Spain’s government is considering reintroducing a nationwide measure of mandatory use of protective masks in hospitals and other health facilities, while in Italy cases of respiratory infections are hitting records as flu and Covid-19 cases spread across Europe.

The European Center for Disease Prevention and Control (ECDC) recommends to Europeans to stay at home if they feel sick and to seriously consider wearing a mask in crowded places or healthcare facilities. It also advises citizens to follow national guidelines for the vaccination of vulnerable groups of the population, underlining that cases of influenza spread faster than those of other respiratory infections, including SARS-CoV-2 which causes the disease Covid-19.

Some regions in Spain have already made it mandatory for doctors, nurses, patients and hospital visitors to wear masks. The government is considering imposing the measure nationally, which is rejected by several regional health authorities, with a final decision expected on Wednesday.

“Something we know will limit epidemics and protect vulnerable people is the mask,” Spain’s Health Minister Monica García told state television (TVE). “It is a measure dictated by common sense, it is scientifically documented and widely accepted by the public,” he added. The Spanish health minister also said that the possibility of allowing workers who are ill – even slightly – to be absent from work for a period of 3 days without requiring a medical opinion is being considered.

Spain was one of the last countries in Europe who abolished the mandatory use of masks as part of the measures against the Covid-19 pandemic. The use of masks in public transport was mandatory until February 2023, while in health facilities and pharmacies it was mandatory until July.

In Italy, cases of respiratory infections, including influenza and Covid-19, reached a record level in the last fortnight of 2023, surpassing even corresponding periods during the pandemic, according to data from the Supreme Institute of Health (ISS). They averaged 17.5 cases per 1,000 residents in the 52nd week of the year, compared to 17.7 per 1,000 residents a week earlier.

Experts from the ISS (Istituto Superiore di Sanità) estimate that the increase is likely due to the fact that most citizens no longer wear protective masks and that the vaccination rate remains low this winter. Currently, the Italian government is not considering reintroducing the mandatory mask measure.

In Portugal, Health Minister Manuel Pizarro said today that there was no reason to issue a directive on mask use, although he admitted that the flu outbreak had caused a significant increase in hospital emergency room waiting times in recent weeks. In intensive care units (ICUs), the percentage of seasonal flu cases reached 17% in the last week of 2023, according to the Portuguese Ministry of Health.