Will Spain end obligatory masks? Experts begin debate

MASKS will cease to be mandatory in health centres, pharmacies and hospitals after more than three years of being a legal requirement in Spain – although health minister José Miñones has not committed himself to a date as yet.

It was widely reported during the last week in June that the obligation to wear surgical or FFP2 masks in all settings linked to human health had been abolished, but Miñones stressed this was not the case – he intended to lift the rule, but had not yet done so.

Even once they cease to be obligatory, masks will continue to be 'strongly recommended' in health centres of all descriptions, hospitals, pharmacies, care homes, and similar, with Spain's government expected to appeal to 'personal responsibility'.

This means anyone who has symptoms compatible with Covid, or who has tested positive, should continue to wear them.

Despite the overwhelming take-up of Spain's Covid vaccine roll-out – more than 90% of the population aged five and over have had at least a first dose and the majority of these have had all doses offered to them – Covid can still cause extremely unpleasant and even dangerous side effects for the most vulnerable members of the population.

To this end, although most cases of Covid are mild and do not require hospital treatment, an infected person should take all possible precautions to avoid passing it to anyone else.

Always obligatory in oncology, intensive care and operating theatres

Minister Miñones has stressed, however, that even after the mask requirement is dropped for hospitals, health centres and pharmacies in general, these will remain obligatory in certain high-risk situations.

They must be worn by all patients and visitors in oncology departments, due to the likelihood of persons receiving cancer treatment being immune-compromised.

Masks will still be required in operating theatres and intensive care units, although this was already the case before the pandemic – visitors to the ICU would be required to wear surgical gowns, gloves, caps and socks.

Patients and visitors in accident and emergency (A&E) departments would be strongly urged to wear them even when they no longer have to.

Head of animal health at the national veterinary college, Juan José Badiola, has already publicly stated his 'reservations' over ending mask use in high-risk settings.

“Keep your masks for the future. I don't think I need to tell you why,” he warned.

Although he can 'understand' why masks might not be deemed necessary in pharmacies, Badiola believes they should continue to be mandatory in certain healthcare environments 'like in A&E, where you can be confined in an enclosed space with other people for four or five hours', or as a visitor to hospital patients 'where you might infect someone who is already ill'.

'Recommended' in winter to prevent colds and 'flu

Madrid Medical College Illustrious Scientific Committee (ICOMEM) is calling for masks to be compulsory in pharmacies and healthcare environments across the board between December and February inclusive at least, as a way of preventing transmission of all types of respiratory conditions such as the common cold and 'flu.

Anyone aged 65 or over, public-sector workers with high exposure to the general population – such as school teachers and emergency services – pregnant women, and people of any age with certain health conditions are eligible for a free 'flu vaccine in Spain, but those who do not take up the offer or who are not given a jab automatically make up a high percentage of A&E patients in late autumn and winter.

People who do not qualify for a 'flu vaccine free of charge via the national health system can buy one from a pharmacy, where the cost is in region of €20, from around October to February.

Stringent mask rules kept Spain's Covid rates down

As at the beginning of July 2023, mask-wearing in Spain has been compulsory in some or all situations for over 1,140 days – approximately three years and two months.

Given that they were difficult to find at the start of the pandemic, masks were not initially obligatory, but from June 2020, anyone who stepped outside their home – even into empty communal areas – was required to wear one, on pain of fines starting at €100.

This meant residents having to put a mask on just to take the rubbish out at night, when the streets were empty, or even going for walks in open countryside where there were no other humans within a radius of several kilometres.

Masks were generally only compulsory on beaches when walking along the shore – normally within a designated strip – but not for sunbathing or swimming; otherwise, the only time a person could go mask-free outside their private home was during the actual act of eating or drinking in a bar or restaurant.

Other than children under six, nobody was exempt; in the very rare cases where a medical condition meant mask-wearing was harmful, the person in question would normally be expected to stay at home or, at least, to show a doctor's note confirming this was the case.

These extreme restrictions did not meet with much opposition in public – residents in Spain quickly became used to them, shops did not allow entry to anyone not wearing a mask, and those who absent-mindedly went out without one would face mass disapproval from the rest of society.

The result was that, by summer 2020, Covid rates in most of Spain were merely anecdotal, and the spike seen with the onset of winter was still considerably lower than in many other countries with more relaxed mask-wearing requirements.