Prospects for the use of macrocyclic photosensitizers for inactivation of SARS-CoV-2: selection of compounds leaders based on the molecular docking data.

The treatment of coronavirus COVID-19, like other viral diseases, is currently underdeveloped. This fact necessitates the search for new drugs and treatment methods that will effectively disrupt the life cycle of the virus. A big problem in the therapy of viral diseases is the ability of viruses to evade the host's immune response. We suppose that the search for drugs that can change the evasiveness of the virus from the immune response of the host is a very promising strategy, as it can help the body to cope with the infection. Protein SARS-CoV-2 ORF8 is one of the key proteins that can suppress antiviral immunity. This paper considers the available information on the structure and functioning of ORF8, as well as the results of molecular docking of ORF8 to a wide range of tetrapyrrole macroheterocyclic compounds capable of generating reactive oxygen species upon photoirradiation. This principle of photoinactivation of biosubstrates underlies the methods of photodynamic therapy of cancer. Application of photoinactivation of drug-resistant forms of bacteria and some viruses can be useful in the fight against COVID-19 and other viral infections. In this work, the structure of ORF8 complexes with macrocyclic compounds is considered in detail, the dependence of their binding affinity on the nature of macrocycles and the nature of peripheral substituents is analyzed and spectral studies of the binding of ORF8 to chlorin is performed. This paper is a part of a large project to investigate the possibility of using macrocyclic compounds for the treatment of viral diseases.Communicated by Ramaswamy H. Sarma.

EuroQol-5D-3L in Long Covid patients After Supplementation with EchA Marine, a Sea Urchin Eggs Extract: a double-blinded, multicentrical study. (preprint)

Patients with Long COVID experience a significant decrease in their quality of life and the lack of effective treatment represents an unmet need in medical care and patient health. One proposed strategy for treating Long COVID is to increase the bodys ability to restore immune balance by controlling inflammation with anti-inflammatory substances. For this reason, the aim of this double-blind study was to evaluate the supplementation of patients with EchA Marine(R), a dietary supplement based on sea urchin eggs rich in Echinochrome A. This compound has demonstrated anti-inflammatory and antioxidant properties by activating the metabolism of glutathione and improving mitochondrial mass and performance. The EuroQol 5-Dimension (EQ-5D) is a standardized questionnaire assessing five dimensions of health: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression used as an instrument to measure health-related quality of life in clinical and economic studies. In this multicenter, double-blind, intervention study, we have demonstrated that the dietary supplement EchA Marine(R) can significantly enhance the quality of life of these patients, particularly in pain and discomfort; notably improving their quality of life and daily activitys ability. EchA Marine(R) is an effective treatment option for Long COVID patients and with further research its efficacy could be further strengthened.

Rapid tissue prototyping with micro-organospheres.

In vitro tissue models hold great promise for modeling diseases and drug responses. Here, we used emulsion microfluidics to form micro-organospheres (MOSs), which are droplet-encapsulated miniature three-dimensional (3D) tissue models that can be established rapidly from patient tissues or cells. MOSs retain key biological features and responses to chemo-, targeted, and radiation therapies compared with organoids. The small size and large surface-to-volume ratio of MOSs enable various applications including quantitative assessment of nutrient dependence, pathogen-host interaction for anti-viral drug screening, and a rapid potency assay for chimeric antigen receptor (CAR)-T therapy. An automated MOS imaging pipeline combined with machine learning overcomes plating variation, distinguishes tumorspheres from stroma, differentiates cytostatic versus cytotoxic drug effects, and captures resistant clones and heterogeneity in drug response. This pipeline is capable of robust assessments of drug response at individual-tumorsphere resolution and provides a rapid and high-throughput therapeutic profiling platform for precision medicine.

Pregnancy Outcomes in SARS-CoV-2-Positive Patients: A 20-Month Retrospective Analysis of Delivery Cases.

