With the introduction of mandatory face masks following the COVID19 pandemic and Safe distancing in most of the places of work, it is a huge challenge for those who are hard of hearing and depend on lip-reading. Working in the NHS, I know more than a couple of people whose life has been affected and there will still be many more who would still be suffering in deep silence. This is only the tip of the iceberg. This should be a wakeup call.

As for an example, I was reviewing a mortality note where the patient depended on lip reading but was struggling as the nurses and doctors were all wearing face masks. Health professionals tried using written prompts/ materials for her but it was struggle for her. Later she had delirium which further complicated the matters for the worse. This jolted me hence started to explore further.

Now, I am aware of a receptionist in a hospital who depended mostly on lip reading and she struggles a lot with patients, visitors, and their relatives as their faces are covered with a face mask (fortunately, she has been deployed in some other area now) in this new pandemic. Another story of a medical student while placed in the theatre even before the COVID19 pandemic hit us, she struggled as everyone was wearing masks as knowingly or unknowingly she depended on lip reading as she is partially deaf. This pandemic also opened up some of the handicaps which were not very overt. For some the coping mechanism was being utilised without the knowledge of the sufferer as the remedy was in hand! Recently there was an article in the BMJ regarding the issue with surgical masks and exploring transparent mask too.

Not only about the lip reading, that is surely a problem which has been exposed by the surgical masks, one also is not able to see the subtle expressions of optimism, challenge, agreement, disagreement, fear, apprehension and so many other facial expressions which speak volumes in our day to day clinical practice. This is completely lost with the masks on. In day to day clinical practice, facial expressions are very important which as clinicians we are missing and our patients and their carer’s are struggling to cope. This is further compounded by the fact that we are working in a very stressful environment due to the pandemic and it is going to be that way for some time to come.

There are lots of people who are deaf or partially deaf who depend on lip reading especially the age group that we care for (being a geriatrician). However, it can also affect others i.e. Students, shops, selfemployed and many more.

Providing a transparent face mask will reduce this handicap and alleviate associated anxieties. We should endeavour to optimise the experience of those who we look after especially these vulnerable patients who are coming at a time when everything looks hostile. It is the right time to address this issue and make adjustments to the new norms that we are experiencing each day.

Dr Anil Kumar
Consultant Physician and Geriatrician
University Hospital of North Midlands
County Hospital, Stafford