For every complex problem, there is a solution that is simple, neat, and wrong. Hence, it is often necessary to make a decision on the basis of information sufficient for action but insufficient to satisfy the intellect. In this COVID-19 pandemic era where the public and the mass media attention is about serious health issues, it is important to explain why taking action should not be based on the basis of research study conducted individually, even though it remained prudently designed, effectively conducted, as well as appropriately interpreted and evaluated, which need to be highlighted. COVID-19 pandemic has been identified as a generation-defining, impacting economic shocks, families, communities and other unforeseen events in any country in the world, and has led to long-term economic financial conditions that have beset as well as create an “extinction-level event” which has cast an eerie shadow around the world long after the COVID-19 pandemic is behind us. Just over a year ago, news of a flu-like deadly virus affecting the central region of China began grabbing international headlines. It was the start of what would become a worldwide news event; one that would raise unique challenges for the environmental and public health practices and pose a series of lethal threats to environmental/public health. However, it is becoming increasingly clear that the threat is not only in the form of a deadly virus. The pandemic is also being used by malign forces as an opportunity to disrupt, unforeseen and unprecedented circumstances, to sabotage and even to prevent the free flow of trusted, independent information toward the impact of the COVID-19 pandemic, which present an acute case of reliability. The highly contagious COVID-19 pandemic has been weaponised to undermine freedom of expression and has provided a valid reason to usher in a range of reporting restrictions on a sliding scale of severity from limiting access to data, right through to punitive legislation and even life threatening [1, 2, 3]. Additionally, the relentless onslaught of misinformation and disinformation riddling social media platforms has created a real obstacle to COVID-19 truth-telling.
Indeed, COVID-19 vaccines offer much-needed protection from disease, but there has so far been no evidence of whether they also curb transmission. Recently, around the world, concern is growing about the impact the new, fast spreading SARS-CoV-2 variants will have on the pandemic. Most countries are facing a widespread variant of SARS-CoV-2 known as B.1.351 and B.1.1.7, which appears to somewhat decrease the efficacy of some vaccines and have raised growing concerns about the extent to which their mutations might help them evade current antibody treatments and highly effective vaccines. The news heightens concerns about B.1.351 and B.1.1.7, nonetheless researchers remain hopeful that the vaccine prevents severe disease and death. However, the chance of dying is around 35% higher for people who are confirmed to be infected with the new variant. Although, the data are preliminary, and it is not clear whether the variant is deadlier than previous strains or is spreading to more people who are vulnerable to severe disease. While it’s possible some COVID-19 vaccines may offer less protection against some of these new variants, recent results have suggested the AstraZeneca vaccine may not provide much protection against the South African variant, there’s still enough protection in most other current vaccines to prevent serious illness, hospitalization, and death. For now, emergence of these new variants should encourage all of us to take steps to slow the spread of SARS-CoV-2. That means following the three W’s: Wear a mask, watch your distance, wash your hands often. It also means rolling up our sleeves to get vaccinated as soon as the opportunity arises. Hence, the global health, economic, and social events that rattled series of activities around the world in 2020 have kicked off a new, uncertain era of environmental/public health practices, and it may take a long time for such uncertainty to ease. As many environmental/public health experts are predicting that it could even outlast the pandemic itself.
While the world remains alarmed to panic at the grip of the demonic novel COVID-19 infection, there is still plenty of bearish perception as 2020 will certainly and no doubt be etched in the minds of health-care professionals, including environmental health officers all over the globe for several years to come which is unprecedented in the modern health care setting [4, 5, 6]. While, the national response toward COVID-19 varies, from the swift and most proactive to haphazard and negligent to the worst. That nations have already managed the spread of the pandemic in a different way is expected, nonetheless COVID-19 pushes all health systems toward their limits, thereby revealing serious gaps in environmental/public health structure, even in countries that are acclaimed as the popular centers for readiness. Thus, the response toward COVID-19 shows a glaring lack of social health determinants as well as meaningful collective learning, community participation and engagement on important issues in a health emergency. The COVID-19 outbreak caused through severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) has adversely affected social, economic events that rattled businesses as well as environmental health determinants and has challenged health professionals such as doctors, nurses, health workers, researchers, decision-makers and many others working in the health sector in many ways, while suspending the usual daily businesses [7].
