A man siting in a wheelchair wears a protective face mask at the Malvarrosa Health Centre, as health authorities in the province made the use of face masks compulsory in health centres due to the high number of patients with respiratory diseases, in Valencia, Spain, on January 5, 2024. Image Credit: REUTERS

MADRID: Wearing masks will be obligatory again in Spain’s hospitals and other healthcare facilities from Wednesday, and Italy said respiratory illness infection rates had hit a record, as flu and COVID spread across Europe.

The decree was announced after a meeting between the health ministry and representatives of the country’s regions, who control their own health systems.

The European Centre for Disease Prevention and Control recommended that people on the continent stay home if they feel sick, and consider wearing masks in crowds or healthcare settings, with flu spreading as it typically does this time of year but hitting some countries harder than others.

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It said Europeans should follow national guidelines on vaccinating vulnerable groups. Flu is now circulating at higher levels than other common respiratory pathogens, including the Sars-CoV-2 virus that causes COVID-19, it said.

Spain, which was hit hard by the first wave of COVID-19 in 2020, has been considering the move for several days but a final decision was held up by disagreements among its regions.

“Since the pandemic, we have learnt,” said Spanish Health Minister Monica Garcia after the meeting.

“We have thought hard about the issue of the mask to protect above all health centres and hospitals, to protect patients as much as (healthcare) professionals.”

The wearing of masks is “a measure that is effective, common sense, that is backed by scientific evidence and that is welcomed by the general population”, she added.

Garcia had already on Friday expressed her support for a return to obligatory masks in healthcare facilities in a post on X, formerly Twitter.

The eastern regions of Valencia and Catalonia had also said on Friday that they would require masks for healthcare workers and patients.

For days, doctors in Spain have been raising the alarm about rising cases of the flu, as well as COVID and other respiratory viruses.

Mask mandates were well respected in Spain during the pandemic, where lockdowns were among the strictest in the world.

Masks were required until July 2023 in places likely to welcome at-risk populations, such as hospitals, retirement homes and pharmacies.

The coming mandate will not apply to pharmacies, the ministry said.


In Italy, people suffering from flu-like illnesses, which include both flu and COVID-19, reached a record high in the last two weeks of 2023, superseding even the COVID epidemic, according to data issued by the issued by National Health Institute (ISS).

The incidence in Italy was 17.5 cases per thousand people in the 52nd week and 17.7 cases per thousand people in the previous week.

ISS experts said the rise could be blamed on the fact that most people were no longer wearing masks and that fewer people had sought vaccinations so far this season. So far there has been no sign that the Italian government is considering re-introducing mask mandates.

Portuguese Health Minister Manuel Pizarro said on Monday there’s currently no reason for a generalised recommendation regarding mask use while acknowledging the country was experiencing a flu epidemic that had increased waiting times in hospital emergency wards to more than 10 hours in recent weeks.

In intensive care units, the proportion of influenza cases reached a record 17% in the last week of 2023, according to the health authority.

Countries in other parts of the world were also adopting mask usage once more. Hospitals in at least four U.S. states have reinstated mask mandates amid a rise in cases of COVID, seasonal flu and other respiratory illness.