Face masks can be devastating for people with hearing loss
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2683 (Published 09 July 2020) Cite this as: BMJ 2020;370:m2683Linked Opinion
The communication needs of D/deaf healthcare workers and patients are being forgotten
Linked Opinion
D/deafness and solidarity in the covid-19 pandemic
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Dear Editor
This letter was written to comment on the article “Face masks can be devasting for people with hearing loss," by Chodosh and colleagues published on July 9, 2020. As a frontline worker, I have first-handedly witnessed the drastic and rapid changes made in the clinical setting caused by the coronavirus pandemic. The Covid-19 pandemic has precipitated change around the world and in the daily lives of many, while there is a lot of focus on numerous of those changes I applaud this article for bringing awareness to one that is often overlooked. According to Higgins and Lieberman (2016), deaf people can be considered a cultural and linguistic minority group, so this article bringing awareness to the way personal protective equipment affects their health care experiences is intriguing.
The use of PPE especially masks poses an additional barrier to communication with deaf people, patients and clinicians, alike because they rely on lip-reading and facial cues. This article brings awareness to this problem as well as providing strategies to approve communication. The suggestions were valid but some lacked credibility like the clear window face masks, this may pose a breathing risk as well can impact the protection of the mask. Other suggestions like the use of speech to text technology show the level of innovation needed to respect those who are a part of this minority.
Communication in the health care field is important between workers and workers and workers and patients as it improves care to each individual through proper understanding and collaboration. Although masks may impede communication, I still strongly agree that it is necessary for everyone to wear to control the transmission of the covid-19 virus. This article sparks minds to find new ways to work around mask-wearing and communication barriers in the deaf community and for that commends are due.
References
Chodosh J, Weinstein B, Blustein J. Face masks can be devastating for people with hearing loss. BMJ. 2020;:m2683
Michael Higgins and Amy M Lieberman, “Deaf Students as a Linguistic and Cultural Minority: Shifting Perspectives and Implications for Teaching and Learning,” January 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416902/.
Competing interests: No competing interests
Dear Editor,
This letter is written to comment on the article “Face masks can be devasting for people with hearing loss, "by Chodosh et.al published on July 9, 2020. Firstly, I would like to express that the article title captured my attention immediately. Also, as I began to read the material, it was noted to be vivid and straight to the point. Which was a trait that I admired deeply.
Nevertheless, as stated in the article, indeed a worldwide crisis known as the Covid 19 has impacted everyone greatly. It is agreed that it came as a surprise to many and a lot of persons are still learning how to cope with this deadly crisis. However, as crucial as this may be, I did not even realize to think about the effects it would have on persons with hearing loss. Nevertheless, to correct this problem I noticed how you spoke about the many strategies that could improve the communication among these persons which on my behalf are to be commended.
Furthermore, I completely agree that the communication between health care workers and patients contribute greatly to positive outcomes. However, I still do believe that face masks are essential in the prevention against Covid 19 for everyone. Contrary to that, I do acknowledge the fact that these face masks do make communication harder for these persons. While still making note that regardless of the impact on their communication this should not exempt them from wearing a mask.
Moreover, another point that I envied the most was the clear face mask suggestion. In addition to this, while doing some extra research I came across a quote that supported your article. The quote wrote “For these specialized masks to help,” she writes, “it’s not those of us who are deaf or hard of hearing who have to wear them. Instead, it’s hearing people who want to make themselves understood.” To unlock the true potential of clear masks for deaf and hard-of-hearing people, she says, “We need you to do your part” (Blakemore, 2020).
In conclusion, a worldwide pandemic is at hand and your promotion of face masks being devastating to persons with hearing loss is admirable. I am sure that there are many persons who feel the same way that I do. I now end by commending you for your research ethics and the quality of the article.
18 November 2020
Neteka Wright
Student
University of The Bahamas
Nassau, Bahamas
Reference
Blakemore, E. (2020, August 08). For those with hearing loss, face coverings make communication difficult. The solution? See-through masks. Retrieved October 25, 2020, from https://www.washingtonpost.com/health/for-those-with-hearing-loss-face-c...
Competing interests: No competing interests
Dear Editor,
The coronavirus disease pandemic has required rapid adaptations to all levels of clinical practice. The wearing of facemasks and other personal protective equipment (PPE) poses not only a challenge in communication with deaf people, but amongst all staff required to wear it. Communication between clinicians and other team members is paramount to patient care and safety, particularly when preforming emergency procedures.