Background and Objectives: The SARS-CoV-2 infection brings supplemental risks for pregnant women. Due to controversial hesitancy, their vaccination rate was lower in 2021 compared to the general population. In addition, access to maternal care was reduced during the pandemic. We conducted a retrospective cross-sectional analysis of the health records data over 20 months (1 April 2020 to 20 November 2021) aiming to explore the outcomes in SARS-CoV-2-positive cases referred for delivery to a tertiary public hospital in Western Romania. Materials and Methods: Women with SARS-CoV-2 infection diagnosed for the first time at the moment of birth who delivered singletons after 24 weeks of gestation, and had a clear immunization status were included in the analysis. Results: Out of the 97 patients included in the study, 35 (36%) had undergone ARN-based vaccination. Five cases of maternal death were recorded (all unvaccinated). Our retrospective exploratory analysis showed that the presence of COVID-19 symptoms in the SARS-CoV-2-positive patients made a significant impact on the delivery hospitalization, with a median hospital stay increase from 5 to 9 days (Mann-Whitney test, p = 0.014): longer hospitalization was recorded in the symptomatic cases irrespective of their vaccination status. No other adverse outcomes, such as gestational age at delivery, C-section rate, 5 min Apgar index, or birth weight were associated with the presence of symptoms. Conclusions: Our clinic maintained safe maternal care for the COVID-19 patients during the analyzed period. Vaccination of the expectant women was beneficial in SARS-CoV-2-positive patients by lowering the risk of COVID-19 symptoms, with subsequent implications on the newborns' health and maternal attachment.

Antiviral Activity of N1,N3-Disubstituted Uracil Derivatives against SARS-CoV-2 Variants of Concern.

Despite the widespread use of the COVID-19 vaccines, the search for effective antiviral drugs for the treatment of patients infected with SARS-CoV-2 is still relevant. Genetic variability leads to the continued circulation of new variants of concern (VOC). There is a significant decrease in the effectiveness of antibody-based therapy, which raises concerns about the development of new antiviral drugs with a high spectrum of activity against VOCs. We synthesized new analogs of uracil derivatives where uracil was substituted at the N1 and N3 positions. Antiviral activity was studied in Vero E6 cells against VOC, including currently widely circulating SARS-CoV-2 Omicron. All synthesized compounds of the panel showed a wide antiviral effect. In addition, we determined that these compounds inhibit the activity of recombinant SARS-CoV-2 RdRp. Our study suggests that these non-nucleoside uracil-based analogs may be of future use as a treatment for patients infected with circulating SARS-CoV-2 variants.

Outcome of Newborns with Confirmed or Possible SARS-CoV-2 Vertical Infection-A Scoping Review.

Severe acute respiratory syndrome virus 2 (SARS-CoV-2), the virus that causes 2019 coronavirus disease (COVID-19), has been isolated from various tissues and body fluids, including the placenta, amniotic fluid, and umbilical cord of newborns. In the last few years, much scientific effort has been directed toward studying SARS-CoV-2, focusing on the different features of the virus, such as its structure and mechanisms of action. Moreover, much focus has been on developing accurate diagnostic tools and various drugs or vaccines to treat COVID-19. However, the available evidence is still scarce and consistent criteria should be used for diagnosing vertical transmission. Applying the PRISMA ScR guidelines, we conducted a scoping review with the primary objective of identifying the types, and examining the range, of available evidence of vertical transmission of SARS-CoV-2 from mother to newborn. We also aimed to clarify the key concepts and criteria for diagnosis of SARS-CoV-2 vertical infection in neonates and summarize the existing evidence and advance the awareness of SARS-CoV-2 vertical infection in pregnancy. Most studies we identified were case reports or case series (about 30% of poor quality and inconsistent reporting of the findings). Summarizing the existing classification criteria, we propose an algorithm for consistent diagnosis. Registration: INPLASY2022120093.

