See-through face masks should be made widely available, leading deaf charities have said, warning that the growing use of face coverings is causing communication difficulties among the 12 million people in the UK who are deaf or have some form of hearing loss. Face coverings must be worn in England on public transport, and by hospital visitors and outpatients, while all hospital staff must wear surgical masks. Face coverings have also been recommended more widely, including in Scotland, in cases where social distancing is difficult. “The main issue is that people who are deaf and have hearing loss rely heavily on visual clues for effective communication – that includes body language, gestures, facial expression and lip-reading,” said Ayla Ozmen, head of research and policy at Action on Hearing Loss. “British sign language (BSL) users also rely heavily on seeing lip patterns as well as facial expressions to understand BSL.” While those who are travelling on public transport in England with someone who relies on lip-reading are exempt from wearing face coverings, something Action on Hearing Loss welcomed, Ozmen said little had been done to publicise this, raising concerns that those legitimately not wearing masks may face abuse. And there are other problems, Ozmen said, noting the rules around masks and face coverings in hospitals come into conflict with the accessible information standard, which puts an obligation on health and social care providers to meet people’s communications needs. “There has been no guidance from the government on how to handle that conflict in both health settings and social care settings,” she said, adding that with more than 70% of people over 70 having hearing loss, many people admitted to hospital with coronavirus may experience difficulties in communication. “We absolutely understand the public health need for wearing PPE but there is also a really significant concern, a safety concern, if people aren’t able to communicate,” said Ozmen. Holly Parker, an 18-year-old from Essex who is profoundly deaf and largely relies on lip reading, said she had encountered problems as a result of face coverings. “My main method of communication is taken away. In shops I am no longer able to understand shopkeepers and this causes me a lot of anxiety,” she said, adding that she was deeply worried about the prospect of going to university if face masks had to be used during practical lessons. Deaf charities, including Action on Hearing Loss, said they welcomed the development of transparent masks, something Parker and others said would make life easier if widely used. Philip Gerrard, chief executive at Deaf Action, said the charity had been testing several prototypes of transparent face masks within the deaf community and hoped it would shortly roll these out to members of staff, clients and the wider community. “We would also like to see the government support the development of deaf-friendly face masks that are PPE approved in hospitals and care settings throughout the UK,” he said. Ian Noon, head of policy at the National Deaf Children’s Society, agreed, adding: “In the meantime, if people pick up some deaf awareness tips like being patient, writing things down or using gestures if a deaf person needs them to, this would also have a big impact.” The deafness, cognition and language research centre at University College London also issued a statement calling for greater awareness of the challenges around hearing difficulties and face masks, but said transparent face shields were a better solution, because they let the whole face be seen. But, it added, dialogue with deaf communities was crucial, noting: “Deaf and hard-of-hearing people are best placed to advise on design needs and ensure any products are fit for purpose.”