Why it’s time to wear face masks again

After a dramatic spike in flu and Covid cases, Spain has reintroduced the mandatory wearing of face coverings in its hospitals. Should we now do the same – and perhaps go even further?

I wouldn’t want to make what is turning out to be an unusually miserable January even worse, but I feel bound to remind you that, well, Covid isn’t over.

This week, the Spanish health department reimposed mandatory mask-wearing in hospitals and health centres. They have not done this because of some spontaneous tyrannical tic, but because there’s been a surge in respiratory illnesses of all kinds – flu (which we know is more dangerous than we like to think), RSV, the common cold, and the various variants of the coronavirus. It’s a common-sense, precautionary step that will probably slow the spread of the disease, especially among more vulnerable folk, ie the ones who tend to spend time in hospitals.

It’s predictably provoked a hysterical response from the anti-mask mob, but really it is not much to ask as a very soft condition of service: “We are talking about putting on a mask when you enter a health centre and taking it off when you leave. I don’t think it is any drama. It is a basic and simple measure of the first order,” says the Spanish health minister, Monica Garcia.

Quite right, too. As an imposition, of sorts, it is proportional and trivial, and even if many masks aren’t 100 per cent effective, it might well help someone avoid serious illness, or worse.

As ever, mask-wearing is more about protecting others rather than oneself, because it can play a role – along with other precautions – in spreading the virus to others, and particularly if you yourself are asymptomatic (which is a thing with the coronavirus, in case we’d forgotten). Even if mask-wearing, say, can save a single person from long Covid per hospital per year, it is well worth everyone doing their bit. For the very few with genuine clinical reasons to avoid mask-wearing, there are exemptions.

It may come as a surprise, but in this country there is still NHS guidance – nothing stronger than that, sadly – that masks should be worn by patients and visitors in higher-risk areas, such as A&E units, eye, oncology and haematology treatment areas and oncology wards.

From personal experience, I’m not sure this is very much observed; and virtually no one wears a face covering elsewhere, in hospital corridors, canteens or waiting areas, for example. We seem to have forgotten how easily Covid can spread, and the winter time is the peak time for infections.

Our schools are even more complacent. Despite the searing experience of the pandemic, where is the investment in filtration and clean air, an innovation that would protect school attendances when the next epidemic comes along, as it surely will?

As we discovered with Covid, just opening the windows isn’t a sustainable strategy in the winter. In the absence of filtration ventilation, it is even stranger that the official guidance on keeping children home from school is still so weak: “Children and young people aged 18 and under who are recommended to take a Covid-19 test by a health professional and test positive, the advice is to try to stay at home and avoid contact with other people for three days. This is because children and young people tend to be infectious to other people for less time than adults.”

That is true, but there seems little accounting for how easily Covid can spread, and how children can be a major vector in transmission to people with much weaker immune systems, ie older relatives and those with immunodeficiency. Again, the advice reads like it is written for the good times, rather than as a precaution against the constant threat of a surge. It is as if the last pandemic never happened.

Most grievous of all is the dangerously reckless approach to Covid vaccination. This was, after all, the great British achievement in the pandemic, a medical breakthrough that liberated the world and saved countless lives. And yet only the oldest citizens and those most vulnerable have been offered a winter booster – and, as it happens, the same goes for flu. Those in their fifties, say, must think the NHS deems them dispensable.

I’ve always respected the experts in charge of our public health, if not the politicians, but it is worth asking rational questions about whether policymakers collectively have got things right.

The key omission would seem to be the economic impact of long Covid on the economy – surprisingly neglected. According to the Bank of England, long Covid and its complications has contributed significantly to reducing the labour force and, thus, to skill shortages and inflation. By the same token, it has pushed up the number of people claiming sickness benefits.

Rishi Sunak says the nation hasn’t suddenly got sicker, but the plain fact is that it has; long Covid will be a drag on the economy and the public finances for unknown years to come. The Office for National Statistics says that about 2 million people suffer long Covid symptoms nationally, about one in 30 of the population, of whom 400,000 had caught the disease more than two years previously.

Fatigue continues to be the most common malaise, as well as a distressing shortness of breath, loss of smell and muscle ache. The recent death of Derek Draper should remind us of the devastating impact the disease can have. As time goes on, and we “learn to live with Covid”, infectious disease experts warn that repeat Covid infections could have cumulative, lasting effects. For example, it can raise the risk of developing blood clots, which can travel to the brain or lungs: catastrophic.

Against all that, popping on a mask in a hospital, testing at home for Covid when potential symptoms appear and taking up the offer of a free jab are surely all well worth it. Long Covid, or worse, isn’t really worth the risk, to you or to others. Next time, you might not bounce back.