When will face masks be scrapped in hospitals and pharmacies in Spain?

People in Spain, and the Canary Islands, have taken mask-wearing quite seriously during the Covid-19 pandemic, but face coverings haven't been compulsory in most indoor public settings since April 20th 2022, just over a year ago, and mandatory use on public transport, at opticians and in hearing centres also ended in February this year.

However, wearing a mask is still obligatory in medical settings, specifically in hospitals, other health-related centres and pharmacies. This is the last Covid measure still in place in Spain more than three years since the pandemic began.

Admittedly, while mask-wearing in hospital settings is still strictly enforced, in many pharmacies around Spain this rule has become a little more lax. But how much longer will this Covid rule continue?

Ministry of Health:
The government are remaining tightlipped about when this last measure will be dropped. When asked by El Mundo newspaper how long masks will be mandatory in medical centres, the Ministry of Health gave a vague non-committal response: "In Spain, the position is that we should try to use masks in healthcare centres and services as a general rule, regardless of whether there is Covid or not, and from their exceptions can be made or particular situations can be assessed."

According to the official government BOE that eliminated masks on public transport (as well as opticians) in February, the justification for keeping them in medical settings was: "The mandatory use of masks is maintained in healthcare centres and services, and pharmacies, since these are areas where there may be a greater concentration of vulnerable people and where the risk of serious illness is greater and, what is more, where the probability of transmission is higher since they are places where there may be a greater number of people with transmissible respiratory infections, in addition to the COVID-19."

Expert opinion:
Many medical experts are now calling for the lifting of this last measure and a return to pre-pandemic normality.

The Spanish Society of Immunology certainly believes so. "We have been wearing masks when there has been a lot of circulation of viruses, and now that it has stopped circulating, I think the removal of the masks could be considered," said the society's president, Marcos López Hoyos, in an interview with Spanish news outlet Antena3.

Hoyos pointed to the fact that society now has vaccine immunity and medicines that we did not have at the beginning of the pandemic. That said, he also insisted that we must "be aware that at a given moment you can go back, at a time of an important resurgence."

The Spanish Society of Immunology now believes that Covid-19 should be managed like any other respiratory virus "because the health situation is no longer an emergency," and recommends that mask use goes back to the pre-pandemic norm, that is, wearing them only in very specific situations.

"Everyone puts on a mask when they enter an ICU, or when they enter a premature unit, or when they are in an operating room, or in a surgical area," virologist Raúl Ortiz de Lejarazu explained.

"Masks have played an important role when the incidence of the virus was very high; but when it is very low, the use of masks has practically no importance because it is something that is not worn continuously and throughout the day we will have the opportunity, at home or elsewhere, to get infected," he added.

However, the experts are not in complete consensus, and some suggest caution and waiting for direction from global bodies before removing medical mask mandates altogether. Amós García, an epidemiologist and member of the Permanent Group for Europe of the World Health Organization (WHO), said that "it would be appropriate to be cautious and wait for the WHO to rule on the matter."

Óscar Zurriaga, president of the Spanish Society of Epidemiology (SEE), has defended maintaining the mask measures on the grounds of protecting vulnerable patients: "Regardless of Covid, the maintenance of masks is an additional measure against this virus and other respiratory viruses, which means that for vulnerable people this measure can be favourable, especially considering that it is an area in which people with all kinds of vulnerability go and in which different pathogens flourish."

Spain was the last country in the EU to lift the indoor mask requirement, and in some European countries, most recently Portugal, masks have also been dropped in health centres.

According to recent figures from the Ministry of Health, the percentage of ICU beds in Spain occupied by patients with Covid-19 is less than 2% (1.31%) and general hospital beds 1.73%. The cumulative incidence for the last 14 days in people over 60 years of age was 70.45 per 100,000 inhabitants.