In the first wave of the coronavirus disease, recommendations to wear full PPE for aerosol-generating procedures quickly resulted in shortages of FFP3 masks [1]. This, combined with an initial lack in availability of mask fit testing, resulted in many UK hospital trusts seeking alternative means of protecting its workforce such as full face respirators and powered air-purifying respirators. These pose even further challenges to communication as not only are speech and hearing abilities impaired, but visual and non-verbal cues are also impacted upon. Subsequently this can result in prolonged communication times and a higher risk of error [2,3].
Studies on communication whilst wearing respirators have been carried out in the aviation industry, and not surprisingly they found the use of a respirators adversely affect the reliability of communication [4]. Published data suggests reduced levels of speech intelligibility, to varying statistical degrees, whilst wearing certain models of respirators [5].
Innovative solutions to communication difficulties have been sought throughout the pandemic, other units have trialled the use of phone apps and audio-communications solutions such as headsets and throat microphones [6].
We have trialled a somewhat simpler solution, thanks to a number of established sign languages; these include the British Sign Language system, as well as hand signals adopted by the military and scuba diving community [7,8,9]. In our unit we devised a novel sign language tool for emergency surgical tracheostomies, published in The Journal of Laryngology & Otology, which has helped bridge the communication gap and reduce errors that may occur as a result of a sensory-impaired environment [10]. Key principles of our communication tool include using simple well know hand gestures, using hand signals only for critical steps and equipment, keeping the number of signals to a minimal and away from the face due to risk of desterilisation. We would recommend that photographs are taken of agreed hand signals, which can be printed, laminated and displayed in the relevant areas.
This simple tool may be pertinent to our colleagues working in emergency settings, particularly those dealing with emergency airways where every second is critical such as emergency department, anaesthetics and ENT. Teams with deaf or hard of hearing members of staff may also find this useful for ensuring effective communication for key procedural steps. It is important to note that local adaptation will be required depending on the procedure and local practice.
As it appears facemasks and PPE are here to stay for the foreseeable future, it is imperative that we continue to work on solutions to impaired communication and we are intrigued to see the innovative solutions proposed and developed in the future.
References
1) Iacobucci G. Covid-19: doctors still at “considerable risk” from lack of PPE, BMA warns. BMJ 2020;368:m1316
2) Nagpal K, Vats A, Lamb B, Ashrafian H, Sevdalis N, Vincent C et al. Information transfer and communication in surgery: a systematic review. Ann Surg 2010;252:225–39
3) Moore A, Butt D, Ellis-Clarke J, Cartmill J. Linguistic analysis of verbal and non-verbal communication in the operating room. ANZ J Surg 2010;80:924–9
4) Thomas F, Allen C, Butts W, Rhoades C, Brandon C, Handrahan DL. Does wearing a surgical facemask or N95-respirator impair radio communication? Air Med J 2011;30:97–102
5) Radonovich LJ Jr, Yanke R, Cheng J, Bender B. Diminished speech intelligibility associated with certain types of respirators worn by healthcare workers. J Occup Environ Hyg 2009;7:63–70
6) Mathews, J.A., Blencowe, N.S., Adcock, S., Gane, S., Nangalia, V., Patel, A., Blazeby, J.M. and Birchall, M. (2020), ‘Theatre Comm’ – optimising communication in surgical theatres during COVID‐19. Br J Surg, 107: e393-e393. https://doi.org/10.1002/bjs.11834
7) British Sign. Fingerspelling alphabet. In: https://www.british-sign.co.uk/fingerspelling-alphabet-charts/ [13 April 2020]
8) Department of the Army. Visual Signals. In: https://fas.org/irp/doddir/army/tc3-21-60.pdf [13 April 2020]
9) Behnke L. Scuba Diving Hand Signal: Underwater Communication Pocket Companion for Recreational Scuba Divers. California: CreateSpace Independent Publishing Platform, 2015
10) Wilkinson, S., Irvine, E., & Valsamakis, T. (2020). Coronavirus disease 2019 communication: Novel sign language system to aid surgical tracheostomy whilst wearing a respirator. The Journal of Laryngology & Otology, 134(7), 642-645. doi:10.1017/S0022215120001255
Competing interests: No competing interests
Dear Editor,
As Chodosh et. al. stated, hearing loss is a relevant and disabling condition associated with poorer ratings of patient-physician communication (1) and worse health outcomes (2). This is even more pertinent in the context of the COVID-19 pandemic and the increasing use of facemasks.