The Quality of the Digital Ecosystem in the Financial Sector

The purpose of the study of the digital transformation of the economy and its financial sector is not so much a quantitative as a qualitative assessment. The digital economy shows the emergence of the phenomenon of platform and ecosystem quality and is defined in different sectors of the economy. The sector of services to business is growing in innovation-driven and efficiency-driven economies. It has appeared and is growing in the Russian Federation. Within the framework of the platform economy and the ecosystem economy, these changes allow defining a new quality of financial and non-financial services. The range of services of banking ecosystems, financial and non-financial companies within these systems is changing. In the financial sector the ecosystems of companies and banks are expanding not only the opportunities for distance selling, but also the opportunities for green financing of economic growth. Therefore, the analysis of the financial traps of sustainable development and ESG (environmental, social, government) growth is of particular interest. From the viewpoint of systemic quality, the approach to green financing of economic growth is changing. Two new factors—digitalization and coronavirus pandemic determine the opportunities and boundaries of economic development today. Both are frame factors, introduced or non-economic ones that allows to use the institutional analysis tools. The world experience of stimulating, motivating and transferring institutions includes financial (credit rates, subsidizing bond loans, etc.) and non-financial (funds, ratings, etc.) tools to achieve a new quality of growth. The transformation of financial markets involves the redistribution of financial flows in favor of companies with an ESG policy. The main conclusion: the transformation of financial markets involves the redistribution of financial flows in favor of companies with ESG policies and is an indicator of qualitative changes. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Complex Sensitive-Motor Rehabilitation in a Patient with Acute Ischemic Stroke During Active SARS-COV-2 Infection: Case Report

Introduction. Stroke is one of the main reasons for acquired disability, and the past 2 years have demonstrated that COVID-19 is a major cause of thromboembolic accidents, which usually determine cardio-pulmonary infraction, as it has a higher incidence on larger blood vessels, but there are also numerous cases reported of stroke in patients after or, more rarely, during COVID-19 active infection. Material and Methods. We present the case of a 52 year old man diagnosed with stroke during hospitalisation for a moderate type of COVID-19(Coronavirus 2019), which after several days from admittance, was found with left hemiplegia in his chamber. A comprehensive sensitive-motor rehabilitation program has been established after two and a half months after discharge, as the deficit did not regress. Results and discussion. The evolution of the patient was favorable, with an improvement of the symptoms after treatment, especially the pain syndrome, but also on improved muscle tonus and slight muscle strength increase and improved disability scores The patient rehabilitation should continue for a longer period of time, as new cerebral pathways take time to be established. Conclusions. In patients with stroke, independent of the mechanism of occurring, complex sensitive-motor rehabilitation should be started as soon as possible, in good condition, so that the benefits outbalance the risks. Extra precautions should be taken in regards to patients with COVID-19 related stroke, as they are more inclined to have a thrombotic related development, even after fully medically recovering from the disease. Copyright © 2021 Stanciu Liliana-Elena et al., published by Sciendo.

“Vaccine Nationalism” As a Great Power Competition: Analysis from the Standpoint of the Securitization Theory

