From the WebMD Archives

July 21, 2020 -- As a primary line of defense against coronavirus, face masks have become the new public norm. However, this barrier of protection has added a barrier of communication for people who are deaf or hard of hearing.

“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,” says the. National Association of the Deaf.

Masks hinder not only lip-readers, but also people who do not lipread, “simply because being able to see the mouth movements and facial expressions are helpful cues to basic communications,” the organization says on its website.

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Coronavirus in Context: The Importance of Facial Coverings and How to Make Our OwnToday’s guest on Coronavirus in Context, WebMD Medical Editor Neha Pathak, breaks down different types of face masks and face coverings, who should be wearing which, and why it shouldn’t make us ignore other protective measures.508

JOHN WHYTE, MD, MPH: Hello, I'm

Dr. John Whyte, Chief Medical

Officer at WebMD,

and welcome to Coronavirus

in Context.

Today, we're going to talk about

whether you should be wearing

something over your face:

mask, covering, whatever it

should be.

And I'm delighted to be joined

by my friend and colleague

Dr. Neha Pathak, who

is medical editor at WebMD.

Neha, thanks for joining me.



NEHA PATHAK, MD: Thank you so

much for having me.



DR. JOHN WHYTE: Let's start off

with what's the difference

between a mask and a covering?



DR. NEHA PATHAK: Sure, so

generally facial masks fall

into two categories,

the N95 respirator,

and the surgical face mask.

The N95 respirator

and the surgical face

masks we're really trying

to prioritize for health care

workers at this point,

so that's where we have

this new addition called

the facial covering.



And actually, people have been

using facial coverings

for a very long time.

But essentially, it's anything

that you can, um, use to create

your own covering that is going

to cover the mouth and the nose

to protect you from droplets

that are incoming,

and then to also protect others

around you from droplets that

are outgoing from your mouth.



DR. JOHN WHYTE: Now we have

a new recommendation

from the CDC that just came out

recently that talked about

cloth facial coverings

in public settings

where other social distancing

measures are

difficult to maintain,

such as grocery stores

and pharmacies,

and in areas

of significant community based

transmission.

It's a voluntary recommendation.

Why do you think this occurred?



DR. NEHA PATHAK: So I think this

is a great question.

I think that, I've really been

doing a deep dive

into the literature around face

masks, facial coverings,

and then transmission

of this new coronavirus.

So I think all of that taken

together really led the CDC

to change this recommendation,

which I think

makes a lot of sense.

And I think there's two pieces

of information

about this particular virus that

really sort of warranted

the CDC to re-evaluate

their understanding,

or their recommendations

around face masks



So the first, I would say,

is really the understanding

around asymptomatic and

pre-symptomatic transmission.

So now they're really

in the literature,

so much evidence of this type

of transmission.

And in some cases,

it seems to be

substantial in some populations.



DR. JOHN WHYTE: And asymptomatic

is the person doesn't have

any symptoms, correct?



DR. NEHA PATHAK: Correct.

Correct.

So asymptomatic and --

those two groups are kind of

grouped together right now.

We don't know what proportion

are completely without symptoms,

what proportion eventually go on

to develop mild symptoms, where

they may not even realize

that they've been sick.

But given that there's so

many people that fall

into that category,

and we have evidence now

from Germany, from China,

from Singapore, where this group

seems to play a large role

in transmitting the virus

to people that are then

vulnerable

and may have

significant complications.



So I think that's one big piece

of information that has led

people to think of ways that we

can protect ourselves

beyond social distancing

and sheltering in place,

because there are situations

where we do have to go out

for essential errands.

I think the other piece

of information

is this question of exactly how

are we transmitting this virus.

So we all know

about droplet transmission.



So droplets essentially are

larger sort of, viral droplets

are essentially a way

for a virus to spread out --



DR. JOHN WHYTE: Yeah.



DR. NEHA PATHAK: -- to other

people --



DR. JOHN WHYTE: [INAUDIBLE].



DR. NEHA PATHAK: -- when we

sneeze and when we cough.

And that's generally what we

think of.

Now, these droplets are

large in size, so they generally

settle out of the air

within a few seconds.

They're not hanging around

in the air.

And then the six feet rule

really comes from the fact

that within six feet,

these droplets have generally

fallen to some surface.



DR. JOHN WHYTE: Those two hand

lengths.

But, but what about people --

or, arm lengths I should say.

But what about those people

that say, you know, Dr. Pathak,

that's a false sense of security

by me wearing

this facial covering.

And again, as you said,

it's not a mask, because we

don't want people to take up

those masks that health

professionals need.

But are we having a false sense

of security?



DR. NEHA PATHAK: Yeah, I think

that that's a great question.

So essentially you have

a false sense of security

if you don't abide

by the social distancing.

If you're think, well, I'm

wearing some sort

of facial coverings,

so let me go out into a group

of people.

I can have a play date as long

as I have my facial covering on.



And the reason that

is a false sense of security

is because there is a potential

that even smaller droplets can

be coming out of our mouths

when we're breathing

or when we're talking.

And the facial covering may not

necessarily protect us

from that, so we still do need

to keep a distance from people.

The other thing to remember

is that it does not in any way,

wearing a facial covering,

take away from the fact

that we still need to be washing

our hands.



DR. JOHN WHYTE: Mm-hmm.



