including myalgia, arthralgia, sore throat, headache and peripheral neuropathies, there are problems associated with during ICU treatment (procedural pain, prolonged mechanical ventilation, muscle wasting, and immobility during prone positioning) that may arise. COVID-19, despite its prevalence, is virtually unknown. For the treatment of pain, each patient requires an individual approach based on available knowledge and, more importantly, the patient’s condition and comorbidities.

Date and Time: 19 May 2021, 11:45 – 13:15 (Eastern Time)

Moderator: Jen Stinson (Canada)

Speakers: Romy Parker (South Africa)

Description: Attendees will learn about the delivery of self-management through online healthcare provider visits and workshops. Physiotherapy, psychology, and overall self-management techniques will be discussed by the presenters. Presenters will discuss challenges and changes needed to convert in-person to online services and will also discuss changes they have had to make in the programming with the added complications of COVID-19 on patients’ health.

Educational Objectives

  • Learn about patients’ experiences with telehealth services and any potential barriers to access/treatment
  • Learn about the adaptations needed to make services relevant to those with complications from COVID-19
  • Learn about differences in online services vs. the traditional in-person service delivery method

Date and Time: 19 May 2021, 13:30 – 15:00 (Eastern Time)

Moderator: Tonya Palermo (United States)

Speakers: Kai Karos (Belgium), Valerie Hruschak (United States), Melanie Noel (Canada)

Description: Nearly all patients (adults, children and adolescents) with pre-existing chronic pain found their care to be abruptly and sometimes profoundly altered. Appointments were canceled or changed to telephone visits, non-urgent surgical and interventional pain management procedures were put on hold, and maintaining ongoing prescriptions became precarious.

Health systems had to urgently modify their routines and either upgrade or newly acquire telemedicine strategies. Patients’ longstanding struggles with anxiety, depression and social isolation worsened, and some had limited or no access to telemedicine technology. Results of multiple studies of the patient experience and useful guides to successful telehealth implementation will be presented.

GlaxoSmithKline provided grant support for IASP to independently develop this COVID-19: Elevating Healthcare Professionals and Available Resources education series

Date and Time: 20 May 2021, 10:00 – 11:30 (Eastern Time)

Moderator: Jennifer Stinson (Canada)

Speakers: Daniel Ciampi (Brazil); Lars Arendt-Nielsen (Denmark), Fernández-de-las-Peñas (Spain)

Description: This presentation will look at the broad variety of pain syndromes experienced by patients after the virus has been cleared, both transient and persistent, and their assessment including self-diagnosis.

How many new chronic pain patients will there be? Some cohort studies have already been completed, and several large and long-term studies are in progress. Our knowledge of pain manifestations in post-COVID-19 patients, including patients with pre-existing chronic pain, is advancing rapidly.

What is known about the benefits and risks of existing pain management strategies for long COVID? What are the opportunities for new treatment development?

Date and Time: 20 May 2021, 11:45 – 13:15 (Eastern Time)

Moderator: Michael Falcon (United States)

Speakers: Sheren Gaulbert (United Kingdom), Katie Knapton (United Kingdom), Andrea Furlan (Canada), Marta Imamura (Brazil)

Description: This session will provide an overview on how to maintain a current chronic pain management regime after a person living with chronic pain is diagnosed with COVID-19. This will involve discussion on non-prescription medication in the United States to manage COVID-19 symptoms in conjunction with any prescription medication for chronic pain, how to assess symptoms and self-manage COVID-19 symptoms (short and long-term) and when to see your doctor.

Date and Time: 20 May 2021, 13:30 - 15:00 (Eastern Time)

Moderator: Lars Arendt-Nielsen (Denmark)

Speakers: Rajesh Khanna (United States), Theodore Price (United States)

Description: Attendees will learn about unexpected pain syndromes as a result of COVID-19, especially the many types of neurologic injuries. This translational virtual session will demystify the science behind the pain.

