The COVID-19 Dilemma: Protection versus Hearing

With the occurrence of coronavirus in late 2019 (COVID-19) and subsequent Worldwide pandemic spread, we have been confronted with learning the history of progression and steps to protect ourselves while living our daily lives.

We know the disease arose from Wuhan, China sometime in the Fall of 2019 and experienced a global spread through every country.  In the United States, the current administration discarded the national plan to handle the possibility of any pandemic in early 2017 and closed the office of global health security in May 2018.  The arrival of this virus in the United States was at least in February 2020, if not before.

The guidelines for the protection of our citizens, include, but are not limited to: wearing face masks, practicing social distancing of at least six feet, frequent hand washing, avoiding groups of more than ten people and especially large crowds, and more.

The required use of protective face coverings have presented a unique problem to those who have a documented hearing loss and those who have a receptive communication deficit but have not sought the help of an audiologist.  In the US, there are more than 48 million people with hearing loss and it is the invisible handicap.

While medical masks help prevent the spread of the disease to and from individuals, they also block the visual modality to view facial expressions, allow for speech-reading (lipreading), and reduce the projected volume from the speaker by 4 to 12 decibels.  Communication is made more difficult for everyone and especially hearing impaired people.  We hear what we see.  Those with hearing difficulty experience an elimination of comprehension without the required visual clues.  Masks make undocumented hearing loss evident and communication exhausting.

Plastic masks allow others to see the mouth and more of the speaker’s face, but the mask tends to fog up.  The plastic face shield allows the recipient to view the entire face for better speech-reading and oxygen for the speaker, but the data is not available for its protective effectiveness.

For those who wear behind-the-ear amplification it is best to put the hearing aids on first so the devices are next to their head.  Then place the string or straps behind and next to the ear to prevent tangling with the hearing aids.  When the person removes the strap from behind the ear, the face mask won’t pull the devices off the ear.


In communicating with a person with hearing difficulty it is critical to speak slowly, rephrase remarks not understood, decrease background noise, face each other, take turns speaking, don’t shout, and the hearing impaired person must be wearing their hearing aids.

With COVID-19 requiring the wearing of protective masks, people with undocumented hearing loss and receptive communication difficulty now realize they have poor hearing.  The first step to better hearing is to schedule an appointment with a board certified and licensed private practice audiologist for a complete audiological evaluation today!

(Sources: U.S. Government, New York Times, Washington Post, Healthy Hearing, Living With Hearing Loss, Hearing Health Matters,,, and WCCO Minnesota)


Thank you for the information about the hearing impaired patients, that will be useful information to share with healthcare workers caring for these patients. We have run into this multiple times since we have to wear masks.


It is amazing how one activity can have an adverse effect on something seemingly unrelated. I never thought of masks causing problems for those with hearing loss to communicate. Very insightful article.

-William R. Cunningham