ABSTRACT
This article examines the role of traditional knowledge, skills, and values in fostering resilience in Vanuatu, the world’s most at-risk country from natural hazards. We study responses to severe Tropical Cyclone (TC) Harold, which devastated the nation’s northern islands in April 2020 just as a state of emergency had been declared in response to COVID-19. This necessitated severe restrictions on the delivery of relief supplies and a ban on the arrival of overseas humanitarian workers, forcing remote communities to adopt local responses to the emergency and cope with food insecurity through traditional resilience strategies and values that promote resource-sharing and cooperation. We use a mixed methods approach to analyse the content, extent, and transmission of traditional knowledge in Vanuatu and link this to evidence of its usefulness during TC Harold. Quantitative data from field surveys with two groups of respondents are combined with reports on responses to TC Harold both nationally and along the remote western coast of Santo Island. We also review the extent of traditional knowledge in current educational curricula in Vanuatu. Results illustrate how traditional ecological knowledge and social capital played a key role in disaster response and recovery, but such knowledge is mainly held by older people, and its use by younger generations is declining. We conclude that with rising global temperatures predicted to generate more extreme weather events, and external funds for disaster relief likely to decline, there is a need to build greater adaptive capacity at the local level through the revival of centuries-old informal transmission pathways of knowledge and values © The Author(s) 2022. (Copyright notice)
ABSTRACT
Children and youth infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have milder disease than do adults, and even among those with the recently described multisystem inflammatory syndrome, mortality is rare. The reasons for the differences in clinical manifestations are unknown but suggest that age-dependent factors may modulate the antiviral immune response. We compared cytokine, humoral, and cellular immune responses in pediatric (children and youth, age <24 years) (n = 65) and adult (n = 60) patients with coronavirus disease 2019 (COVID-19) at a metropolitan hospital system in New York City. The pediatric patients had a shorter length of stay, decreased requirement for mechanical ventilation, and lower mortality compared to adults. The serum concentrations of interleukin-17A (IL-17A) and interferon-γ (IFN- γ), but not tumor necrosis factor–α (TNF- α) or IL-6, were inversely related to age. Adults mounted a more robust T cell response to the viral spike protein compared to pediatric patients as evidenced by increased expression of CD25+ on CD4+ T cells and the frequency of IFN- γ+ CD4+ T cells. Moreover, serum neutralizing antibody titers and antibody-dependent cellular phagocytosis were higher in adults compared to pediatric patients with COVID-19. The neutralizing antibody titer correlated positively with age and negatively with IL-17A and IFN- γ serum concentrations. There were no differences in anti-spike protein antibody titers to other human coronaviruses. Together, these findings demonstrate that the poor outcome in hospitalized adults with COVID-19 compared to children may not be attributable to a failure to generate adaptive immune responses.