DR. NEHA PATHAK: And as we said,

really keep -- maintain that

social distance if we are out

in an area with a lot of people.

And I would say that there's

a couple of times you want

to wash your hands when you are

putting

on this facial coverings.

So one is before you go

to create your facial covering,

and we'll talk some about that,

um, and then once you have it

on, you do not want to continue

to adjust it, and touch

your face,

and touch the covering,

because then you've contaminated

it.



When you get home, you also want

to wash your hands before you

touch the facial covering.

And that is to make sure

that any virus that may be

on your hands

doesn't now contaminate

the facial covering.

So once --



DR. JOHN WHYTE: You could be

making it worse.



DR. NEHA PATHAK: Exactly.

And then once you remove

the facial covering,

you want to wash your hands

again, because now anything that

was on that face

mask or the facial covering

could be on your fingers.



DR. JOHN WHYTE: Use it once?

Single use?



DR. NEHA PATHAK: Yeah, so it's

the one time that you're

out and about.

You come home and then you want

to make sure that you clean

that facial covering.

This is -- again, the moisture

from your mouth creates a great

environment for other germs

to live.

So really where -- this is not

a one time and I'm going to keep

using it until it's soiled.



DR. JOHN WHYTE: Sure.



DR. NEHA PATHAK: This is I'm

home.

I was out.

Let me wash it.

And really, putting it in your,

um, the way you would wash

any type of laundry,

as long as you're putting it

on a high heat setting when

you're drying it

should be sufficient to kill

any virus.



DR. JOHN WHYTE: So we use

hot water.

Now, we've been talking

about, uh, online

that people are making

their own.

There's a lot of DIY.

And you're going to show us how

to make our own facial covering.



DR. NEHA PATHAK: Yes, so this

is a t-shirt that I've borrowed

from my husband.

But essentially, you want

to fold the t-shirt in half.

And then what you want to do

is you want to bring down

the piece that, uh, where

the collar is.



DR. JOHN WHYTE: OK.



DR. NEHA PATHAK: Bring up

the bottom piece that you have.



DR. JOHN WHYTE: Can you lift

the -- yeah.

Mm-hm.



DR. NEHA PATHAK: Bring up

the bottom piece.

And now you have

a rectangular facial covering.

Um, and then two rubber bands

should be sufficient.

And you want to put it

around the edges of your newly

created facial covering.

And once you've done that,

you've essentially created loops

for your ears.

So you can then put the covering

over your mouth

and loop it around your ears.



DR. JOHN WHYTE: That didn't seem

very hard to do.



[LAUGH]



DR. NEHA PATHAK: Not too bad.



DR. JOHN WHYTE: All right.

Well, Dr. Pathak,

I want to thank you for taking

the time to talk

to us about the importance

of facial coverings

and really helping us make

our own.



DR. NEHA PATHAK: Thank you so

much for having me.



DR. JOHN WHYTE: And thank you

for watching Coronavirus

in Context.

I'm Dr. John Whyte.

Neha Pathak, MD. Medical Editor, WebMD. John Whyte, MD, MPH. Chief Medical Officer, WebMD./delivery/aws/80/9f/809ffd4a-fbf6-3040-8948-544811b852e3/091e9c5e81eae917_caronavirus-in-context-ep-013-neha-pathak-v2_,4500k,2500k,1000k,750k,400k,.mp404/06/2020 21:58:00180012001800x1200_coronavirus_in_context_ep_013_neha_patha/webmd/consumer_assets/site_images/article_thumbnails/video/1800x1200_coronavirus_in_context_ep_013_neha_pathak_v2_video.jpg091e9c5e81eae917

The non-profit urges hearing people be inclusive by using visible written communications and clear masks.

“The lack of support has been one of the hardest challenges we have faced at work during the pandemic,” wrote Helen Grote. MD and Fizz Izagaren, MD, in an article published in the BMJ “It leaves us and our D/deaf patients feeling isolated and ignored.”

Grote and Izagaren say that “a focus on ensuring access to transparent masks, and enabling safe, effective communication for health care workers and patients with hearing loss will be a legacy for years to come.”

The FDA has approved one surgical mask with a fog-resistant clear window, called The Communicator.

The company Safe’N’Clearproduces the mask.

Other clear masks, though not FDA cleared for healthcare use, are also gaining attention with coronavirus. The ClearMask is geared toward the deaf and hard of hearing by allowing full-face visibility and can be purchased in bulk. Individual customers are looking to handmade-goods retailer Etsy who offers high-rating fully transparent masks, as well as anti-fog clear masks.

Safe’N’Clear was founded by Anne McIntosh, who has profound deafness in both ears. She was inspired to create clear masks after undergoing an emergency c-section.

“The nurse, doctor, and even my husband were in surgical garb head to toe, including regular facemasks,” she says. “I was not able to lipread them or to partake in the conversations surrounding our daughter's birth.”

“The Communicator allows the deaf and hard-of-hearing to receive the same protection that others receive without cutting them off from visual communication,” she says.

Safe’N’Clear has increased their supply, but according to McIntosh “the demand still outpaces production.” She says they are having to limit the number of masks sent to each customer in order to reach as many as possible.

“The inability to hug, shake hands, or touch others has made the human smile even more important as we continue the need to establish rapport between providers and patients or between teachers and students,” she says.

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