Environmental Geotechnics: Challenges and Opportunities in the Post COVID-19 World

The outbreak of the COVID-19 pandemic not only created a health crisis across the world but is expected to negatively impact the global economy and societies at a scale that maybe larger than the 2008 financial crisis. Simultaneously, it has inevitably exerted many negative consequences on the geoenvironment upon which human beings depend. The current article articulates the role of environmental geotechnics to elucidate and mitigate the effects of the current pandemic. It is the belief of all authors that the COVID-19 pandemic presents significant challenges, but also opportunities for the development of our field. Our discipline should make full use of our professional skills and expertise to look for development opportunities from this crisis, to highlight our discipline’s irreplaceable position in the global fight against pandemics, and to contribute to the health and prosperity of our communities, so as to better serve humankind. In order to reach this goal, while taking into account the specificity of the SARS-CoV-2 and the uncertainty of its environmental effects, it is believed that more emphasis should be placed on the following research directions: pathogen-soil interactions, isolation and remediation technologies for pathogen-contaminated sites, new materials for pathogen-contaminated soil, recycling and safe disposal of medical wastes, quantification of uncertainty in geoenvironmental and epidemiological problems, emerging technologies and adaptation strategies in civil, geotechnical, and geoenvironmental infrastructure, pandemic-induced environmental risk management, and model pathogen transport and fate in geoenvironment, among others. Moreover, COVID-19 has made it clear to the environmental geotechnics community the importance of urgent international cooperation and of multidisciplinary research actions that must extend to a broad range of scientific fields, including medical and public health disciplines, in order to meet the complexities posed by the COVID-19 pandemic

Levofloxacin versus placebo for the prevention of tuberculosis disease in child contacts of multidrug-resistant tuberculosis: study protocol for a phase III cluster randomised controlled trial (TB-CHAMP)

Background Multidrug-resistant (MDR) tuberculosis (TB) presents a challenge for global TB control. Treating individuals with MDR-TB infection to prevent progression to disease could be an effective public health strategy. Young children are at high risk of developing TB disease following infection and are commonly infected by an adult in their household. Identifying young children with household exposure to MDR-TB and providing them with MDR-TB preventive therapy could reduce the risk of disease progression. To date, no trials of MDR-TB preventive therapy have been completed and World Health Organization guidelines suggest close observation with no active treatment. Methods The tuberculosis child multidrug-resistant preventive therapy (TB-CHAMP) trial is a phase III cluster randomised placebo-controlled trial to assess the efficacy of levofloxacin in young child contacts of MDR-TB cases. The trial is taking place at three sites in South Africa where adults with MDR-TB are identified. If a child aged < 5 years lives in their household, we assess the adult index case, screen all household members for TB disease and evaluate any child aged < 5 years for trial eligibility. Eligible children are randomised by household to receive daily levofloxacin (15–20 mg/kg) or matching placebo for six months. Children are closely monitored for disease development, drug tolerability and adverse events. The primary endpoint is incident TB disease or TB death by one year after recruitment. We will enrol 1556 children from approximately 778 households with an average of two eligible children per household. Recruitment will run for 18–24 months with all children followed for 18 months after treatment. Qualitative and health economic evaluations are embedded in the trial. Discussion If the TB-CHAMP trial demonstrates that levofloxacin is effective in preventing TB disease in young children who have been exposed to MDR-TB and that it is safe, well tolerated, acceptable and cost-effective, we would expect that that this intervention would rapidly transfer into policy. Trial registration ISRCTN Registry, ISRCTN92634082. Registered on 31 March 2016