I Can’t Hear You: Face Masks and the impact on hearing impaired and deaf people at work

Face masks or some form of facial covering are legally required in most indoor public spaces and on public transport in the UK and have been for several months in an attempt to reduce the spread of Covid-19. Wearing a mask is a relatively selfless act (legal obligation aside) in the sense that the mask wearer, in covering their face, protects their fellow citizens more effectively than they themselves reap the protective benefits.

Despite the proven advantages of wearing a mask from a virus control point of view, some people see it as an inconvenience. Tensions between those who are respecting the law and those who are not (exemptions on health grounds not included) have been reported, such as by shop workers. 

The potential for conflict over the enforcement of mask-wearing has been highlighted by the shop workers’ trade union Usdaw as serious enough that shop workers are not obliged to confront customers who do not wear a mask.

But for the 12 million people in the UK with a hearing impairment, the issues surrounding the widespread use of face masks are more multi-faceted.

As Sue Evans, joint Chief Executive of the Royal Association for Deaf People explained, “Communication for deaf people relies in part on being able to see someone’s face clearly – whether this is for lip-reading, understanding facial expressions or for understanding non-verbal communication more widely (e.g. seeing whether someone is smiling or looks upset).”

Therefore, face masks which cover half of a person’s face, including their mouth, present a great challenge for deaf or hard of hearing people.

While temporary removal of a face mask upon request by someone with a hearing impairment constitutes a legal exemption in the UK, the safety implications of this are not yet fully understood. This is of particular concern for people who work with those who rely on lip-reading and thus may spend extended periods of time with their faces uncovered. 

Action on Hearing Loss are among the groups currently calling for greater government clarity on this issue.

And, as how wearing a mask protects others more than it does oneself from the virus, the person who wishes to lip-read is reliant on others wearing a see-through mask that then facilitates this form of communication.

Once more, while face masks with a transparent window to allow someone to lip-read may seem like a good solution to the communication difficulties faced by those who are deaf or hard of hearing, they are not without their drawbacks.

From a Covid-19 point of view, evidence is unclear regarding the efficacy of plastic (used for the see-through windows) in protecting the emission of respiratory droplets from the wearer. Only one company’s clear face masks have been approved by the UK’s Department of Health as guaranteed to be sufficiently protective. 

Aside from how a see-through mask may or may not afford as much protection against the virus as a cloth mask, they also pose further problems for someone who is hard of hearing.

For example, as the Ideas for Ears blog points out, some masks’ plastic windows muffle sound, thus posing a significant communication barrier for people with partial hearing ability. The transparent panel can also reflect light or fog up if the manufacturer fails to account for this when choosing the type of see-through material to use. 

All of these issues, while arising as a result of the transparent mask-wearer’s willingness to facilitate easier communication with someone who is deaf or hard of hearing, can lead to communication being made even more difficult – light reflection or a fogged-up window can obscure the mouth.

Yet, many of the people with a hearing impairment in the UK who would benefit from widespread use of transparent face masks have to instead navigate communication through opaque face coverings. This is, among other reasons, because windowed face masks are more difficult to clean (they cannot necessarily be machine washed like a cloth mask), more difficult to make at home, and they are not sold as widely in shops. For these reasons, the onus is on the individual to seek out a hearing impairment-friendly mask.

Some activists see the lack of widespread availability of these masks as a failing on the part of the Government to consider people with hearing impairments as part of their response to the Covid-19 pandemic.

A prominent example of an activist going to great lengths to demonstrate their frustration is Lynn Stewart-Taylor. She walked from Gloucester to Downing Street earlier this month to “shame” the Government into resolving the lack of British Sign Language interpreters at Covid-19 press briefings.

Charities such as Deaf Action have been raising funds in order to distribute transparent masks to front-line workers themselves, to supplement the 250,000 supplied by the Government. The Institute of Fiscal Studies estimates that there are around seven million key or front-line workers in the UK. 

Action on Hearing Loss and many other hearing health charities have dedicated pages on their websites for information on how to best communicate with someone who is deaf or hard of hearing during the pandemic.

Shari Eberts, hearing health advocate and founder of LivingWithHearingLoss.com urges people “ [to] be open to using other methods of communication such as using speech-to-text apps which turn the spoken word into text or writing notes, if necessary. Communication is a two-way street and requires effort from both sides.”

