In this context, regional governments such as those of Extremadura, Aragon, the Valencian Community, and Andalusia have begun to update their guidelines on the Use of face masks in hospitals, health centers and nursing homesAlthough the general message points to a recommendation rather than an obligation, each territory is adjusting its criteria according to the level of circulation of respiratory viruses and the pressure on healthcare services.
A common and flexible stance: the state's vision and the case of Extremadura
During a recent session of the Interterritorial Council of the National Health SystemIn a meeting held remotely, the autonomous communities and the Ministry of Health analyzed the spread of respiratory viruses and the need for coordinated measures. Extremadura clearly emphasized the importance of maintaining a common strategy regarding the use of face masks throughout the country, but at the same time flexible enough to adapt to the contagion situation at any given time and in any territory.
The approach taken by the Extremadura community is based on the recommendation, not impositionAt this time, their approach involves advising the use of masks in healthcare settings and in situations of special vulnerability, especially when it comes to protecting people at risk, but without establishing a general obligation for the entire population.
The Extremadura Health Service also insists that the most effective measure to avoid serious complications remains the flu vaccination, especially in at-risk groups, such as pregnant women and breastfeeding mothersIn addition to this main tool, other recommendations that are already familiar include: frequent hand hygiene, ventilation of enclosed spaces, use of antivirals when indicated by a healthcare professional, and, if necessary, certain social isolation to prevent contagion to the most vulnerable.
The Ministry of Health and Social Services of Extremadura emphasizes that its decisions are based on the available scientific evidence and that it will maintain close coordination with the rest of the State to adapt the measures according to how the respiratory virus season evolves.
Aragon: maximum recommendation and margin for mandatory use
Aragon has positioned itself among the regions that have taken a further step in regulating Use of masks in healthcare and social care centers, motivated by a significant increase in the flu, especially in the province of Zaragoza, where the epidemic threshold has already been exceeded.
The Aragonese Government has established the highest recommendation Masks are required for professionals working in healthcare, social care, and specialized social services centers, whenever they perform activities involving direct care to the public. This measure is intended as a self-protection measure for staff and to prevent the spread of infection to patients and users.
The Official Gazette of Aragon has published an order that, in addition to this reinforced recommendation, authorizes school management to require masks as mandatory For professionals, this depends on their risk assessment, their specific action plans, or their contingency plans. In other words, it is not imposed uniformly by the regional government, but legal coverage is provided so that each center can take further steps if it deems it appropriate.
For all other workers in these centers, even those not directly serving the public, the use of masks has been declared highly recommendedThis recommendation also extends to patients, users, and the general public when accessing healthcare and social care facilities. The aim is to minimize the possibility of transmission in indoor spaces where vulnerable people congregate.
The order is already in effect in the province of Zaragoza and will be applied in Huesca and Teruel when the incidence rate exceeds the threshold of 59,67 cases per 100.000 inhabitants. As soon as the rate falls below the epidemic level again, the measure will be repealed, reinforcing this approach. dynamic adjustment based on the data.
Early flu season and staggered measures in Aragon
The flu outbreak in Aragon has arrived earlier than usual. According to Public Health data, the incidence has exceeded [the number of cases]. epidemiological threshold With just over 64 cases per 100.000 inhabitants in a week, and in the province of Zaragoza the figure rises above 76 cases per 100.000 inhabitants. This is a situation that, in previous years, was usually reached around the Christmas holidays or in the first month of the year.
Aragonese health authorities link this advance to several factors that explain Why do we catch colds?: a lower flu vaccination coverageThe low circulation of other respiratory viruses and the emergence of a new flu strain may have left part of the population with fewer defenses against the virus. This combination is generating a increase in cases and some saturation in hospital emergency services.
In this scenario, the Government of Aragon has activated risk level 2 in the province of Zaragoza, while maintaining level 1 in Huesca and Teruel. Level 2 entails the reinforced mask recommendation in health and social care centers, both for professionals who care for patients and for other workers, inpatients, companions and users who access these resources.
The regional regulations also stipulate that those in charge of the centers may impose the mandatory use of masks if the local situation requires it. Thus, a hospital, a health center, or a care home can decide, according to its own circumstances. contingency plans, tighten rules to prevent internal outbreaks and protect their most vulnerable residents or patients.
In addition to masks, the Aragonese Department of Health reminds us of other guidelines: proper hand hygiene and ventilation of indoor spacesAvoid crowds in enclosed spaces and limit contact with vulnerable people if you experience respiratory symptoms. Although the focus is on the flu, authorities emphasize that these measures also help reduce the transmission of other viruses.
Valencian Community: face masks recommended in vulnerable settings
In the Valencian Community, the Ministry of Health has sent all health departments an instruction from the General Directorate of Public Health that establishes specific recommendations on the use of face masks in public health facilities. Although the community is in a "low level" epidemic scenario, with approximately 788 cases of acute respiratory infections per 100.000 inhabitants, the document seeks to anticipate a possible resurgence.
