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Editorials

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:m2683

Linked 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

Rapid Response:

Re: Face masks can be devastating for people with hearing loss

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

01 August 2020
Shelly-Ann Moore
Clinical Instructor
The University of the West Indies, Mona