As of Wednesday, April 20, the gesture of putting on a mask when entering any covered public space is no longer mandatory in Spain after almost two years. Several exceptions will remain in force: it will have to continue to be carried on all types of public transport (buses, trains, planes, subways, boats…) and discretionary (such as taxis and VTC); also in all health centers and establishments, including hospitals (except for hospitalized people, if they are in their room without visitors), health centers, pharmacies, blood transfusion places or the like. Finally, masks will be mandatory in social health centers (residences) for visitors and employees. In the work centers, the use of the face mask will be in the hands of the occupational risk prevention services of each company.
Those are the general lines that the Minister of Health, Carolina Darias, has advanced on the decree that the Council of Ministers will approve on Tuesday. In that text there will be no recommendations, but her department insists on making “responsible use” of the mask. Here are some criteria that can guide its use:
what mask to wear
A study by the American Conference of Governmental Industrial Hygienists (ACGIH) calculated the time it takes to become infected in a closed, unventilated space. It goes from 15 minutes in the event that neither the person who already has covid nor the potentially infected wear a mask, up to 25 hours, when both use an FFP2. Between both extremes, there is a whole gray scale depending on what type of protection one and another person carry.
Elena Vanessa Martínez, president of the Spanish Society of Epidemiology (SEE), recalls that the mask has more of a collective protection function than an individual one. “Whoever wants to continue wearing it to minimize their own risk in places where it is not mandatory should use the FFP2 ″, she maintains.
Assess personal risk
Both health authorities and public health experts recommend that people most vulnerable to covid continue to wear masks in closed spaces, especially if there are crowds. Special caution should be exercised by all people over 60 years of age, immunocompromised patients and pregnant women.
Antoni Trilla, Professor of Public Health at the University of Barcelona, believes that for these groups “the risk remains low” if they have been vaccinated. “But it is greater than for the rest and, therefore, they should be more careful to wear them. Not always, but in closed spaces with many people, ”he explains. Trilla also recommends extreme caution when living with or frequenting vulnerable people, and putting on a mask in contact with them.
Another vulnerability factor is not having received the vaccination. Even young and healthy people are at greater risk of becoming infected and seriously ill if they have not received the complete guideline: in Spain, 92.5% of people over 12 years of age have done so. The booster dose is an additional protection that decreases the probability of complications. One in five over the age of 40 has not received this puncture.
Assess where I’m going
The use of the mask does not always have the same utility. There are three vectors that serve to guide when it is most effective: the time spent in a room, its size or ventilation and the number of people in it. As a summary, it could be said that the risk of infection decreases the less you stay indoors, the more space there is and the fewer people.
In a small and poorly ventilated place that is also crowded, the protection of the mask makes more sense than in a very large one where there are few people. In addition, it should be borne in mind that if you spend a lot of time in the same place, the risk of infection increases, so the mask becomes more important.
Three weeks ago in Spain the tests are not indicated for the majority of the population. The general accumulated incidence is no longer measured, the indicator that has guided the country for almost two years to know the presence of the virus in each territory. But diagnoses are maintained for those over 60, which the Ministry of Health continues to publish every Tuesday and Friday.
Since this new surveillance strategy came into force, Health has also published a new covid traffic light, which establishes thresholds to consider the risks based on these measurements: with less than 250 cases per 100,000 inhabitants in 14 days, circulation is considered to be “ controlled”; between 250 and 500 the risk is “low”; from 500 to 1,500, “medium”; between 1,500 and 2,500, “high” and, from that figure, “very high”.
According to the latest report, dated April 12, the cumulative incidence among those over 60 years of age was 435 cases per 100,000 inhabitants, which would place the risk at a “low level.” It is a figure that has stabilized for weeks, with small rises and falls. The next reports will show how Holy Week has affected infections and may be an indicator to decide whether or not to continue wearing a mask in closed spaces, beyond the fact that it is no longer mandatory.
What do I do if I have symptoms
In the absence of knowing the small print of the new decree, which will be published in the State official newsletter (BOE) on April 20, Minister Darias said when she announced the end of outdoor masks that people who had symptoms of covid should wear it for 10 days from the start. Regardless of what the rule states, Martínez, president of the SEE, recommends that everyone who has signs of respiratory illness wear a mask while they last. “This is something that could be kept forever,” she says. Trilla adds that, if possible, avoid contact with other people, especially if they are vulnerable.