Furthermore, Chodosh et. al. advocated that ‘adopting simple strategies can help maximise communication whilst innovation ramps up’, suggesting the use of personal amplifiers ‘(costing £50-160)’ and speech to text applications. Although both excellent alternatives, commonplace access to personal amplifiers cannot be guaranteed and speech to text apps may be particularly difficult in aging populations, especially when considering a demographic whose eyesight is likely to be affected alongside their hearing (3). Both methods are also likely to cause difficulty in the acute setting, requiring time to set up and explain.
In view of Chodosh et.al’s search for a ‘simple strategy’, we would like to highlight a straightforward and effective method to help maximise communication; the reverse stethoscope technique. This entails putting the stethoscope earpiece into the patient’s ears and the healthcare professional speaking into the diaphragm. This is a resource that all health professionals have readily available in every healthcare setting, be it the ward or the accident and emergency department. This technique has been reported before in the BMJ (4) and we have used this technique in more than 60 patients (age range 50-99yrs) with hearing loss with great success. The greatest benefit of this technique is the removal of background, ambient noise. We are in the process of assessing whether the benefit is maintained with the addition of facemasks.
Admittedly, infection control could pose a challenge for this method due to the lack of social distancing and the reusing of stethoscopes. However, with appropriate PPE and either the use of alcohol wipes to sterilise the stethoscope in between patients or to have a one patient, one stethoscope policy, this risk would be mitigated. We believe that, in the emergency setting the reverse stethoscope technique is an effective, simple, easily accessible yet underused technique that many clinicians could utilise to improve communication in some patients with hearing impairment.
References
1. Mick P, Foley D, Lin F. Hearing Loss is Associated with Poorer Ratings of Patient-Physician Communication and Healthcare Quality. Journal of the American Geriatrics Society. 2014;62(11):2207-2209.
2. Chodosh J, Weinstein B, Blustein J. Face masks can be devastating for people with hearing loss. BMJ. 2020;:m2683.
3. Besser J, Stropahl M, Urry E, Launer S. Comorbidities of hearing loss and the implications of multimorbidity for audiological care. Hearing Research. 2018;369:3-14.
4. Vadodaria B. BMJ 1998; 316:1382.
Competing interests: No competing interests
Dear Editor,
Chodosh J et al (1) concisely summarised the consequences of mask wearing by health professionals for people with hearing loss and the urgent need for innovation in tackling this. We agree that communication between clinician and patient is at the heart of medical care. From the start of the covid-19 pandemic, the detrimental impact of personal protective equipment (PPE) (2), including mask wearing, on communication between clinicians and all patients was evident to us as an inpatient team.
We agree with Chodosh et al (1) that rapidly adopting simple strategies to improve communication while innovations ramp up is important. We would like to share one simple change we introduced during the covid-19 pandemic.
This came about as a result of feedback from patients, that staff wearing masks was a contributing factor to the fear, loneliness and isolation, that they felt. The difficulty patients in hospital have in recognising their clinicians, even prior to mask wearing, is well described, as is the negative impact this can have on communication and patient experience (3). Hearing one patient with covid-19 describe how helpful learning and using clinician names was as a coping strategy, in the context of the evidence that providing names and photos to patients, improves recall of their clinicians (3), led us to design and introduce our ‘Meet your medical team behind the masks’ hand-out.
This document is given to each patient when they first arrive on the ward. It includes the full name and role of each team member in large text and a colour photograph. The hand-out is stored in a wipeable plastic wallet, is left with the patient, and referred to by the reviewing doctor, by way of re-introduction, throughout a patient’s admission.
Our ‘Meet your team behind the masks’ hand-out has been in use since April 2020 and has already been through several iterations of formatting and rotating team members. We continue to offer it to all patients under our ward team’s care as mask-wearing continues to be standard practice in hospital. Patient feedback has been universally positive, including comments such as this “would have helped me to feel less scared when I first came to hospital”. We have found that many patients ask to take the hand-out home with them, which we think is one measure of how it is valued by patients!
Wearing masks is likely to be part of how we work as healthcare professionals for years ahead. We need a range of approaches that have potential to reduce the harmful effects of mask-wearing on communication between clinicians and patients to be prioritised and rapidly evaluated. Until we have these innovations in place, hospital ward-based teams may wish to try out offering a wipeable version of ‘Meet your team behind the masks’ as a simple, easily produced aid to communication for mask-wearing clinicians (3).