Introduction. State leaders and heads of international organizations argue that COVID-19 is a global security threat that requires international responses. However, to date, there is no stable international cooperation regime in the field of counteracting the virus, primarily at the level of vaccine development. Moreover, countries are competing in this area, considering primacy in the creation of a COVID-19vaccine not only as a step towards the fight against the virus, but as a tool to strengthen their international positions and increase international prestige and “soft power”. Methods and materials. The authors investigate the problem from the standpoint of the securitization theory, according to which national and international security threats are formed by political actors as speech acts and discursive practices. Analisys. From the standpoint of this theory, despite the fact that the COVID-19 pandemic is securitized at the national level in many countries, at the global level, this securitization discourse about COID-19 discourse is embedded in a broader macrosecuritization framework, which assumes that the dominant threats are associated with the confrontation of great powers. Results. The consequence of this is the legitimization of the policy of “vaccine nationalism” and the lack of international cooperation in the field of vaccine production.Alternate : Лидеры государств и международных организаций, занимающихся вопросами здравоохранения, утверждали, что коронавирус COVID-19 представляет собой глобальную угрозу безопасности и требует международных ответов. Однако на международном уровне не сложилось устойчивого режима международного сотрудничества в области противодействия вирусу, что особенно явно проявилось на этапе создания вакцины. Страны конкурировали в данной области, рассматривая первенство в создании вакцины от коронавируса COVID-19 не только как шаг на пути в борьбе с вирусом, но и как инструмент для укрепления позиций на международной арене и повышения международного престижа, «мягкой власти» своей страны. Авторы статьи исследуют проблему с позиций теории секьюритизации, согласно которой угрозы национальной и международной безопасности формируются политическими субъектами как дискурсивная практика. С позиций данного подхода, несмотря на то что пандемия COVID-19 секьюритизирована на уровне отдельных стран, на глобальном уровне данный дискурс встроен в более широкую рамку макросекьюритизации, которая исходит из того, что доминирующие угрозы связаны с противоборством великих держав, а не с угрозами в области здравоохранения. Следствием этого является легитимация политики «вакцинного национализма» и отсутствие международного сотрудничества в области производства вакцины. Вклад авторов. М.В. Харкевич разработал концепцию исследования, проработал его теоретико-методологические основания. Е.С. Зиновьева провела анализ политики государств в области разработки вакцин и сформулировала итоговые выводы.

[Diagnostic properties of case definitions of suspected COVID-19 in Chile, 2020Características diagnósticas das definições de caso suspeito de COVID-19 no Chile, 2020]. / Propiedades diagnósticas de las definiciones de caso sospechoso de COVID-19 en Chile, 2020.

OBJECTIVE: Compare the diagnostic properties of five case definitions of suspected COVID-19 that were used or proposed in Chile during the first eight months of the pandemic. METHODS: An analysis was done of the diagnostic properties (sensitivity, specificity, and positive and negative predictive values) of three case definitions of suspected COVID-19 used in Chile between March and October 2020, as well as two alternative proposed definitions. The sample was 2,019 people with known results for the polymerase chain reaction (PCR) test for SARS-CoV-2. Stepwise logistic regression was used to develop criterion 5, optimizing sensitivity and specificity values. Multifactor logistic regression was used to explore the association between demographic variables, symptoms and signs, and PCR positivity. Different positivity scenarios were analyzed and ROC curves were compared. RESULTS: The presence of anosmia (OR = 8.00; CI95%: 5.34-11.99), fever (OR = 2.15; CI95%: 1.28-3.59), and having been in close contact with a person sick with COVID-19 (OR = 2.89; CI95%: 2.16-3.87) were associated with a positive PCR result. According to the analysis of the ROC curve, criterion 5 had the highest capacity for discrimination, although there were no significant differences with the other four criteria. CONCLUSIONS: Criterion 5-based on anosmia, close contact with people with COVID-19, and fever as sufficient unique elements-was the most sensitive in identifying suspected cases of COVID-19, a key aspect in controlling the spread of the pandemic.

OBJETIVO: Comparar as características diagnósticas de cinco critérios das definições de caso suspeito de COVID-19 usados ou propostos no Chile nos oito primeiros meses de pandemia. MÉTODOS: Foram avaliadas as características diagnósticas (sensibilidade, especificidade e valores preditivos positivo e negativo) de três critérios das definições de caso suspeito de COVID-19 usados no Chile entre março e outubro de 2020 e de duas alternativas propostas para definição de caso. A amostra do estudo consistiu 2 019 pessoas com resultados conhecidos no exame de reação em cadeia da polimerase (PCR) para SARS-CoV-2. Para elaborar o critério 5, uma regressão logística com método stepwise foi realizada otimizando os valores de sensibilidade e especificidade. A associação entre variáveis demográficas, sintomas e sinais e resultado positivo no exame de PCR foi testada em um modelo de regressão logística multifatorial. Situações diferentes de resultado positivo foram testadas com uma análise comparativa das curvas ROC. RESULTADOS: Presença de anosmia (OR 8,00; IC95% 5,34­11,99), febre (OR 2,15; IC95% 1,28­3,59) e contato próximo anterior com uma pessoa com COVID-19 (OR 2,89; IC95% 2,16­3,87) foram associados a um resultado positivo no exame de PCR. De acordo com a análise das curvas ROC, o critério 5 demonstrou maior capacidade discriminatória, apesar de não existir diferença significativa com os outros quatro critérios. CONCLUSÃO: O critério 5 ­ presença de anosmia, febre e contato próximo com uma pessoa com COVID-19 como elementos únicos e suficientes ­ demonstrou maior sensibilidade para identificar casos suspeitos de COVID-19, o que é fundamental para controlar a disseminação da pandemia.

