Health will impose mandatory masks on communities in hospitals and health centers Society

The Ministry of Health will impose the mandatory use of masks in hospitals and health centers from Wednesday following the increase in flu infections, as Efe announced this Monday afternoon and the department headed by Monica Garcia confirmed to EL PAÍS. A few hours ago, in the morning, most of the autonomous communities opposed the measures in an extraordinary inter-regional conference of the National Health System, and opted for the recommendation. So far only six have decided to implement it.

Health did not wait 48 hours.

The Ministry of Health will impose the mandatory use of masks in hospitals and health centers from Wednesday following the increase in flu infections, as Efe announced this Monday afternoon and the department headed by Monica Garcia confirmed to EL PAÍS. A few hours ago, in the morning, most of the autonomous communities opposed the measures in an extraordinary inter-regional conference of the National Health System, and opted for the recommendation. So far only six have decided to implement it.

The health department itself did not wait for the 48 hours given to the autonomies to raise objections on the proposal made this morning. The ministry has explained that it will take the declaration of concerted actions to equalize protection against respiratory viruses for all citizens and legally protect those communities that have implemented it.

Mandatory masking in health centers was the responsibility of the communities themselves: some were enforcing it and others were not. The six that were already running or ending are the Valencian community (run by PP and Vox); Catalonia (ERC); Murcia (PP); Aragon (PP), which initially imposed them on healthcare workers and has extended them to patients in waiting rooms; Canarias (CC), which announced it this Monday, and Asturias (PSOE), which also reported measures after the Council and which, if applicable, will be in force for 15 days. Health has scaled back its initial idea to impose it in social health centers and even pharmacies, where it now asks that it be only a recommendation.

The legal format used by the ministry to impose the use of masks is unprecedented. During the pandemic, it was the central government that controlled its mandatory nature in various places, but through decree laws. The last one to retain masks in health centers, social health centers and pharmacies was canceled five months ago. On this occasion, health ensures that it is protected by Article 65 of the law on the coordination and quality of the national health system, which regulates the declaration of integrated actions in public health and that “obliges all parties” involved. Sources in the department justify that now only hospitals and health centers are being considered and the only way is for regional governments to implement the rule with legal guarantees.

Most communities made it clear this morning that they are against accountability. With different political colors, at least Andalusia, Galicia, Madrid, La Rioja, Navarra, Cantabria, Castilla y León and the Balearic Islands (governed by the PP), Euskadi (PNV) and Castilla-La Mancha (PSOE) have rejected him. Many of the public have asked the ministry for technical criteria to take a decision.

Councilor from Madrid, Fatima Matute (PP), confirmed that her position and the majority of the council is to maintain the responsible use of masks in the cases already indicated. “And of course, that’s what we will continue to apply with scientific rigor and with the evidence provided by the data we have in every community to protect our population.” He said after the meeting.

Castilla-La Mancha’s health minister, Socialist Jesus Fernández Sánchez, maintained a similar thesis and communicated that his department proposes that masks are not mandatory, but that the recommendation “appeals to the responsibility of the population” is maintained. He also requested that the Alert Report (composed of technicians) and the Public Health Commission (composed of Ministries and Directors of Autonomy) “so that the technicians themselves propose measures.”

It is a reproach that the Minister of Health of Murcia, Juan José Padreno, also presented to the Minister, who regretted that health “arrived late” and considered a proposal that did not pass through the aforementioned technical institutions as an “incident”. “Given the high incidence of flu and respiratory viruses, the regional government has already taken prevention and control measures, without the ministry consulting or taking an interest in the evolution of the autonomous communities,” he said.

Some communities that deny responsibility, such as La Rioja, suggest that masks only be imposed in health centers if a certain threshold of respiratory virus incidence is reached, although they have not established what these criteria should be.

Garcia’s proposal, however, is widely supported in the health sector: both medical-scientific societies and professional representatives believe that masks should be kept in health centers during epidemics like the current one. CSIF, the most representative union in the public administration, reprimands the Ministry of Health and regional authorities for their inability to reach an agreement on the measures to be adopted and urges the strengthening of staff and the mandatory nature of face masks. The General Nursing Council has also ruled in favor, believing that the latter may be the case Temporary preventive measures that reduce the peak of infection due to respiratory infections expected in the coming days.

Auto-discharge to unclog primary

In addition to this debate, the Minister, Monica García, has informed the Council that she is studying the possibility of approving sick leave with responsible self-declaration for citizens with minor illnesses during the first three days of disability. It is a measure that medical societies have been demanding for years to ease the burden on health centers and the ministry is now weighing with the rise in winter epidemics of respiratory viruses, particularly influenza.

According to sources in the department headed by Garcia, the Ministry of Health is negotiating with the Ministry of Social Security on the form and timing for their implementation. The minister explained that the system already works this way in many other countries, and similarly, as citizens disclose their illness to a doctor (even when this is to obtain sick leave), they can do so responsibly. Without the involvement of a health professional, which can save time for more essential care tasks.

Some communities, such as Aragon, had already rejected the measure, while medical societies, which had been demanding it for some time, applauded it. This is the case of the Spanish Society of General and Family Physicians (SEMG), whose occupational health group spokesman, Francisco Sáez Efe, said running to the health center to sign a sick leave “which does not mean that a worker with flu or a cold” is nonsense and Nonsense,” but it also “overloads” already saturated health centers.

Paulino Cubero, spokesperson for the Spanish Society of Family and Community Medicine (semFYC) similarly states: “As is done in other countries, the last one is Portugal in 2023, one to three days of sick leave can justify itself. Electronic means between the patient and his company, so that many unnecessary visits can be avoided in self-limiting procedures, such as colds, gastrointestinal episodes, migraines, dysmenorrhea and other minor procedures that do not require a medical diagnosis.

To reverse the collapse of primary care, however, immediate action is required. The flu epidemic is skyrocketing: In the absence of more recent data, which will be published on Thursday, infections have increased by 75% in the last week of the year. Experts predicted that it would continue to rise, although there are numerous family and festive celebrations after those dates that facilitate the spread of the virus.

Although it cannot be determined when the peak will occur, experts predict that cases will begin to decline in the second half of the month. The impact of the flu, moreover, does not only affect health centers: emergencies are saturated in many areas of Spain and some hospital plants, such as those of the Valencian community, which has the highest incidence, are already suffering.

Finally, the Interterritorial Council on Monday addressed the implementation of the winter plan for the future season of the viral epidemic. This will be a joint and coordinated action from the moment the first infections start, trying to avoid the collapse seen this year.