Are Spaniards the most willing adopters of face masks in Europe?

Walk down any street in Spain and you are likely to see most people wearing a face mask, albeit not always correctly. Groups of young people may be the exception to the rule, especially if they are drinking on the street, as well as patrons of outdoor bars and restaurants. Even so, similar scenes are hard to find in France or the United Kingdom, even though both countries have been hit equally hard by the Covid-19 pandemic. In France, for instance, wearing a face mask has only been mandatory in closed public spaces since Monday.

Spaniards, like Italians, lead Europe in terms of the use of face masks, which experts now agree is a key measure to preventing contagion. Within a few months, the Spanish people have adopted a practice common to countries like Japan that aims to reduce infection in public spaces and during the flu season. Experts, however, are not clear on why this is the case. Some reasons suggested are that people are now more educated about the benefits of face masks, that they are scared of a virus that has killed more than 28,000 people, and even that survey respondents may be replying that they wear face masks even if they don’t, because it is considered the “right” answer.

More than 60% of Spaniards are willing to wear a face mask, compared to 35% in Finland

Last week, the most critical Spain has seen since the end of the state of alarm on June 22, a trickle of regions joined Catalonia in making masks mandatory in all public spaces even when social distancing rules can be respected. Of Spain’s 17 regions, only the Canary Islands and Madrid have not followed suit. According to a survey of several countries (nine of them European) by Imperial College London and YouGov, Spaniards are more willing to wear face masks than any of their European counterparts. The poll showed that a wide majority (more than 60%) were favorable or very favorable to wearing one, a similar percentage to those reported in Asian countries. Finland ranked at the bottom of European countries, with only 35% of respondents saying they were willing to wear a mask, even though the measure has been recommended by international organizations.

Spain, however, did not introduce the measure immediately. Face masks were made mandatory on public transportation on May 2, and elsewhere when social distancing rules cannot be respected on May 22. Two months earlier, the Czech Republic became the first European country to make face coverings compulsory in supermarkets, pharmacies and public transportation. Six other nations introduced similar measures before the Spanish government issued its order.

A macrostudy on the prevalence of the coronavirus – which looked at the use of face masks as Spain rolled back confinement measures as well as what percentage of Spaniards had developed antibodies to the virus – found that the safety measure became widespread within one month, between mid-May and the end of June. At the beginning of the study, one in five (20%) Spaniards said they did not use the covering. By the end of it, that figure had fallen to 7.3%. The study also highlighted regional differences in Spain. While in the provinces of Badajoz and Jaén, practically all of the respondents wore masks (with the exception of 3.9%), in Gipuzkoa province in the Basque country, just over half the population took the precaution (55%).

Should face masks be mandatory at all times?

The sight of people without masks sitting at tightly packed outdoor tables in the Basque city of Hondarribia came as a shock to Santiago Moreno, the head of infectious diseases at Madrid’s Ramón y Cajal hospital, who went there on a recent trip. “I thought, if someone is infected, they will infect 25 others. The only ones with masks were the people from Madrid,” he remembers.

Moreno believes that making face masks mandatory, even if social distancing can be respected, is a conceptual necessity. “By being so strict, those who don’t meet [the rules] will feel like they are breaking the law,” he explains. “It’s better for us to do too much than too little.” The spokesperson of the Spanish Association of Infectious Diseases and Clinical Microbiology, María del Mar Tomás, agrees: “The only preventive measures we have at the moment are masks, distance and having outdoor meetings and contact.”

But other health experts disagree. Epidemiologist Andrea Burón, the vice-president of the Spanish Association of Public Health and Health Administration (SESPAS), believes the measure should only be required in exceptional situations “when the risk to collective health really calls for it.” She believes it is more reasonable and appropriate to wear a face mask “when you enter a store or travel on public transportation, in an elevator or when there are sporadic gatherings of people, because that is when there is a greater risk.” This way, she says, the “discomfort is limited in time and space.” “Touching them [face masks] is inevitable (which we know we shouldn’t do) and making them mandatory when safe distances can be perfectly maintained does not make a lot of sense.”

“These measures have been justified by the fact that people have become complacent about wearing them when they are needed most,” continues Burón. “But I would prefer for authorities to have greater trust in the general public, to provide more information and education on the potential risks, so that they will be empowered to use [face masks] better, and in places and moments where there is risk.”

Jesús Molina, the spokesperson for the Spanish Association of Preventive Medicine, Public Health and Hygiene, agrees that face masks do not need to be mandatory when safe distances can be maintained. “The key is not the frequency of the use of masks, but rather that they be used correctly, covering the nose and mouth, throwing out the surgical [masks] and washing the hygienic ones.”

So why are Spaniards so willing to wear face masks? Given that people respected a strict three-month lockdown to curb coronavirus contagion, it follows that they would equally respect safety measures like face masks, as the antibody study indicates. Experts have no further explanation other than that the education effort around face masks took hold in Spain more than in other European countries. “And I’m happy that’s the case,” says Moreno.

Tomás says the adoption of the safety measure, as well as being mandatory, stems from the desire to lead a life as normal as possible under the circumstances. But Molina warns the data from the surveys may not be accurate. “These are self-declared responses, there is no observer recording the use of masks. What’s more, it could be the result of a complacency bias, in other words, [the respondents] replied what they hoped sounded correct.”

English version by Melissa Kitson.