Research priorities to reduce the impact of COVID-19 in low- and middle-income countries

Background The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. Methods The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability;2) potential for burden reduction;3) potential for a paradigm shift;4) potential for translation and implementation;and 5) impact on equity. Results Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients’ needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts. Interpretation Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.

Case Report: COVID-19-Associated ROHHAD-Like Syndrome.

It is known that the SARS-CoV-2 virus may cause neurologic damage. Rapid-onset obesity, hypoventilation, hypothalamus dysfunction, and autonomic dysregulation (ROHHAD) syndrome is a disease of unknown etiology with a progressive course and unclear outcomes. The etiology of ROHHAD syndrome includes genetic, epigenetic, paraneoplastic, and immune-mediated theories, but to our knowledge, viral-associated cases of the disease have not been described yet. Here we present the case of a 4-year-old girl who developed a ROHHAD syndrome-like phenotype after a COVID-19 infection and the results of 5 months of therapy. She had COVID-19 pneumonia, followed by electrolyte disturbances (hypernatremia and hyperchloremia), hypocorticism and hypothyroidism, central hypoventilation-requiring prolonged assisted lung ventilation-bulimia, and progressive obesity with hypertriglyceridemia, dyslipidemia, hyperuricemia, and hyperinsulinemia. The repeated MRI of the brain and hypothalamic-pituitary region with contrast enhancement showed mild post-hypoxic changes. Prader-Willi/Angelman syndrome as well as PHOX2B-associated variants was ruled out. Treatment with non-steroidal anti-inflammatory drugs and monthly courses of intravenous immunoglobulin led to a dramatic improvement. Herein the first description of ROHHAD-like syndrome is timely associated with a previous COVID-19 infection with possible primarily viral or immune-mediated hypothalamic involvement.

Inhaled Placental Mesenchymal Stromal Cell Secretome from Two- and Three-Dimensional Cell Cultures Promotes Survival and Regeneration in Acute Lung Injury Model in Mice.

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) is a common clinical problem, leading to significant morbidity and mortality, and no effective pharmacotherapy exists. The problem of ARDS causing mortality became more apparent during the COVID-19 pandemic. Biotherapeutic products containing multipotent mesenchymal stromal cell (MMSC) secretome may provide a new therapeutic paradigm for human healthcare due to their immunomodulating and regenerative abilities. The content and regenerative capacity of the secretome depends on cell origin and type of cultivation (two- or three-dimensional (2D/3D)). In this study, we investigated the proteomic profile of the secretome from 2D- and 3D-cultured placental MMSC and lung fibroblasts (LFBs) and the effect of inhalation of freeze-dried secretome on survival, lung inflammation, lung tissue regeneration, fibrin deposition in a lethal ALI model in mice. We found that three inhaled administrations of freeze-dried secretome from 2D- and 3D-cultured placental MMSC and LFB protected mice from death, restored the histological structure of damaged lungs, and decreased fibrin deposition. At the same time, 3D MMSC secretome exhibited a more pronounced trend in lung recovery than 2D MMSC and LFB-derived secretome in some measures. Taking together, these studies show that inhalation of cell secretome may also be considered as a potential therapy for the management of ARDS in patients suffering from severe pneumonia, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), however, their effectiveness requires further investigation.