Is the nervous system directly infected? What about persistent immune system dysfunction? Damage to other tissues that might lead to pain, such as myocarditis and new onset insulin-requiring diabetes, will also be explored.

Date and Time: 21 May 2021, 10:00 – 11:30 (Eastern Time)

Moderator: Brian Walitt (United States)

Speakers: Daniel Clauw (United States), Lynn L. Debar (United States)

Description: In the flare of scientific exchange at the start of the pandemic many articles were fast tracked to provide insight on the findings seen in the clinical management of COVID-19 as cases grew, including papers on management of acute pain and the possible risk of worsened survival. Retraction rates of published science during the first wave was high.

How has basic and clinical research been affected by the pandemic? Many scientists were no longer able to enter their laboratories for more than a short time and many experiments had to be put on hold. Funding priorities for research changed, and some laboratories quickly changed their primary research focus.

Clinical trials, which traditionally rely on intensive in-person contact, had to change to a more virtual paradigm. Tools for remotely obtaining informed consent, self-measurement techniques, fully virtual efficacy and safety monitoring, and even contactless delivery of investigational agents have been employed.

Date and Time: 21 May 2021, 11:45 – 13:15 (Eastern Time)

Moderator: To be confirmed

Speakers: Harriet Wilkinson (United Kingdom), Deepak Ravindran (United Kingdom), Kerry Thornhill (United Kingdom), Karen Matthews (United States)

Description: In this webinar, the speakers will look at the lived experience of people who have contracted COVID-19 and how they have had to struggle with the issues of pain alongside the other Long COVID symptoms. Musculoskeletal aches and pains are the third most common side effect of long COVID and understanding the patient perspective can allow for tailoring of therapy according to their needs rather than reaching out to usual medications. There will be two patient perspectives - one from a patient with chronic pain exacerbated due to Long COVID and the other will be the start of de novo pain due to long COVID. Do they differ, and, if so, how? What are the needs of the patient, which can define treatment paths forward? How should then pain and long COVID services evolve then to deal with this potential problem? We then will hear from two clinicians who have helped set up one of the initial 43 national clinics for Long COVID in the UK and see how they have designed a system that is responsive to patient needs and the opportunities and challenges of designing a service for a condition where the knowledge is still evolving and forming.

Educational Objectives

  • Introduce the issue of chronic pain both as a consequence of Long COVID and also its exacerbation by contracting acute COVID-19
  • Participants will hear from patients struggling with Long COVID symptoms (how they have managed and the supports they received and their needs during this difficult time amidst multiple waves of acute COVID-19 and lockdowns).
  • The role of coproduction and its utility in designing new innovative ways of providing support.

Date and Time: 21 May 2021, 13:30 – 15:00 (Eastern Time)

Moderator: Abrahao F. Baptista (Brazil)

Speakers: Marion Choinière (Canada), Elena Krumova (Germany), Santosh Chaturvedi (India)

Description: A review of COVID-19 and its impact on the ability to effectively treat pain in developing countries where resources were already limited in pre-pandemic times will be reviewed in this virtual session.

Pre-existing disparities in access to medical care have come into sharper relief during the pandemic. Within countries, inequality between rich and poor in the care received, limited access for persons of color, and worse outcomes, especially in persons with co-morbidities, have been well documented. Geographic variation in attitudes about school and business closures, mask-wearing, and social distancing have been particularly pronounced in the United States.

Geographic variation has been tremendous – some countries have experienced low infection rates due to rigorously enforced lockdowns while others have had surprisingly low infection rates despite a lack of masks and population density too high to allow social distancing. The medical care provided, including pain care, has likewise varied.

Now that vaccines are available, additional disparities have emerged. Within countries there are significant variations in willingness to be vaccinated along with variations in vaccine access. Between countries, availability of vaccines varies widely with some countries having already vaccinated a majority of their citizens.