COVID-19 pandemic has presented an acute case and also tested and assesses the national capacity of health systems toward withstanding health shocks while maintaining routine functions in many ways [8, 9, 10]. Hence routine reopening of service/activities toward approaching normalcy could continue for months or else years, but some positive results have been emerged and achieved in its wake. At the same time, global effort is being made to develop relevant international technologies, resources as well as available information that would create and accelerate data-driven results for all facets of this coronavirus pandemic. The coronavirus crisis is a global changing phenomenon and has become a top priority for our healthcare system, halting patient care processes which ranges from disrupting childhood vaccination as well as campaigns on polio eradication [11], maternal and child mortality are projected toward rising sharply, and health of young people to injuries, non-communicable diseases, as well as universal health coverage, despite unleashing enormous social, economic and health crises that threaten the world with antimicrobial resistance which threatens our ability to treat common infections, disrupting many research activities as well as overwhelmingly impacting medical education in various research activities. The coronavirus pandemic is not the first and foremost serious health challenge facing the world, nevertheless its long-term achievement will largely depend on rapid data synthesizing and information, appropriately and responsibly into comprehensive public and environmental health policies both national and international.
In the face of great uncertainty around Covid-19 pandemic future, epidemiologic models become an important planning tools for decision makers, clinicians as well as public health practitioners [2, 3, 1]. COVID-19 has made visible major global weaknesses, vulnerabilities and highlighted the necessity for health reforms towards promoting global access toward affordable care. At the same time, countries are examining their different policies towards protecting people at increased severe risk of disease. It may be the policies intended at preventing transmission in the general population, immunization (as the Oxford AstraZeneca vaccine and Pfizer BioNTech COVID vaccine has turn out to be available) because the world has received the Oxford AstraZeneca vaccine and Pfizer BioNTech COVID vaccine and has been roll-out to millions of people in the United States of America (USA), India, United Kingdom (UK), Ghana, Cote d’ivoire and Nigeria, also its distribution and immunization has commenced without political, religious or ethnic affiliation. Up until now, the seemingly bulletproof important priority is to rebuild and reenergize the country towards acting rather than reacting. As uncertainty around the peril of COVID-19 calamity grows continuously and geometrically, long-term protection policies need to be developed such as specific public safety measures towards protecting vulnerable populations at increased risk through reducing contacts between individuals in danger, etc. Recognizing that promoting sustainable development is risky, difficult and exhausting, particularly as the spread of SARS-CoV-2 pandemic increased geometrically, as those living in poverty which is leading to growing anger and frustration are currently at increased peril of setbacks with more than thirteen (13) million children out of school [1, 3, 8, 9, 12]. This stresses the importance of linking the results of environmental research with human health has mentioned. This necessitates understanding of the significance of interventions towards addressing system inequalities, universal health care as well as coverage issues, and wide-ranging public protection schemes as being part of response.
Now is the time toward realizing that we are not at equal peril of severe COVID-19 consequences and that there is need to work with stakeholders and development partners towards developing and improving effective response as well as solutions [13, 14, 15, 16, 17, 18, 3]. This paper offers research evidence to inform decision makers about people that could remain at increased peril or severe high risk of COVID-19 pandemic in diverse countries. Hence, scientific research evidence is required to investigate the environmental as well as public health practices in the coronavirus diseases era, which ought to place emphasis on diverse policies guidelines towards preventing those that are vulnerable and at increased risk. It is imperative toward comparing those individuals at high peril of severe COVID-19 pandemic toward helping nations to design as well as develop improved interventions measures toward protecting vulnerable populations as well as reducing straining on health complications as well as health systems [3, 18, 9, 2, 1]. These evidences can offer as well as advise a wide-ranging health assessment, social, as well as economic significances of protecting diverse groups [15, 16, 17, 19, 20, 8, 21], highlighting the prerequisite toward developing and providing a long-term Covid-19 management policy as well as given the unprecedented scale of policy-makers’, scientific evidence require large-scale partnership as well as collective learning in the scientific evidence synthesis community. Henceforth, outcomes improvement across countries can be attained through successful high-quality evidence certification that is properly implemented. To accomplish this, national systems, policies as well as political milieus require to be hospitable toward evidence informed methods, besides there is prerequisite toward fostering partnership, facilitate negotiation, promote as well as advance scientific evidence-informed decision-making (SEIDM) in Sub-Saharan Africa as well as the world at large toward achieving effective greater performance and worldwide sustainable implementation.
Since the 2019 coronavirus disease (COVID-19) has triggered seismic economic and societal changes which grapple with an uncertain future, that has consumed and changed our lives, the COVID-19 global crisis also revealed that the country is deteriorating in terms of environmental/public health readiness. As COVID-19 has become an imminent emerging, rapidly evolving situation of environmental/public health concern with ‘threat multiplier to health in the 21st century [10, 22, 23]. As confusion, disorientation, agitation and even psychosis have been associated with symptoms of COVID-19. The body of research is making the link among infection as a result of virus and neurological symptoms. The number of publicly reported deaths rate of the population due to the coronavirus disease 2019 (COVID-19) may underestimate the pandemic’s death toll. These estimates are based on provisional data that are often incomplete and may rule out unreported deaths from COVID-19. In addition, the restrictions imposed by the pandemic (for example, stay-at-home orders, school closures, quarantine measures, personal hygiene, physical distancing measures used to contain the spread of the virus) may possibly claim lives indirectly through delayed care for acute emergencies, exacerbations of chronic diseases, and psychological distress (for instance, drug overdoses). As a result, the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic continues to rise, both due to morbidity and mortality from the pandemic itself and the impact of mitigation strategies [2, 3, 8, 9, 24]. Tailoring policies based on emerging evidence on the conditions associated with the severity of COVID-19 is essential to informing the actions of both decision-makers and individuals. This means moving from generalized population-based mitigation strategies to focusing on people exposed to the risk of severe outcomes from COVID-19 [15, 16, 17, 19, 20, 21].
