If you think your face mask is an annoying inconvenience, just imagine how much trouble it is for the deaf and hard of hearing people in your midst.

Months into the COVID-19 pandemic, wearing masks to prevent the spread of coronavirus has become a normal facet of public life. But for people who often rely on lipreading to communicate, the prevalence of masks has become a major obstacle.

“I have experienced people who have talked just repeatedly with a mask on and I have no idea they’re talking to me,” John Moore, executive director of Ohio nonprofit Deaf Services Center (DSC), said through an American Sign Language (ASL) interpreter. “I had no idea. I can’t read your lips. I don’t even know that you’re talking.”

Since accelerating to the point of business closures and stay-at-home orders in mid-March, the pandemic has altered countless aspects of modern life. That includes many functions of the DSC, which provides a range of services across Ohio, including interpreting, camps for deaf youth, peer-to-peer support and American Sign Language classes. Deaf-blind clients, whom DSC provides with equipment to help them communicate and safely navigate their homes, were hit the hardest, Moore said: “They require physical contact with tactile communication, so we are required to go to their homes.”

After a six-week lull from March to May, DSC’s services to the deaf-blind population have resumed with social distancing measures in place. The center’s ASL classes have gone online. Temperature checks are now required for anyone visiting the center’s Worthington campus. But the face mask problem persists for Ohio’s roughly 1.6 million deaf and hard of hearing people (a total that balloons to 40 million across the United States).

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Even for people communicating in ASL, the masks present complications, Dennis Williams, a preschool teacher at the Ohio School for the Deaf (OSD), said through an interpreter. “The mouth is part of the ASL language,” Williams said, including numerous signs that involve touching the face. “The eyes communicate. Tone, body, it’s all linked up.”

Things get even muddier when trying to understand spoken English from behind a mask. “You can’t see the expressions of the person,” Moore said. “You can’t see their jawline. When a mask is being used, you cannot lipread. You only see eyebrows.”

Moore called widespread mask usage the most significant communication barrier that has arisen on a societal level in his lifetime. Erin Carberry agrees. “I knew right away it was going to be challenging,” said Carberry, a preschool teacher’s aide at OSD. Carberry is deaf, but thanks to hearing aids and a cochlear implant, she can effectively converse in English under normal circumstances. “I’m a little bit stubborn,” she said. “I like to be able to communicate for myself. I don’t want to rely on using the phone or using paper because I can talk.”

Still, a trip to the bank in April proved difficult. “They had the glass in front of us, and they were wearing a mask, and I was wearing a mask,” Carberry said. “They couldn’t understand me, and I couldn’t understand them. I was really frustrated. Luckily I brought paper with me so we wrote back and forth.”

Some deaf people have begun actively working to sidestep such encounters. “I do carefully plan when I run errands and how often I go out so I do not have to deal with not being able to have clear communication,” said Erin Royse, who teaches seventh grade math and science to deaf and hard of hearing students at Dominion Middle School.

Others haven’t had the luxury of avoiding contact. “There are several deaf and hard of hearing people who were essential employees during the shutdown working in environments that require constant communication,” Royse said. “A lot of workplaces really had to work hard to accommodate and make modifications in how they were running things.”

Communication breakdowns can be frustrating under any circumstances, but especially when someone’s health is at stake. The National Association of the Deaf’s FAQ page explains, “Due to the pandemic, more and more medical professionals are treating COVID-19 patients from behind a barrier, using masks that impede lip-reading, and not allowing in-person interpreters.” The association has issued guidelines for medical professionals and deaf people alike, reminding them of rights and regulations under the Americans with Disabilities Act and Rehabilitation Act.

So far, there is no perfect solution to the face mask problem. Some, like Carberry, carry a pen and pad. Moore sometimes uses phone apps to type out messages, but in the COVID era, “You can’t really have people touching your phone back and forth,” he said. People have sometimes briefly pulled down their masks so he can lipread, which more or less defeats the purpose of the mask.

As lockdown wore on, more companies began to offer masks that leave the mouth visible through a clear plastic strip, but you have to special order them, something most hearing people wouldn’t think to do. Even with a surge of amateurs selling their own homemade versions, these masks have sometimes been hard to come by as suppliers struggle to catch up with demand. According to the MIT Technology Review, as of May, orders from a company called ClearMask had increased 566 fold compared to last year. If you do manage to acquire a clear mask, “It can have a potential to fog,” Williams said. “Then there you are back at square one with not being able to see the mouth movements.”

As glasses wearers know, fogged-up surfaces can be a problem on the receiving end of communication, as well. This has multiplied complications for people like Williams, who is legally blind in addition to being deaf. “I do have a very heavy eyeglasses prescription,” he said. “So then if I am wearing a mask, it fogs my glasses, so I have to pull my mask away and get my glasses to clear up. And so it’s tough. I feel like I can’t hear, I can’t see and I have a mask. It’s kind of crazy. I feel like I can’t function.”

The mask situation may reach a new frontier this fall if schools resume in-class instruction. It was hard enough for deaf students to adjust to remote learning this spring, before companies like Zoom and Google began implementing more advanced captioning services and other support functions. “Students who are deaf or hard of hearing, along with adults who work in the education setting around the world, are going to struggle when we are cleared to return to work but still have to wear a mask,” Royse said.

Even in school environments where signing is the norm, the masks could present problems. “A lot of our kids are not fluent signers yet,” Carberry said. “A typical kid, when they’re talking, they babble. It’s the same thing with signing. If they’re still learning and they’re not able to fully express themselves completely, and if they have to wear a mask, that’s going to be a bit challenging and awkward for them.”

“In general, people do not think about the deaf and hard of hearing students that are in the school system,” Moore said. “So people are going to show up and they’re going to have masks, and they’re not going to have clear openings in the mouth, and there’s going to be a teacher and students and they’re all mingling around, and then your deaf and hard of hearing students [are] going to be lost. I would just encourage the school systems, if they do have deaf and hard of hearing students in their schools, to provide the teachers with clear masks.”

Teachers aren’t the only ones who should have clear masks on hand, Moore said. “I would encourage people who are in the medical field, doctors, nurses, or if they’re in public service, even at, like, Target and CVS, the people who are generally in the public and are available to help folks like me who are deaf that show up,” Moore said. “If they could have a [clear] mask ready, that would be nice if they had that for clear communication.”

And for anyone out there who wants to accommodate the deaf and hard of hearing population, there is one solution that predates the pandemic by many years. “They can take a sign language class,” Moore said, “and they can start signing with me.”