The instruction considers it "appropriate" that people with respiratory symptoms use surgical masks in shared spacesespecially when visiting healthcare facilities. At the same time, masks are recommended for professionals attending to symptomatic patients, in order to reduce the chances of transmission in clinics, emergency rooms, and other healthcare areas.
Valencian regulations become even stricter in so-called vulnerable areas: intensive care units, chemotherapy treatment rooms, transplant units and other high-risk services, as well as hospital and primary care emergency departments. In these settings, both healthcare staff and patients and their companions are urged to wear masks to minimize the risk to immunocompromised individuals or those with serious illnesses.
The document opens the door for these measures to be extended to other areas where patients and their families congregate if the center's management so decides, depending on their risk assessment and its internal action planIn this way, a hospital can expand the areas where masks are advised or reinforced if it perceives an increase in transmission or a particular vulnerability among its users.
These actions are part of the Contingency Plan for increases in acute respiratory infections (ARI)This plan, distributed to all health departments of the Valencian Health System, defines different risk scenarios based on the transmissibility of the virus and the operational capacity of the centers, and establishes strategies to maintain healthcare activity during epidemic peaks.
Vaccination and other preventive measures in the Valencian Community
The Valencian Ministry of Health emphasizes that the flu and COVID-19 vaccination It remains the cornerstone of preventing serious complications and reducing hospitalizations. The campaign began focusing on high-risk groups and, starting in November, expanded to the general population, facilitating appointments through digital channels and extending opening hours at primary care centers.
To increase coverage, the department has deployed vaccination campaigns in residences, day centers, schools and special education centersand has begun sending SMS reminders to priority groups. All of this is intended to complement the mask recommendations in healthcare settings, with the aim of reducing the impact of respiratory viruses on the healthcare system.
The Valencian Contingency Plan also includes organizational and operational measures to guarantee the care continuity in primary care and hospitals. These measures include the reorganization of circuits to separate patients with respiratory symptoms from other users, and the flexible application of mask recommendations based on data provided by epidemiological surveillance systems.
Andalusia: its own plan to combat the flu and masks in health centers
Andalusia has joined the regions that have decided to take early action and has activated a Specific Action Plan for the flu seasonAlthough the community is still below the epidemic threshold, the positivity rate for the flu virus exceeds 20%, and models predict a more intense and earlier season than in previous years, largely driven by the H3N2 virus.
The Minister of Health, Presidency and Emergencies explained that this plan includes the reinforcement of the virological surveillance, with more sentinel physiciansand the improvement of indicators that measure the pressure on healthcare services in emergency departments and at other levels of the healthcare system. The intention is to be able to react quickly if a sudden increase in cases or greater severity of clinical conditions is detected.
Among these actions, the decision to issue an order stands out. recommend the use of masks in healthcare and social care centersThis applies to both professionals and users. The measure covers hospitals, health centers, nursing homes, and centers for people with disabilities, both public and private, and is part of a preventative approach before the flu reaches its peak.
The management of these centers will have the possibility of further strengthening protection if their circumstances so require, assessing, in their local contingency plansThe option of making masks mandatory in certain services or areas, especially where highly vulnerable people congregate.
This Andalusian plan also prioritizes the dissemination of Informative messages to the public The message focuses on well-known measures such as the responsible use of face masks, frequent hand hygiene, adequate ventilation of enclosed spaces, and the need to avoid contact with particularly vulnerable individuals when experiencing respiratory symptoms. Ultimately, the goal is for the population to regain certain protective habits that proved useful during the pandemic, adapting them to the current situation.
A common pattern: reinforced recommendation and protection of vulnerable people
Although each community has used its own timelines and legal tools, a common pattern can be observed in the management of use of masks in healthcare facilities In Spain, in response to the spread of influenza and other respiratory viruses, regional governments generally favor strong recommendations linked to risk levels and areas of particular vulnerability, reserving mandatory measures for specific and very limited scenarios.
Extremadura, Aragon, the Valencian Community and Andalusia agree in pointing out the spaces where high-risk populations are concentrated —such as critical care units, oncology, transplant, emergency departments, and nursing homes— as priority locations for mask use. In these settings, even where there is no formal requirement, the recommendations are particularly strong.
There is also agreement that decisions about tightening or easing measures should be based on objective indicators: cumulative incidence, epidemic thresholdsPressure on emergency rooms, virus positivity rates, and the operational capacity of healthcare facilities. The underlying idea is to adjust the level of demand as quickly as the epidemiological data evolves.
Another recurring element is the combination of masks with other preventative strategies: expanded vaccination campaignsPromoting hand hygiene, ensuring adequate ventilation, and recommending avoiding unnecessary contact when symptoms are present are key measures. Health authorities emphasize that no single measure is sufficient, but that the combination can significantly reduce transmission and, above all, the most serious complications.
At a time when social fatigue with restrictions is evident, communities are trying to reinstate mask use as part of daily routines in healthcare and social care facilities, while avoiding measures perceived as overly coercive when the data does not justify them. The message that is repeated, with nuances depending on the region, is that Wearing a mask in a healthcare setting It is once again a simple way to take care of yourself and those who have more to lose from the flu and other respiratory viruses.
