The aim of this study is to determine the effects of COVID-19 pandemic on the city of Samarkand, Uzbekistan and by adopting an institutional approach, to generate solutions that might contribute to the future development of the tourism and hospitality industries. A computer-based survey was developed and administered online using the Google Forms platform. The survey consisted of the following questions: (1) reactions to the pandemic's influence on tourism (2) short-term recovery plans (3) longterm challenges, and (4) demographic characteristics of respondents. Surveys were distributed to email addresses of over 150 tourism managers and employees in Uzbekistan in June, 2020. A final total of 77 responses were found acceptable for analysis. Findings identified a number of institutions used as a response to the pandemic: additional state support for entrepreneurs, webinars, new investment projects, post-crisis measures, actions aimed at improving the product, and marketing campaigns to promote the tourism product. Several initiatives were instituted by Samarkand Regional Government including support for entrepreneurs and small business owners through start-up investment projects. However, overall, a lack of trust was shown between the tourism owners/providers and regional government with the majority of owners preferring to solve their own problems that were created as a result of the pandemic. Contribution/Originality:This paper uses an institutional framework for the analysis of the tourism industry in Samarkand, Uzbekistan which is unique and different from other current mainstream approaches. In addition it suggests solutions about how governments can use tourism as a major tool for the 'start-up' of the economy after COVID-19. INTRODUCTIONCoronavirus or the COVID-19 pandemic has been described as the most defining global health crisis of our time, and the greatest challenge the world have faced since World War II (United Nations Development Program, 2020). Coronavirus disease (COVID-19) has been defined by WHO as an infectious disease caused by a newly discovered coronavirus. The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. On March 11, 2020, the World Health Organization

The aim. Based on the study of the effect of invasive mechanical ventilation and NIV in the CPAP mode on the pathomorphosis of lung damage in patients with HRF caused by SARS-nCoV-2 and deaths in intensive care unit (ICU), determine the safest method of respiratory support. Materials and methods. The study included morphological material from 20 patients with HRF caused by SARS-nCoV-2 (COVID-19) who died in ICU. Group 1 included patients who received non-invasive lung ventilation in CPAP mode through a face mask (n=10), group 2 - patients who underwent invasive ventilation (n=10). The prepared sections, 5 μm thick, were stained according to the Van Gizon method. Photomicrographs were taken using Zeiss ZENliteimaging. Data are presented as M [25-75] and P±Sp. Statistical analysis of the results was performed using the program “Statistica 10”. Significance of differences in indicators was assessed using the nonparametric Wilcoxon test, the parametric Student's test. The results were considered reliable at values of p<0.05. Results The morphological structure of the lungs of patients of group 1 corresponded to the exudative phase of DAD with severe edematous-hemorrhagic syndrome, signs of interstitial pneumonia with desquamation of alveolocytes and the formation of hyaline membranes. In patients of group 2 in the lung tissue there was a picture of the proliferative phase of DAD with signs of interstitial pneumonia, and the development of focal fibrosing alveolitis. Thus, invasive mechanical ventilation, can accelerate the development of irreversible processes in the lungs in the form of fibrosing alveolitis and promote the formation of ventilator-associated pneumonia Conclusions. CPAP NIV is a promising method of respiratory support in patients with ARDS caused by SARS-nCoV-2 virus (COVID-19), which needs further study

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