CPQ Medicine (2020) 11:1
Editorial

The Toughest Triage in Decision Impacts: Rethinking Scientific Evidence for Environmental and Human Health Action in the Times of Concomitant Global Crises

Raimi Morufu Olalekan^1* & Raimi Aziba-anyam Gift²

¹Department of Community Medicine, Environmental Health Unit, Faculty of Clinical Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria
²Entrepreneurship Development Centre, Federal University Otuoke, Nigeria

*Correspondence to: Dr. Raimi Morufu Olalekan, Department of Community Medicine, Environmental Health Unit, Faculty of Clinical Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.

Copyright © 2020 Raimi Morufu Olalekan & Raimi Aziba-anyam Gift. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 09 December 2020
Published: 28 December 2020

Keywords: Political Environments; Decision Impacts; Effective Response; Evidence Informed Approaches; SARS-CoV-2 Pandemic; Sustainable Development Goals; Implementation Science; Large-Scale Collaboration; Global Crises

Comment
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 [1,2]. 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 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 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 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 and COVID-19 has also tested and assesses the national capacity of health systems toward withstanding health shocks while maintaining routine functions in many ways [3]. 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 [4], 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 [5]. 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 Pfizer BioNTech COVID vaccine has turn out to be available) because the world has received the COVID-19 Pfizer BioNTech COVID vaccine and has been roll-out to thousands of people in the United States of America (USA) and United Kingdom (UK), also its distribution and immunization has commenced. While Nigerians still enthusiastically anticipates an effective COVID-19 vaccine that will be easily distributed without political, religious or ethnic affiliation. Up until then, most 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 10 million children out of school [3,6,7]. 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 as solutions [8-13]. 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 [3,5,12]. These evidences can offer as well as advise a wide-ranging health assessment, social, as well as economic significances of protecting diverse groups [6,10,13,14], 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 joint 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.

As the Chinese proverb used to say “Problems give opportunity and changes, and the gods cannot help those who do not take advantage of this opportunity”. Out of a disaster provide opportunities toward building a safer, healthier, as well as a more just world. In all these domains, addressing health toughest triage will be crucial and will help strengthen and maintain the scientific integrity as well as political neutrality of environmental and human health action in the times of concomitant global crises. Of course, this is not only a response toward COVID-19, but also for the full gamut of health challenges. Time has come toward revitalizing and rethinking governance, policies, as well as investments in scientific research for better health, which precede a more sustainable future for global as well as national health leadership in preparedness, response, and health recovery for emergencies, which will necessitate a range of research methods and analytic decisions. Increased focused attention toward these approaches and analytic decisions has the potential toward increasing the importance of policies and its uses towards health systems strengthening, hence potentially assisting policy makers towards improving mitigation efficiency while concurrently improving global and national health, with an attempt toward drawing remarkable lessons for strengthening pandemic preparedness as well as response. While the response to COVID-19 is constantly evolving and the situation is constantly changing, how a country respond to an outbreak depends on the resilient of its health systems, effective response is needed to fight the immediate outbreak and reduce its downstream impact on health. In general, environmental and public health research analyses as well as comprehensive health systems in all countries which may include integrated core capacities for environmental/public health at all governance levels, will be the best protection/defense against other major great pandemic outbreak. Therefore, effective national planning/preparedness necessitates clearly understanding states situation’ ability toward predicting, managing and balancing public/environmental health needs at all stages of the pandemic. This requires leveraging data for rapid, accurate and responsibly impacting on sound public/environmental health policies.

Acknowledgements
I thank all anonymous reviewers, for feedback and discussions that helped to substantially improve this manuscript.

Authors’ Contributions
All authors included in the manuscript provided substantial contribution to (i) conception and design, (ii) drafting the article or revising it critically for important intellectual content and (iii) final approval of the completed manuscript.

Funding
This article receives no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Declaration of Competing Interest
Both authors declare that they have no competing interests.

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