key: cord-0988411-aj299wqp authors: Lagman, James Darwin N; Vergara, Raymond John D; Sarmiento, Philip Joseph D title: Distressing healthcare workers during the COVID-19 pandemic: the challenges of holiday season in the Philippines date: 2021-01-27 journal: J Public Health (Oxf) DOI: 10.1093/pubmed/fdab003 sha: 32fec7cc57990d0d08df76a54d4efe67e1bd3b49 doc_id: 988411 cord_uid: aj299wqp The holiday season, Christmas to New Year, is the most festive period of each year in the Philippines. However, the beginning of the festive holiday season in the Philippines seems to be a predicament to healthcare workers and professionals especially during this coronavirus disease 2019 (COVID-19) pandemic. The holiday season is considered a health risk in the Philippines because of the change of lifestyle leading to the increased number of health consultancies and hospitalization. Thus, the expected surge of people in the hospitals and clinics pose an added stress to healthcare workers and professionals. Pre-Holiday policies and programs are therefore essentials especially during the course of battling COVID-19. In recent correspondence, several researches raise the concern for healthcare workers and professionals. Some pointed out the need for prioritization of healthcare workers in this time of coronavirus disease 2019 (COVID-19) as 'they are our only lifeline'. 1 Studies have shown the psychological burden that is being experienced by healthcare workers and professionals. 2 Thus, healthcare workers and professionals are considered wounded healers as they also in need of physical and spiritual care at this time. 3 However, there seems to be another predicament and stress for the healthcare worker and professionals as the holiday season starts and be celebrated by the people. The holiday season, Christmas to New Year, is the most festive period of each year. For instance, in the Philippines, the holiday season is celebrated from September to December. Filipinos, during the said period turn to be spendthrifts, basically splurging their Christmas remuneration in merrymaking, holding endless parties such as reunions, indulging in food and firing up of pyrotechnic materials. 4 The Holiday Season in the Philippines, however, is also described as a health risk period. Due to the excessive indulgence in extravagant and fatty foods and alcoholic drinks, 4 the rate of diseases such as cardiovascular ailments, diabetes, liver problems exponentially spikes up. Hence, medical experts expect an increase in medical consultations and hospitalizations during the holiday season. Consequently, this season is also called 'holiday heart syndrome' as a cardiac mortality rate is higher than other times of the year. 5 Studies have also shown due to the change of lifestyle in this season, mortality and hospitalization could be correlated. 6 Other research findings suggest that there seems to be sufficient evidence to establish that the Christmas to New Year holiday season is a health risk factor for both cardiac and non-cardiac mortality. 5 Further, the number of injuries caused by fireworks and firecrackers during the New Year's Eve celebration, a common scenario in the Philippines, adds to the number of patients in the hospitals. 7 However, with the expected number of surging of patients this holiday season, there will certainly be a bigger problem on health care services. While hospital space and health care providers are limited due to the excessive number of COVID-19 patients being attended to, the number of holiday season-related ailments will contribute to the stress problems of health care providers. 8 Hence, it would constitute again the burden and stressing of the healthcare workers and professionals working as 'frontliners'. Distressing healthcare workers mean proper regulation of patient-attending health care worker ratio and enough time for rest and recreation for healthcare workers and professionals. However, with the celebration of the holiday season, there will be an increase in the number of patients. The Government seems not to be prepared for the scenario. Consequently, while some local government issued reminders and protocols against the COVID-19 during the holiday season, it seems that they failed to touch on the issues of excessive indulgence on food and alcohol and curtailing or total ban of pyrotechnic materials. Hence, there is a need for a response from the governments to add a more stringent and effective policy that would cater to distressing the healthcare workers and professionals in time for the holiday season. The World Health Organization calls for a safe and healthy working environment for healthcare workers and professionals. 9 Thus, this paper eagerly suggests totally implementing Republic Act 7305 or the 'Magna Carta of Public Health Workers' in the Philippines. 10, 11 Thus, this paper suggests highlighting the sections regarding no understaffing/overloading of health staff, no overtime work and additional compensation to health staff. 10 The expected combined action of the government and the public to follow health instructions and to stay at home can reduce the disease spread and the workload of health workers and professionals and improve their mental health and distress them. 12 Further, a specific Pre-holiday season policy or program that caters the physical, 9 mental 2 and spiritual 3 needs of the healthcare workers and professionals in the Philippines is suggested. All authors contributed to all aspects of the manuscript. COVID-19: prioritizing healthcare workers Psychological burden of healthcare professionals in Germany during the acute phase of the COVID-19 pandemic: differences and similarities in the international context Effect of new year holidays on hospital mortality: a time series study Fireworks-related injury surveillance in the Philippines: trends in 2010-2014 Unprecedented Financial Pressures Due to COVID-19 WHO calls for healthy, safe and decent working conditions for all health workers, amidst COVID-19 pandemic Republic Act 7305: Magna Carta of Public Health Workers 6cdc3575f24f_PSI-Ph-Health-Sector-Affiliates-Joint-Statement-on-Frontliners-Call-for-Time-out Exploring nurses' experiences of psychological distress during care of patients with COVID-19: a qualitative study No funding was received from this paper. The authors declare no conflict of interest in this paper.