**1. Introduction**

For each complicated challenges, there are simple, neat, as well as discreet solutions. It is therefore regularly obligatory toward making a decision on sufficient evidence for action, but then deficient toward satisfying the intellect. In this COVID-19 pandemic era where the public and the mass media attention are 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 eighteen months ago, the flu-like news of a deadly virus affecting central China region started making headlines around the world. It was the start of what become a worldwide news and press conference; one that will constitute an exceptional problem 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 peril is not only in the form of a deadly virus". While the COVID-19 pandemic is likewise being used through maligning forces as an opportunity toward disrupting unforeseen as well as 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 offer valid reason toward ushering in a series of reporting limitations on a descending severity scale from limiting data access, right through toward corrective legislation and even life threatening [1–3]. Additionally, the persistent disinformation onslaught as well as misinformation piercing platforms like the social media has formed a physical 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 increasing apprehensions around the degree toward which their mutations are likely to aid them in evading present antibody treatments as well as extremely active 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. In fact**,** the COVID-19 vaccine

*'Silent Pandemic': Evidence-Based Environmental and Public Health Practices to Respond… DOI: http://dx.doi.org/10.5772/intechopen.100204*

might offer the necessary protection against some of these novel variants, current outcomes have recommended that the AstraZeneca vaccine might not offer much needed defense against that of South African variant, while there's still sufficient defense in most other existing vaccines toward preventing hospitalization, serious illness, as well as death. At the moment, the public health emergence of this novel variants ought to inspire us all toward taking steps to reduce SARS-CoV-2 spread. Meaning the three W's must be strictly followed: Wash your hands, watch your distance, wear a mask regularly. This likewise means we have to wrap up our sleeves toward getting vaccinated once 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 [4–6]. 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 outbreak of COVID-19 triggered severe acute respiratory syndrome of coronavirus 2 (SARSCoV-2) and 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].

### **2. How SARS-CoV-2 infects cells**

To better understand SARS-life CoV-2's cycle and how it evades detection, as well as what makes the Delta variant so hazardous, scientists are working to unravel the virus's life cycle (**Figure 1**). Researchers have identified crucial modifications that enable viruses infect and hide inside of human cells with remarkable force. SARS-CoV-2 then performs a key processing phase as it exits the cells, preparing its particles to infect even more human cells.

Accordingly, 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 [9–11]. 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 [12], maternal and child mortality are projected toward rising sharply, and health of young people

**Figure 1.**

*Life cycle of the pandemic coronavirus: a simplified account of how SARS-CoV-2 enters and exists cells. Source: Adapted from [8].*

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 [1–3]. COVID-19 has made visible major global weaknesses, vulnerabilities and highlighted the necessity for health reforms toward promoting global access toward affordable care. At the same time, countries are examining their different policies toward 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

#### *'Silent Pandemic': Evidence-Based Environmental and Public Health Practices to Respond… DOI: http://dx.doi.org/10.5772/intechopen.100204*

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 toward 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 toward 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, 9, 10, 13]. This stresses the importance of linking the results of environmental research with human health has mentioned. This necessitates understanding of the significance of interventions toward 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 toward developing and improving effective response as well as solutions [3, 14–19]. 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 toward 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 [1–3, 10, 19]. These evidences can offer as well as advise a wide-ranging health assessment, social, as well as economic significances of protecting diverse groups [9, 16–18, 20–22], 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 [11, 23, 24]. 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 2019 coronavirus disease (COVID-19) might underrate the death toll from the pandemics. These estimates are based on provisional data that are frequently incomplete as well as might rule out unreported COVID-19 deaths. In addition, the pandemic restrictions imposed (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 and indirectly claim lives through delayed care for acute emergencies, exacerbations of chronic diseases, as well as psychological distress (for instance, drug overdoses). As a result, the severe burden of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic remains to rise, both due to morbidity as well as pandemic mortality along with the impact of mitigation strategies [2, 3, 9, 10, 25]. Tailoring policies based on emerging evidence on the conditions associated with the severity of COVID-19 is essential toward actions informing of both decision-makers as well as individuals. Meaning moving from generalized population-based mitigation strategies toward focusing on people exposed to the risk of severe COVID-19 outcomes [16–18, 20–22].

