ROME (AP) — Italy, Spain and other European countries are reinstating or stiffening mask mandates as their hospitals struggle with mounting numbers of COVID-19 patients.

Other nations like the Netherlands are considering introducing masking rules.

The use of more protective FFP2 masks in Italy is also seen as a way to keep businesses running and public services provided.

The Italian government says vaccinated people who had contact with someone who tested positive for the coronavirus can avoid quarantine as long as they wear an FFP2 mask when in public for 10 days.

On Christmas Eve, the country announced that FFP2 masks must be worn on public transport, including planes, trains, ferries, and subways, the Associated Press reported.

They must also be worn at theaters, cinemas and sports events, indoors or out, and can’t be removed when eating or drinking, the news outlet reported.

These strategies sharply contrast with those of Britain whose government has emphasized vaccination and where mask-wearing dropped off markedly last year.

In Spain, they reinstated its outdoor mask rule on Christmas Eve, the AP reported.

In Portugal, they restored its mask mandate back at the end of November.

In Greece, they brought back its outdoor mask mandate, while also requiring everyone to wear an FFP2 mask on public transport and in indoor public spaces.