Spain’s government proposed a nationwide mandate for people to wear masks in hospitals and health clinics on Monday, and Italy said respiratory illness infection rates had hit a record, as flu and COVID spread across Europe.

The European Centre for Disease Prevention and Control recommended that people on the continent stay home if they feel sick, and consider wearing masks in crowds or healthcare settings, with flu spreading as it typically does this time of year but hitting some countries harder than others.

It said Europeans should follow national guidelines on vaccinating vulnerable groups. Flu is now circulating at higher levels than other common respiratory pathogens, including the Sars-CoV-2 virus that causes COVID-19, it said.