Too often, Jenicek [26] has repeatedly described evidence-based environmental/ public health (EBEPH) 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 succinct definition arisen from Kohatsu [27]: "Evidence-based public health is the process of integrating sciencebased 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 toward supporting evidence-based policy making? How do we promote and influence inducements so that practitioners can make effective evidence usage? Just as evidence-based environmental/public health has turn out to be a topic of conversation for both practitioners and policymakers, it is so fundamental toward people concept of justice, it is likewise important for environmental/public health. Therefore, it ought to notify our decisions on how the intervention will be implemented, and in what populations, when as well as how to assess both the negative and occasionally positive impact of such interventions. Justice commitment also bears the obligation of finding effective approaches toward reducing disparities in health between groups existing in practically entirely geopolitical units. For environmental and public health professionals, evidence is a type of data that includes (quantitative) epidemiologic data, program policy evaluations or outcomes**,** as well as the qualitative data to be used in establishing decisions or judgments [2, 3, 28, 29] (see **Figure 2**). Indeed, Brownson and colleagues identify a (6) six-stage procedure through which environmental and public health practitioners remain able toward taken an approach that is evidence-based toward policy making, with the community members perspectives, fostering an added population-centered method, which seems toward a combination of consensus that are of scientific evidence, along with resources, values, as well as contexts, ought to cross the threshold of policy making. Hence, "Evidence-based public/environmental health is the process of integrating science-based interventions with community preferences

*'Silent Pandemic': Evidence-Based Environmental and Public Health Practices to Respond… DOI: http://dx.doi.org/10.5772/intechopen.100204*

#### **Figure 2.**

*Different forms of evidence. Source: Adapted from chambers and Kerner [28] and Raimi et al., [2].*

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, 30].

Evidence in public and environmental health is often the outcome of a complicated concepts of theory, observation, as well as experiment [3, 31]. The evidence value, on the other hand, remains in the beholder eyes (for example, the value of evidence might differ from a stakeholder type) [2, 3, 32]. Research not only encompasses medical evidence, then also patient characteristics, readiness of patients toward undergoing a therapy, as well as society's values [33]. Decision-makers pursue distributional penalties (i.e., who pays, how much as well as who profits) [34, 35], and practically, settings anecdotes and occasionally provide detailed experimental data [2, 3, 36]. The evidence is typically imperfect, as Gray Muir note [37], "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." Some authors describe diverse types of scientific evidence for public health practice [38, 39] (see **Table 1**). Evidence from Type 1 identifies the diseases causes as well as the degree, severity, as well as risk factors preventability associated with the diseases. They suggest that a specific disease or risk factor needs to be done. Evidence from Type 2 establishes the absolute effects of a particular actions that cause or do not advance health, with the caveat that, "In particular, this must be done" [39]. The situation has remained observed that strict adherence toward regulatory study designs guidelines can strengthen an "inverse (see **Figure 2**) evidence law" through which most probable toward influencing the public interventions (e.g., change in policy) remain least appreciated from an evidence matrix highlighting randomized designs [29, 40–45]. In comparison to descriptive/epidemiologic research (Type 1), a recent study showed a paucity of research intervention (Type 2). In a randomized controlled trial of cigarette use, alcohol consumption [46–48], as well as insufficient physical activity, the team discovered that in 2005–2006, 14.9 percent of subjects reported an intervention, while, 78.5 percent of research articles reported remained descriptive or epidemiologic. Less research is probable published on Type 3 evidence showing in what way as well as beneath what circumstantial interventions conditions remained implemented, as well as by what method they remained received, indicating "how it


community-wide

Comprehending the political problems of increase in price or aiming at media messages toward specific audience

segments

How can this intervention be implemented

Price upsurges from a targeted media campaign decrease the rates of smoking.

These specific priorities must be implemented.

community setting

4. Quantity More Less Less

lung cancer.

be done.

*Source: Adapted from Brownson et al., [39] and Raimi et al., [2].*

5. Action Something must

3. Example Smoking results in

#### **Table 1.**

*Comparison of the types of scientific evidence.*

should be done" [38]. So far, research has focused on internal validity (for examples, well-controlled trials efficacy) with external validity while receiving sparse consideration (e.g., adaptation of scientific knowledge to a different context) [2, 3, 49, 50].