Too often, Jenicek [25] has repeatedly described evidence-based public health (EBPH) as “the conscientious, explicit, as well as judicious usage of available evidence in decisions making process towards communities care as well as populations in the realm of health maintenance and protection, disease prevention and development (health promotion).” Similarly, a concise definition emerged from Kohatsu [26]: “Evidence-based public health is the process of integrating science-based interventions with community preferences to improve populations health”. While, public health has succeeded in solving numerous problems, but almost all successes have a double-edged sword. Programs as well as policies have remained enacted as well as, in most cases, results that are positive which shows an increase in the improvement number of population health. However, some people suffer from health disparities as well as social inequalities. This raises such questions like, is there a way to approach the lessons learned directly from successful interventions as well as applies them toward other topics and situations? Are we using evidence that is based on scientific research/evidence? How can we greatly foster political will towards supporting evidence-based policy making? How do we promote and influence incentives so that practitioners can make effective evidence usage? Just as evidence-based public health has become a topic of conversation for both practitioners and policymakers, it is so fundamental to our notion of justice, it is equally important for environmental/public health. Therefore, it should inform all of our decisions on how the intervention will be implemented, and in what populations, when and how to assess both the positive and sometimes negative impact of those interventions. Our commitment to justice also bears the responsibility of finding effective ways to reduce health disparities between groups existing in virtually all geopolitical units. For environmental and public health professionals, evidence is a type of data that includes epidemiologic (quantitative) data, program results or policy evaluations, and the qualitative data to be used in establishing judgments or decisions [2, 3, 27, 28] (see Fig. 1 below). Indeed, Brownson and colleagues identify a six-stage procedure through which practitioners are able to take a more evidence-based approach toward decision making, with the community members perspectives, fostering a more population-centered method, which appears to be a consensus that a combination of scientific evidence, as well as values, resources, and contexts, should enter into decision making. Hence, “Evidence-based public/environmental health is the process of integrating science-based interventions with community preferences toward improving populations health” or it involves “the available body of facts or information indicating whether a belief or proposition is true or valid.” [2, 29].
Environmental/Public health evidence is often the result of a complex concepts of observation, theory, and experiment [3, 30]. However, the value of evidence remains in the eye of the beholder (e.g., the value of evidence may differ from a stakeholder type) [2, 3, 31]. Medical evidence includes not only research, but also patient characteristics, patient’s readiness to undergo a therapy, and society’s values [32]. Decision-makers seek distributional consequences (i.e., who pays, how much and who benefits) [33, 34], and in practice, settings anecdotes sometimes provide detailed empirical data [2, 3, 35]. The evidence is typically imperfect and, as Muir Gray note [36], “The absence of excellent evidence does not make evidence-based decision making impossible; what is needed is the best available evidence, not the best evidence possible.”
Most authors describe different types of scientific evidence for public health practice [37, 38] (see Table 1 below). Type 1 evidence identifies the causes of the diseases as well as the magnitude, severity, and preventability of risk factors associated with the diseases. They suggest that a specific disease or risk factor needs to be done. Type 2 evidence describes the relative effects of a particular interventions that cause or do not advance health, adding, “In particular, this must be done” [38]. It has been observed that adherence to regulatory guidelines of study designs can strengthen an “inverse (see Fig. 1 above) evidence law” through which interventions most likely to influence the public (e.g., policy change) are least valued in an evidence matrix emphasizing randomized designs [28, 39, 40, 41, 42, 43, 44]. A recent study showed a lack of research intervention (Type 2) compared to descriptive/epidemiologic research (Type 1). In a randomized controlled trial of tobacco use, alcohol use [45, 46, 47], and inadequate physical activity, the team found that in 2005–2006, 14.9 % of subjects reported an intervention, while, 78.5% of articles reported were descriptive or epidemiologic research. There is probable to be even less research published on Type 3 evidence showing how and under what contextual conditions interventions were implemented as well as how they were received, thus informing “how it should be done” [37]. So far, research has focused on internal validity (e.g., well-controlled efficacy trials) while giving sparse attention toward external validity (e.g., adaptation of scientific knowledge to a different context) [2, 3, 48, 49].