Business ideas to reactivate tourism in a pandemic context in “la Encantada”, Chulucanas, Peru

The COVID-19 pandemic paralysed the tourism sector and negatively affected the employment of artisans engaged in the ceramics trade. The aim of this study is to determine the business ideas of the artisans of “La Encantada”, Chulucanas, Peru. An action research was carried out with 12 artisans dedicated to ceramics in “La Encantada” who were interviewed and the macro and micro filter method was used to prioritize business ideas. The results show that 100% of the artisans have valuable business ideas in the field of tourism associated with the ceramics trade and the excursions that take place in the town, among them: The construction and management of restaurants, hotels, recreation centres, museums of historical ceramics and the organisation of ceramics workshops. In conclusion, “La Encantada” is a potential scenario where business plans can be financed and implemented. However, priority must be given to reviving tourism in the face of the pandemic, as well as attracting investors to revive commercial activity in the area. © 2021, Universidad del Zulia. All rights reserved.

The efficacy and safety of levilimab in severely ill COVID-19 patients not requiring mechanical ventilation: results of a multicenter randomized double-blind placebo-controlled phase III CORONA clinical study.

OBJECTIVE AND DESIGN: The aim of this double-blind, placebo-controlled, phase III CORONA clinical trial was to evaluate the efficacy and safety of IL-6 receptor inhibitor levilimab (LVL) in subjects with severe COVID-19. SUBJECTS: The study included 217 patients. The eligible were men and non-pregnant women aged 18 years or older, hospitalized for severe COVID-19 pneumonia. TREATMENT: 206 subjects were randomized (1:1) to receive single subcutaneous administration of LVL 324 mg or placebo, both in combination with standard of care (SOC). 204 patients received allocated therapy. After the LVL/placebo administration in case of deterioration of symptoms, the investigator could perform a single open-label LVL 324 mg administration as the rescue therapy. METHODS: The primary efficacy endpoint was the proportion of patients with sustained clinical improvement on the 7-category ordinal scale on Day 14. All efficacy data obtained after rescue therapy administration were considered missing. For primary efficacy analysis, all subjects with missing data were considered non-responders. RESULTS: 63.1% and 42.7% of patients in the LVL and in the placebo groups, respectively, achieved sustained clinical improvement on Day 14 (P = .0017). The frequency of adverse drug reactions was comparable between the groups. CONCLUSION: In patients with radiologically confirmed SARS-CoV-2 pneumonia, requiring or not oxygen therapy (but not ventilation) with no signs of other active infection administration of LVL + SOC results in an increase of sustained clinical improvement rate. TRAIL REGISTRATION: The trial is registered at the US National Institutes of Health (ClinicalTrials.gov; NCT04397562).

Island Tourism-Based Sustainable Development at a Crossroads: Facing the Challenges of the COVID-19 Pandemic

Tourism is often seen as the ‘golden ticket’ for the development of many islands. The current COVID-19 pandemic, however, has ground global tourism to a halt. In particular, islands that depend heavily on tourist inflows—including mass-tourism islands, and small island developing states (SIDS)—have seen their revenues diminish significantly, and poverty rates increasing. Some alternative-tourism islands have fared better, as they have focused on providing personalized, nature-based experiences to mostly domestic tourists. This article focuses on the experiences of mass-tourism islands, SIDS, and alternative-tourism islands during the COVID-19 pandemic, and offers possible post-pandemic scenarios, as well as recommendations for sustainable island tourism development. Although the pandemic has largely had a negative impact on the tourism sector, this is a unique opportunity for many islands to review the paradigm of tourism development. In this newly emerging world, and under a still very uncertain future scenario, the quadriptych of sustainability is more important than ever. Responsible governance and management of islands’ natural resources and their tourism activities, addressing climate change impacts, the diversification of islands’ economies, and the promotion of innovative and personalized tourist experiences are all necessary steps towards increasing islands’ resilience in case of future economic downturn or health- and environment-related crises.