Cambridgeshire Deaf Association has found a solution to the issue of getting a person’s attention in order to ask them to remove their mask – something which, although seemingly simple to someone with full hearing, is difficult for someone with a hearing impairment. The charity distributes ‘I am a lip-reader’ badges to those who will benefit from having this information conveyed to the people around them at a glance.

But the difficulties that deaf and hard of hearing people face during the pandemic extend beyond speaking to a shop assistant or watching a broadcast live from Downing Street. 

As presented in the Citizens Advice ‘Unequal Crisis’ report published in August, workers with disabilities or long-term health conditions have been disproportionately made redundant during the pandemic. 

One of the reasons for this is that workers who cannot wear face coverings on health grounds may have opted to go on furlough to protect themselves and others. The Citizens Advice report shows that people already on furlough have been targeted for redundancies.

Wearing a mask can be difficult for someone with a hearing impairment as the ear loops can interfere with a hearing aid microphone or the external hearing aid itself. 

But for those employees who are deaf and continuing to interact with colleagues in person in their normal workplace, transparent masks are, again, crucial to being able to do their job as usual.

A spokesperson for Hearing Link said: “Face coverings provide an extra layer of protection against the spread of coronavirus, in addition to social distancing measures, but it can make communication in the workplace incredibly difficult for those who rely on lipreading.

 “Wearing a clear face covering within a workplace could help reduce the barriers lipreaders have to face, making their lives much easier.”

In addition to being potentially more vulnerable to redundancy than a person without a hearing impairment, home-working can be particularly isolating for someone who is deaf or hard of hearing.

A greater reliance on phone calls for communication between colleagues – either about work or to catch up and boost morale more generally – means that someone who relies on lip-reading or written communication loses out on opportunities to collaborate or to touch base with colleagues. This can adversely impact motivation and mental health at work – two things which employees without a hearing impairment working from home struggle with as it is.

Working in a healthcare setting with a hearing impairment is equally as challenging, as the job revolves around communicating with patients, often in order to determine the nature of symptoms or to obtain consent for certain treatments. The consequences of miscommunication, therefore, have the potential to be life-threatening in some cases. Fizz Izagaren, a paediatric doctor in Surrey who is profoundly deaf, told the BBC of her struggles communicating with both patients and colleagues if they happen not to be wearing transparent masks.

An added difficulty in a healthcare setting is that PPE has to be strictly approved, thus limiting workers’ ability to source their own transparent mask in order to better communicate with hard of hearing colleagues, as well as patients with hearing loss. 

According to the British Medical Journal, up to two-thirds of people over 70 have a “clinically significant” hearing impairment and, given that this demographic is the most seriously affected by Covid-19, how to communicate safely with patients is a real concern for UK healthcare as a whole. 

However, despite criticisms levelled by lobbyists such as Lynn Stewart-Taylor, the Government has been taking steps to tackle Covid-related employment issues from a hearing impaired standpoint.

In April, the Department for Work and Pensions announced a video relay service for users of the Universal Credit online system. The press release explained that this allowed “British Sign Language users [to] easily access Universal Credit through a video relay service provided by the Department for Work and Pensions” and that “[t]he move will support many of the 87,000 Deaf BSL users currently living in the UK.”

This improved service is a positive example of a step taken to make life easier for people who are deaf or hard of hearing during the current Covid-19 pandemic.

Charities and other activists are demonstrably committed to putting pressure on the Government to continue to consider the needs of people with disabilities whose needs can be forgotten amongst those of the rest of the population. However, in the meantime, the best solution to the problem of face masks and lip-reading seems to be clear, literally.

Sue Evans from the Royal Association for Deaf People: “We are acutely aware of the effect that the pandemic is having on many people’s wellbeing and the lack of access for a deaf people further exacerbates this situation. There are clear masks available which can assist in some situations and we implore people to use these where possible and/or make every effort to understand the challenges that deaf people face at work and make the necessary adjustments.”

Freelance journalist Liam O’Dell echoed the importance of wearing a clear face covering, making reference to his personal experience day-to-day as someone with a hearing impairment: For the longest time, I’ve been anxious about venturing outside into public areas […] I have wondered if some of the anxiety came from the potential for me to misunderstand someone who is wearing an ‘opaque’ face mask […]”

He explained that a positive experience at his barber’s helped alleviate some of this anxiety: “all of the staff were wearing clear face shields. I could see their full facial expressions and while I don’t believe I consciously lipread people, it certainly helped me to understand what they were saying.”

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