References:
1. Chodosh et al
2. World Health Organisation. Advice on the use of masks in the context of COVID-19: interim guidance, 5 June 2020.
3. Appel L, Abrams H, Morra D, et al. Put a face to a name: A randomized controlled trial evaluating the impact of providing clinician photographs on Inpatients’ recall. Am J Med Published Online First: 2015. doi:10.1016/j.amjmed.2014.08.035
Competing interests: No competing interests
Dear Editor
There are concerns for persons with hearing impairment and wears hearing aid that uses faces mask. Since the rise of the COVID 19 pandemic. CDC recommended that everyone should wear a face mask in public to prevent the spread of the virus. Wearing a mask will help protect people around you, including those at higher risk of severe illness from COVID-19 and workers who frequently come into close contact with other people (CDC, 2019). The recommendation for wearing of mask does not exempt person with hearing impairment or those that wears hearing aid.
What is the great issue that surrounds persons with hearing loss/hearing impairment and the use of face mask? According to National Deaf Children Society (2020), the use of face mask prevents effects communication for person with hearing impairment. This group of people usually relies on lip reading and facial expressions to make communication easy for them. Whether you have normal hearing or hearing loss, to put meaning to what is being said. Additionally, it was also stated that persons with hearing impairment particularly children may even feel more isolated because of the ineffective communication cause using face mask.
Furthermore, persons with normal hearing are noticing that sounds are somewhat muffled, and they struggle to hear, imagine those who have hearing impairment/hearing loss. It was also found that the use of face mask can reduce sound by as much as 12 decibels (University of South Florida, 2020).
There is no doubt that face mask caused behind the ear irritation and can be very uncomfortable when worn for a prolonged period. Persons who uses hearing aids may experience challenges wearing face masks that are worn behind the ears. The elastic bands commonly placed over the ears to secure the mask can get in the way of the tubing that connects the hearing aid to the speaker that sits in your ear. Beyond the discomfort, there is also a chance of losing a hearing aid when removing the mask (Urban, 2020).
With all these concerns about the deaf community and face mask, what are some of the recommendations that are in place to make communication easier for this group.
According to University of South Florida (2020), utilizing a face mask that has a clear plastic around the mouth instead cloth covering, help with a more effective communication where lips can be read.
When you remove your mask to avoid losing a hearing aid or cochlear implant (CI) processor, which sits on the ear. Always check to make sure that the hearing aids or CI are still in place. This is Just like removing glasses or a hat (Urban, 2020).
using alternative forms of communication – such as writing things down or via text messages, depending on the individual needs (National Deaf Children Society, 2020).
Rather than looping the elastic of the mask on the ears, utilize button extensions for the mask (which can be made or bought)
Obtain a mask that has four strings and ties behind the head rather than worn with elastic on the ears.
Check that the hearing aid is still in place during and following removal of the mask (Boys Town National Research Hospital, 2020).
There is no one way of ensuring that every member of the population is catered for during the COVID 19 pandemic. It is up us as health care providers to make the best possible decisions for our patients and tailor for their needs accordingly.
References
Boys Town National Research Hospital. (2020). How to Wear a Face Mask with Your Hearing Aids. https://www.boystownhospital.org/knowledge-center/wearing-hearing- aids-with-face-mask
Centre for Disease Control and Prevention. (2019). Use of Masks to Help Slow the Spread of COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting- sick/diy-cloth-face-coverings.html
National Deaf Children Society. (2020). The impact of face masks on deaf children. https://www.ndcs.org.uk/blog/the-impact-of-face-masks-on-deaf-children/
University of South Florida. (2020). USF audiologists address COVID-19 challenges for the hearing impaired with new face masks. https://www.usf.edu/news/2020/audiologists-address-covid19-challenges-fo... impaired-with-new-face-masks.aspx
Competing interests: No competing interests
Dear Editor,
We welcome the editorial by Chodosh and colleagues and the other responders, that calls for awareness, mitigation and innovation to ensure clear communication in medical settings where masks are worn (1). Although the article proposes several solutions for communicating with D/deaf patients or clinicians, including older patients with hearing loss, we perceive the relevance of the article for paediatrics.
Perioperative complications are known to be more common in neonates, infants and young children versus adults (2). Previous studies have documented subjective communication difficulties of healthcare staff whilst wearing N95 facemasks (3) and ventilated hoods (4). During the Covid-19 era, objective measures of this impaired communication impact have been demonstrated (5).
