Challenges to climate change adaptation in coastal small towns:Examples from Ghana, Uruguay, Finland, Denmark, and Alaska

The ability of a coastal settlement to adapt to climate change is largely dependent upon access to a range of resources, which many coastal towns and small cities lack. Coastal small towns of less than 10,000 are therefore at a significant disadvantage compared to larger settlements when it comes to adaptation. One way to begin to overcome this disadvantage is to compare coastal small towns in order to identify efficiencies and support knowledge sharing. In this article we present and analyse five case studies of coastal small towns: Fuvemeh, Ghana; Kiyú, Uruguay; Hanko, Finland; Lemvig, Denmark; and Nome, Alaska, USA. A number of key outcomes and lessons were identified which highlights the need for a formal network of international coastal small towns to encourage and develop knowledge sharing practices going forward. A further lesson is the importance of using a range of indicators in order to establish the regional/national importance of a town. Basing this solely on population size can result in an erroneous interpretation of the significance (and therefore adaptive capacity) of a coastal small town. Finally, despite many barriers to adaptation in coastal small towns, being small offers some potential advantages, such as the possibility of being able to form a community consensus more easily, using 3D visualisations for adaptation planning, and having managed realignment as a realistic management option. It is imperative that climate change resilience in coastal small towns is increased by focussing on overcoming barriers and developing appropriate adaptation approaches by governments, non-governmental organisations, business, and researchers

Challenges to climate change adaptation in coastal small towns: examples from Ghana, Uruguay, Finland, Denmark, and Alaska

The ability of a coastal settlement to adapt to climate change is largely dependent upon access to a range of resources, which many coastal towns and small cities lack. Coastal small towns of less than 10,000 are therefore at a significant disadvantage compared to larger settlements when it comes to adaptation. One way to begin to overcome this disadvantage is to compare coastal small towns in order to identify efficiencies and support knowledge sharing. In this article we present and analyse five case studies of coastal small towns: Fuvemeh, Ghana; Kiyú, Uruguay; Hanko, Finland; Lemvig, Denmark; and Nome, Alaska, USA. A number of key outcomes and lessons were identified which highlights the need for a formal network of international coastal small towns to encourage and develop knowledge sharing practices going forward. A further lesson is the importance of using a range of indicators in order to establish the regional/national importance of a town. Basing this solely on population size can result in an erroneous interpretation of the significance (and therefore adaptive capacity) of a coastal small town. Finally, despite many barriers to adaptation in coastal small towns, being small offers some potential advantages, such as the possibility of being able to form a community consensus more easily, using 3D visualisations for adaptation planning, and having managed realignment as a realistic management option. It is imperative that climate change resilience in coastal small towns is increased by focussing on overcoming barriers and developing appropriate adaptation approaches by governments, non-governmental organisations, business, and researchers

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-w (IFN-w) (13 patients), against the 13 types of IFN-a (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

International audienceInterindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-ω (IFN-ω) (13 patients), against the 13 types of IFN-α (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men

The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies

International audienceSignificance There is growing evidence that preexisting autoantibodies neutralizing type I interferons (IFNs) are strong determinants of life-threatening COVID-19 pneumonia. It is important to estimate their quantitative impact on COVID-19 mortality upon SARS-CoV-2 infection, by age and sex, as both the prevalence of these autoantibodies and the risk of COVID-19 death increase with age and are higher in men. Using an unvaccinated sample of 1,261 deceased patients and 34,159 individuals from the general population, we found that autoantibodies against type I IFNs strongly increased the SARS-CoV-2 infection fatality rate at all ages, in both men and women. Autoantibodies against type I IFNs are strong and common predictors of life-threatening COVID-19. Testing for these autoantibodies should be considered in the general population

The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies

International audienceSignificance There is growing evidence that preexisting autoantibodies neutralizing type I interferons (IFNs) are strong determinants of life-threatening COVID-19 pneumonia. It is important to estimate their quantitative impact on COVID-19 mortality upon SARS-CoV-2 infection, by age and sex, as both the prevalence of these autoantibodies and the risk of COVID-19 death increase with age and are higher in men. Using an unvaccinated sample of 1,261 deceased patients and 34,159 individuals from the general population, we found that autoantibodies against type I IFNs strongly increased the SARS-CoV-2 infection fatality rate at all ages, in both men and women. Autoantibodies against type I IFNs are strong and common predictors of life-threatening COVID-19. Testing for these autoantibodies should be considered in the general population