Spanish health officials in at least five regions of the country are reintroducing masks in health care facilities and recommending their use elsewhere as cases of flu and COVID-19 are seeing a post-holiday spike.

Health officials in the Valencia region — an area that includes popular tourist destinations — implemented mandatory masks rules in all health facilities after the rate of respiratory infections was found to be at 1,501 cases per 100,000 inhabitants.

Catalonia, Murcia, Aragon and Galicia have also reportedly issued similar mask rules.

In an interview with the Spanish news agency, EFE, the vice president of Spain’s Society of Emergency Medicine (SEMES), Pascual Piñera, said acute respiratory infections, specifically influenza A, are up 35% from a year ago and are putting a strain on emergency services in the country.

Piñera blamed the spike in cases on social interaction that comes during the Christmas and New Year holidays and expects cases will continue to rise through the third week of January.

Spain was among the last European countries to drop requirements to wear face masks following the COVID-19 pandemic, with people told to wear them on public transport until February last year and in health centers and pharmacies until July.

Some information for this report was provided by Reuters.