Although scientists, clinicians and groups advocating for the D/deaf community have promoted clear masks (6,7) or hoods (8) (rather than FFP3 masks and visors) to ensure clear communication in medical settings, we have concerns for acute settings. Many dedicated clinicians have established techniques to reduce children’s uncertainty and fear of masks and PPE (9). The suitability of these measures is unclear for anaesthesia and aerosol generating surgery. Most clear window mask suggestions in the literature are either home-made or lack sufficient registered safety standards, and although hoods may allow better lipreading, most brands have loud fans/respirator units which cause further communication issues and additionally prevent the use of stethoscopes in critical situations (10). Although Chodosh and colleagues propose microphones and personal amplifiers to provide improved communication, we are not aware of any existing solutions that provide mutli-directional speech interaction in the operating theatre setting when multiple clinicians need to interact making complex acute decisions for paediatric surgery.
Whilst acute covid-19 appears to have been milder in children than adults, much has been written about the longterm effects for children in terms of educational, emotional, nutritional and financial impact (11) and modelling predicts large increases in paediatric mortality due to routine health care disruptions (12). As universal masking and other PPE strategies seem likely to continue throughout the year, we feel that targeted communication solutions for operating theatres are required, or this could present yet another challenge faced by children and health-care professionals involved in their care.
Ref
1) Chodosh Joshua, Weinstein Barbara E, Blustein Jan. Face masks can be devastating for people with hearing loss BMJ 2020; 370 :m2683
2) Weiss M, Hansen TG, Engelhardt T,Ensuring safe anaesthesia for neonates, infants and young children: what really matters, Archives of Disease in Childhood 2016;101:650-652.
3) L.K.P. Suen, Y.P. Guo, S.S.K. Ho, C.H. Au-Yeung, S.C. Lam, Comparing mask fit and usability of traditional and nanofibre N95 filtering facepiece respirators before and after nursing procedures, J. Hosp. Infect. 104 (3) (2020) 336e343,https://doi.org/10.1016/j.jhin.2019.09.014.
4) M.J. Coates, A.S. Jundi, M.R. James, Chemical protective clothing: a study into the ability of staff to perform lifesaving procedures, J. Accid. Emerg. Med. 17 (2) (2000) 115e118, https://doi.org/10.1136/emj.17.2.115.
5) Hampton, T., Crunkhorn, R., Lowe, N., Bhat, J., Hogg, E.Afifi, W., . . . Sharma, S. (2020). The negative impact of wearing personal protective equipment on communication during coronavirus disease 2019. The Journal of Laryngology & Otology, 1-11. doi:10.1017/S0022215120001437
6) https://blogs.bmj.com/bmj/2020/05/20/d-deafness-and-solidarity-in-the-co...
7) https://actiononhearingloss.org.uk/about-us/research-and-policy/coronavi...
8) Elkington, P., & Morgan, H. (2020). Personal respirators for population level control of the COVID19 pandemic. Journal of Infection. doi:10.1016/j.jinf.2020.04.025
9) http://www.southend.nhs.uk/about-us/media-centre/southend-news/paediatri...
10) Roberts V. To PAPR or not to PAPR?. Can J Respir Ther. 2014;50(3):87-90.
11) Sinha Ian, Bennett Davara, Taylor-Robinson David C. Children are being sidelined by covid-19 BMJ 2020; 369 :m2061
12) Roberton T, Carter ED, Chou VB, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health2020; [Epub ahead of print.]. doi:10.1016/S2214-109X(20)30229-1 pmid:32405459
Competing interests: No competing interests
Dear Editor
As an over seventy physician with hearing loss, I would like to add an additional hazard for those with behind ear hearing aids. The demands of Corona include wearing a mask, which must find place behind the ears, together with glasses and hearing aids. The tiny hearing aid (which costs a considerable sum), can easily be dislodged when removing the mask, causing much clinical and financial anguish. The over seventies are not known for their fine coordination skills, and vendors of hearing aids and health professionals should include this problem as part of preventive health activity.
Basil Porter MD MPH
Competing interests: No competing interests
Dear Editor
Chodosh et al[1] and Grote et al[2] highlight an important issue but overlook the use of face shields, hoods and other clear barriers that decrease disease transmission, facilitate lip reading, and reduce muffling. Face shields are also easier to manufacture, clean and reuse[3]. They protect the user’s eyes and are more acceptable than masks in a paediatric setting[4].
