Coronavirus: Concerns raised over face masks and lipreading

As the coronavirus pandemic continues, The Limping Chicken has been investigating how the outbreak has affected different members of the Deaf community.

With concerns being raised over supplies of personal protective equipment, Liam O’Dell looks into the issue of face masks and fears this may impact communication for deaf people.

“Face masks, two-metre distancing and other challenges are adding considerable strain and burden to people with hearing loss as they seek to stay in touch with family and friends, use important services, and navigate workplace communication,” says Sally Shaw, founder of Ideas for Ears. “To prevent a downward cycle of isolation and exclusion, there is a need to identify the most helpful and realistic actions that can reduce the impact.

“This is likely to involve a combination of solutions that are about the behaviour of people and the use of technology and equipment,” she adds.

Her organisation, which focusses on access and the inclusion of people with hearing loss, has just published the results of their survey of over 300 people on face masks. Of the 249 respondents who identified as having a hearing loss, 89% of them said they had experienced difficulties caused by facial coverings.

79% went on to say face masks “will make life with hearing loss or deafness much harder”.

When asked about the specific issues which come with facial coverings, 87% of those with hearing loss said it was around the blocked visibility of the face or mouth, preventing lipreading. Almost three quarters of them said masks ‘muffled voices and reduced clarity’.

The findings follow the release of non-mandatory guidance around face coverings from the Scottish Government last week.

The information states that coverings made from cloth and other textiles – as opposed to medical grade masks – may be worn in circumstances such as travelling on public transport or entering a food shop, “where it is not always possible to maintain a two-metre distance from another customer”.

The guidance reads: “As some people can have the virus but experience no symptoms (asymptomatic infection), wearing a face covering in [these situations] may provide some level of protection against transmission to other people in close proximity.

“We are recommending that you consider using face coverings in the limited circumstances described above as a precautionary measure,” it continues. “Given that the evidence of impact on transmission is relatively weak, the public use of facial coverings is not being made mandatory and will not be enforced at this stage.”

The British Medical Association, which represents all UK doctors and medical students, said at the end of April that the Government should explore the use of face coverings by the public, with priority given to NHS workers when it comes to personal protective equipment (PPE).

In the daily coronavirus briefing on Tuesday, Health Secretary Matt Hancock said the UK Government’s position on face masks “hasn’t changed”, adding that the “most important thing people can do” is social distancing, compared to the “weak science” around members of the public wearing face coverings.

Professor Angela McLean, deputy chief scientific advisor, added that the Government’s Scientific Advisory Group for Emergencies (SAGE) recommended that there is “weak evidence of a small effect” in which a face mask “can prevent a source of infection going from somebody who is infected to the people around them”.

A few days later, Prime Minister Boris Johnson told reporters on Thursday: “What I think SAGE is saying – what I certainly agree with – is that as part of coming out of the lockdown, I do think that face coverings will be useful”

He added that more information about the issue will be revealed this week.

While the conversation continues over whether the public should wear face coverings, Deaf health workers have posted online to express their concern over a lack of PPE, and Deaf individuals have already encountered communication barriers when it comes to face masks being worn by medical professionals.

In a video from interpreting service BSLHealthAccess, one Deaf person, referred to as ‘Pete’, had an ambulance sent to his home after NHS 111 suspected he had sepsis.

“An hour later the ambulance arrived, the paramedics were wearing facemasks which meant Pete and his wife were unable to read their lips and couldn’t understand what they were saying.

“The couple had no choice but to ask their hearing child to act as a make-shift interpreter,” the video says.

Pete later tested positive for coronavirus and was only able to communicate with doctors and nurses by using a pen and paper.

SignHealth, the deaf health charity funding BSLHealthAccess, says the service has been set up to help when Deaf people struggle to communicate with medical professionals wearing PPE. It is just one of the creations which have surfaced to support deaf people in the crisis.

In the United States, deaf education student Ashley Lawrence designed clear face masks to aid lip-reading. Writing on Facebook, she says: “Right before the pandemic, masks were made and made commercialized to help people with hearing loss have access to their doctor’s mouths for lip reading/speech reading.

“Because of the shortage of masks, everyone started making their own, so I thought: why not make them for all?”

The 21-year-old has received over $3,000 in donations on the fundraising site GoFundMe, and later shared a document with instructions to enable others to create the see-through versions of the masks.

Elsewhere, in the UK, software company Widgit has created a communication chart for critical care patients in hospital with coronavirus, while an NHS anaesthetist has launched CARDMEDIC – a collection of online flashcards covering medical topics – with the view to develop an app containing illustrations and British Sign Language videos.

Dr Rachael Grimaldi, founder of CARDMEDIC, says: “Unable to be patient-facing during the COVID-19 pandemic, I was desperate to do something to help while on maternity leave. What started out as me wondering if healthcare staff could use a pen and paper to communicate with patients, within 72 hours, turned into an online A-Z index of digital flashcards.

“Initially, I thought I would share the site with colleagues at Brighton and Sussex University Hospitals NHS Trust, and it would hopefully help make a difference to a few patients,” she continues. “I never envisaged it would have grown so rapidly and at such pace.”

The digital flashcards are now being used by hospitals across the UK, with support from the Department for International Trade leading to the communication tool being utilised in 47 countries.

When asked by The Limping Chicken if guidance had been created around face masks and communicating with deaf and hard of people, a Public Health England spokesperson said that guidance is written for settings in which staff work, as opposed to individual roles.

They went on to add that it is the responsibility of hospital trusts “to communicate the clinical options available to a patient”, working with “patients and interpreting services” to make sure this happens.

By Liam O’Dell. Liam is a mildly deaf freelance journalist and blogger from Bedfordshire. He wears bilateral hearing aids and can be found talking about disability, theatre, politics and more on Twitter and on his website.

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This article is the eighth and final report in our ongoing series on coronavirus and how it affects different members of the Deaf community. Previous pieces in the series have covered the pandemic’s impact on:

• British Sign Language interpreters
• Deaf university students
• Deaf mental health
• Deaf charities
• Access to government announcements
• Deafblind people
• Local Deaf clubs