ABSTRACT
This article evaluates the impact of COVID on urban tourism in Ecuador through a systematic analysis of several studies carried out by the authors during 2020 into companies, human talent and the demand for domestic tourism. The problems facing the tourism sector in Ecuador are very serious and complex, not only in terms of the economy and job losses, but also due to the absence of any public reactivation plan that goes beyond good intentions. 2021 is a year of presidential elections, which will also impact on the possible reactivation of the sector. The authors argue that the challenge of stimulating recovery in the country's tourism sector can only be met by reaching an agreement among all stakeholders to design and implement an urgent plan to save jobs, companies and the tourism value chain in the country.
ABSTRACT
Background: The low susceptibility of children to severe illness with SARS-CoV- 2 infection could be related to distinct virus-host interactions. Some studies indicate that SARS-CoV-2 infected adults with mild symptoms rapidly lose their antibody responses, but the kinetics of the antibody response in children have been less studied. To evaluate the antibody response of SARS CoV-2 antibodies in infected children, we used samples from the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study, a community-based prospective cohort study of children and adolescents with SARS-CoV-2 infection or exposure. Methods: Samples from 71 SARS-CoV-2 infected children (median age: 9.7 years, IQR 4-16) collected at enrollment (M0), 2 and 4 months after exposure (M2, M4) were analyzed. A Luminex-based multiplex binding assay was used to measure Ig isotype (IgG, IgM, IgA) and IgG subclass (IgG1, IgG3) against 7 SARS-CoV-2 epitopes: whole spike (S), subunit 1 (S1), S2, receptor binding domain (RBD), N-terminal domain (NTD), nucleocapsid (NC) and membrane (M). The ability of antibodies to block viral interaction with the human receptor ACE2 was evaluated by an ELISA-based assay, and neutralization was assessed in a pseudovirus assay. Results: At time of enrollment (median of 5 days after infection), all participants had detectable levels of IgM and IgA against at least one of the tested SARS-CoV-2 antigens, and 91% had detectable IgG levels. IgM and IgA levels declined with time, although all children still had detectable levels of anti-S IgM and IgA at M4. In contrast, IgG binding to all viral regions increased significantly at M2 and, at M4, most children maintained robust IgG response. IgG1 and IgG3 antibodies were detected against most antigens. ACE2 blocking increased at M2 as compared to M0, and at M2 the percent blocking was higher in younger children than in older children (Fig 1). Similarly, younger children had higher levels of anti-RBD IgG at M2, whereas older children showed higher levels of anti-RBD IgM. We found no differences in antibody profiles between asymptomatic and symptomatic children. Preliminary analysis in 4 children indicated that neutralizing antibody responses were still detectable at M4. Conclusion: SARS CoV-2 infected children develop robust antibody responses that are still detectable 4 months after infection. This suggests that children could respond well to SARS CoV-2 vaccination and highlights the need to test candidate vaccines in pediatric populations.
ABSTRACT
Background: SARS-CoV-2 vaccines have shown promising efficacy in human adult trials, but immunogenicity and efficacy studies in the pediatric population are lagging behind. Here we evaluated the immunogenicity of two prefusion stabilized Spike protein (S-2P) vaccine platforms in infant Rhesus Macaques (RM): an adjuvanted S-P2 subunit and mRNA vaccine. Methods: Infant RMs (2.5 months-old) were immunized intramuscularly at weeks (wks) 0 & 4 with 15 μg S-P2 adjuvanted with the toll-like receptor 7/8 agonist 3M-052 in stable emulsion (n=8), or 30 μg of S-P2 mRNA in lipid nanoparticles (mRNA-LNP, Moderna) (n=8). Blood was collected at wks 0, 4, 6, 8, & 14. Plasma (Spike[S]) and salivary (receptor binding domain [RBD]) IgG responses were measured by ELISA and epitope specificity by multiparameter bead array. Antibody function was assessed by an ACE2 blocking assay and neutralization by pseudovirus (PSVA) and whole virus neutralization assays, both with D614G. Flow cytometry was applied to measure S-specific memory B cells using fluorochrome-conjugated recombinant S, and S-specific IL-2, IL-17, TNF-α, or IFN-γ producing T cells after stimulation with overlapping peptides of full-length S. Results: No adverse effects were observed with either vaccine. Plasma S-specific IgG responses were induced by both vaccines at wk 4, increased after the second dose, and persisted through wk 14 (Fig 1A). All S regions were targeted by plasma IgG (Fig 1B), and RBD-specific IgG was also detected in saliva. Serum antibodies achieved >95% ACE2 blocking by wk 6 (1:10 dilution), remaining >90% at wk 14. Geometric mean ID50 titers of neutralizing antibodies in the PSVA exceeded 10[3] from wk 6 through wk 14 (Fig 1C) and strongly correlated with whole virion neutralization (p<0.0001). In the protein vaccine group, S-specific CD27+ memory B cells peaked at 3.1% (mean) of total memory B cells;and S-specific CD4+ T cell responses were dominated by IL-17 and IFN-γ Mean S-specific CD27+ B cells peaked at 0.9% total memory B cells in mRNA vaccinees and S-specific CD4+ T cells produced IL-2, IFN-γ, IL-17, or TNF-α. Conclusion: The S-2P-3M-052-SE and mRNA-LNP vaccines were well-tolerated and highly immunogenic in infant Rhesus Macaques, with persistent IgG binding and neutralization responses that are comparable to those reported for adult RMs and humans. Our results provide proof-of-concept that a pediatric SARS-CoV-2 vaccine could induce long term protection against SARS-CoV-2.
ABSTRACT
The COVID pandemic has made telematic consultations a basic tool in daily practice. AIMS: The main objective of the study is to assess the results of the application of telematic consultations to limit the mobility of patients. The operational objectives are; to propose a consultation plan, to know how attendance limits consultations and to define which pathologies benefit the most from this plan. METHODS: A scheme is proposed with the creation of pre-scheduled clinic to assess suitability and the possibility of carrying them out in a single non face-to-face act. RESULTS: Phone call to 5,619 patients were made with a lack of response of 19%. The cases of 74% of the patients that answered were resolved virtually. There is a difference between units, obtaining a higher answering rate from patients appointed to specific clinic units, OR = 0.60, or to general trauma ones, OR = 0.67. The lowest answering rate was obtained from those derived from the emergency department. Twenty per cent of the consultations were not accompanied by complementary tests that would have favored the resolution in a single act. The general trauma consultations, OR = 0.34, postoperative control, OR = 0.49, and specific unit ones, OR = 0.40, were the ones that better met this requirement. Out of the remaining patients, the general trauma consultations, OR = 0.50, and those referred to units, OR = 0.54, were the ones that had a higher resolution rate without in- person consultation. CONCLUSIONS: The cases of 74% of the patients who answered the phone call were resolved virtually. Cases of 20% of the patients cannot be solved in a single act because they are derived without complementary tests. Osteosynthesis and postoperative arthroscopic follow-up consultations are the ones that need to be carried out in person the most.