The suggestion to adopt masks with clear windows is premature given the lack of evidence that they are more effective than face shields. Using a laser particle counter, we found that facemasks and Perspex barriers had similar efficacy in reducing airborne and droplet transmission across a slit lamp[5].
When a higher level of protection is required, clear ventilated hoods can be used and these have been successfully trialled with a view to widespread adoption[6]. The authors have identified a salient problem to which cost effective and viable solutions are available and can be readily applied.
References
1 Chodosh J, Weinstein BE, Blustein J. Face masks can be devastating for people with hearing loss. BMJ 2020;370. doi:10.1136/bmj.m2683
2 Grote H, Izagaren F. Covid-19: The communication needs of D/deaf healthcare workers and patients are being forgotten. BMJ 2020;369. doi:10.1136/bmj.m2372
3 Perencevich EN, Diekema DJ, Edmond MB. Moving Personal Protective Equipment Into the Community: Face Shields and Containment of COVID-19. JAMA 2020;323:2252–3. doi:10.1001/jama.2020.7477
4 Forgie SE, Reitsma J, Spady D, et al. The “Fear Factor” for Surgical Masks and Face Shields, as Perceived by Children and Their Parents. Pediatrics 2009;124:e777–81. doi:10.1542/peds.2008-3709
5 Poostchi A, Kuet M-L, Pegg K, et al. Efficacy of slit lamp breath shields. Eye (Lond) 2020;34:1185–6. doi:10.1038/s41433-020-0940-y
6 Elkington P, Morgan H. Personal respirators for population level control of the COVID19 pandemic. Journal of Infection 2020;81:318–56. doi:10.1016/j.jinf.2020.04.025
Competing interests: No competing interests
Re: Face masks can be devastating for people with hearing loss
Dear Editor
This letter was written to comment on the article “Face masks can be devastating for people with hearing loss, "by Chodosh and colleagues published on July 9, 2020. As a frontline worker, I have first handedly witnessed the drastic and rapid changes made in the clinical setting caused by the corona-virus (Covid-19) pandemic. The Covid-19 pandemic has precipitated change around the world and in the daily lives of many, while there is a lot of focus on numerous of those changes I applaud this article for bringing awareness to one that is often overlooked. According to Higgins and Lieberman (2016) deaf people can be considered a cultural and linguistic minority group, so this article bringing awareness to how personal protective equipment, specifically masks affects their health care experiences and daily lives is very intriguing.
The use of PPEs especially masks pose an additional barrier to communication between deaf individuals or those with hearing loss and clinicians. Lip reading and facial queues are often used in daily conversations but it is especially vital in the deaf community to aid in communication and understanding. Both of these communication enhancers are obscured when wearing a mask.
This article brings awareness to this problem as well as provides strategies to approve communication. The first and basic steps provided concerning awareness and adaptation were very good and a step in the right direction to improving health care experiences in the population with hearing loss. Yellow pads for writing, using speech-to-text technology and voice amplifiers were also good suggestions. The voice amplifiers can pose a patient confidentiality risk if not directly connected to the client’s hearing aids or in an open area by possibly allowing other individuals to over-hear confidential information about that client.
Another suggestion that struck a discord was the clear window face masks. Presuming its cloth, they are not as effective as medical/surgical masks or N95 masks they still offer protection from respiratory droplets. Clear window face masks may impact the wearer’s breathing as the window may limit air flow in and out the mask. It can also cause a visual barrier due to the condensation of one’s breath, ultimately making the visual aid foggy. With awareness comes innovation and engineering to make these issues better, possibly an anti-fog clear window mask can be made to be inexpensive and easily accessible to facilitate its use.
Communication in the health care field is imperative to ensure that the correct information is exchanged. Proper information exchange from patient-to-clinician, vice-versa, and clinician-to-clinician is needed in order not to impede exceptional patient care or efficiency as well as to reduce the chances of medical errors. This article sparks the minds of clinicians to notice and find new ways to work around or address the dilemmas concerning the deaf community or individuals with hearing loss and mask wearing.
Chodosh J, Weinstein B, Blustein J. Face masks can be devastating for people with hearing loss. BMJ. 2020;:m2683
Michael Higgins and Amy M Lieberman, “Deaf Students as a Linguistic and Cultural Minority: Shifting Perspectives and Implications for Teaching and Learning,” January 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416902/.
Competing interests: No competing interests