“We have been concerned about this issue from the start of the pandemic as many with hearing loss struggle much more in conditions where others are wearing masks,” said Dr. Debara Tucci, who directs the National Institute on Deafness and Other Communication Disorders, a part of the National Institutes of Health.

A new study published Wednesday in PLOS One has tackled the problem by comparing four ways of masking up: using two different kinds of cloth masks, a surgical mask and an N95 mask, which filters 95% of tiny virus particles. The study did not investigate double masking.

“In the context of the pandemic, we were motivated to look at this issue more closely, since there was little previous research on how different types of masks affect speech,” said study author Joseph Toscano, an assistant professor of psychological and brain sciences who directs the cognitive science program at Villanova University in Pennsylvania.

“In high levels of background noise, the surgical mask was shown to least hinder speech recognition, said Dr. Jawad Fares, a postdoctoral research fellow in the department of neurological surgery at the Feinberg School of Medicine in Chicago’s Northwestern University.

“The findings of the study are important in light of the current pandemic, as it acknowledges the communication challenges that we are facing,” said Fares, who was not involved in the study.


Statistics have shown almost 25% of people ages 65 to 74 and 50% of people over 75 in the United States have disabling hearing loss — where they wouldn’t be able to hear a vacuum cleaner, barking dog or even a baby’s cry.

And it’s not just the elderly. Globally, some 466 million people have disabling hearing loss — 34 million are children, according to the World Health Organization. One in eight people in the United States 12 years or older have some form of hearing loss in both ears.

Many people with hearing loss — and even some who don’t — rely on lip reading to follow conversational speech. That tool, of course, is removed by the use of masks during the pandemic.

The good news is that when background noise was limited, as is typical of many everyday settings, the study found cloth, surgical and N95 masks allowed speech to be conveyed effectively, Toscano said.

When background noise was loud enough that it might interfere with understanding speech, “we found that a surgical mask worked better than other masks for communication,” Toscano said.

“The finding that surgical masks cause less of a problem than cloth masks or N95 masks is interesting,” said NIDCD’s Tucci. “However, these (surgical masks) are not always available to the public, and certainly early on use of these masks was discouraged so as not to interfere with supply for use in medical facilities.”


Designed to be used by surgeons and other health-care professionals, surgical-grade masks are loose-fitting, disposable devices meant to “help block large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria), keeping it from reaching your mouth and nose,” according to the U.S. Food and Drug Administration.

True medical-grade masks are made of three layers of nonwoven fabric typically made from plastic. The colored top layer of fabric is made of medical-grade spunbond polypropylene, which is a resin polymer heat-bonded into a weblike structure.

Surgical masks also have small, bendable wires to help the mask stay in place, and are often tied behind the head or secured with ear ties. Such masks are one-time use only. If they are soiled or breathing becomes difficult, the mask should be carefully discarded and replaced, the FDA said.


The NIDCD and the U.S. Centers for Disease Control and Prevention suggest teachers and caregivers wear clear masks or cloth masks with a see-through plastic panel when interacting with young children learning to read, students learning new languages or people with hearing loss or disabilities.

That would certainly apply to caregiving in hospitals, nursing homes and long-term care facilities, and within families of mixed generations. Now it appears that there could be a new option, Tucci said, because the study found that “intelligibility is better with surgical masks.”

“It is worth emphasizing to the public that if they are struggling to communicate — for example if they have a close family member or friend who struggles to hear — it would be worthwhile to procure either surgical masks or masks with a transparent panel to see if that is helpful,” she said.


There are also many other ways to improve communication.

First, try to avoid loud background noise. Turn off the television, music and other distractions or move to a quieter area.

Modulate your voice so your speech is deliberately clear and precise. This approach was just as easily understood with a mask on as when the mask was off, a separate new study published in Cognition found. Speaking this way is much more understandable than casual or emotionally charged and hurried speech.

“Altering speech rate and vocal intensity is also helpful,” said Fares, who co-authored a December 2020 study on coping strategies to ease communication with face masks

That means slowing down the pace of your speech, even when you’re excited or upset.

Speak face to face. Another good technique is “facing the communication partner directly,” Fares said. That ensures that the “communicator has the receiver’s attention while nothing is blocking the visual field between them.”

Use nonverbal cues. This is critical for clear communication, experts said.

Face masks only cover the middle and lower parts of the face, Fares said, so speakers can use their eyebrows, eyes and upper cheeks to improve understanding.

“For example, the emotion of happiness is usually perceived when the corners of the lips rise upward. With face masks, happiness can be caught on the face by focusing on the wrinkles at the edge of the eyes,” Fares said. “The eyebrows, specifically, have been shown to help in conveying emotional expression and nonverbal communication.”

Take sadness, for example. People tend to raise the inner corners of the eyebrows, with eyelids loose, Fares explained.

“Expression of anger emphasizes the downward and central movement of eyebrows and the glaring eyes. The expressions of surprise and shock, however, are usually formed of elevated eyebrows,” he said.

Body movement can also facilitate communication. Nod in agreement, hold up a finger to request a chance to speak or lean in to show engagement. Watch the other person carefully for signs of confusion, such as lack of eye contact or slumping of the body.

Don’t be afraid to stop and ask the other person if they are having trouble. Check to make sure they understand the conversation, the NIDCD recommends. It’s also OK to write something down or use a talk-to-text application on a smartphone to facilitate communications.

Don’t take off your masks. Whatever you do, just don’t, experts say.

“First and foremost, the emphasis should be on the effectiveness of the masks for preventing the spread of the virus,” Toscano said. “Our study suggests that concerns about speech communication, on their own, don’t provide a compelling reason not to wear a mask in everyday settings.”

Source: https://www.ctvnews.ca/lifestyle/which-face-mask-is-best-for-communication-a-new-study-weighs-in-1.5322835

By Sandee LaMotte


You’re fully vaccinated against the coronavirus — now what? Don’t expect to shed your mask and get back to normal activities right away.

That’s going to be a disappointment, if not a shock, to many people.

In Miami, 81-year-old Noemi Caraballo got her second dose on Tuesday and is looking forward to seeing friends, resuming fitness classes and running errands after nearly a year of being extremely cautious, even ordering groceries online.

“Her line is, `I’m tired of talking to the cats and the parrots,”‘ said her daughter Susan Caraballo. “She wants to do things and talk to people.”

But the U.S. Centers for Disease Control and Prevention hasn’t yet changed its guidelines: At least for now, people should follow the same rules as everybody else about wearing a mask, keeping a 6-foot distance and avoiding crowds — even after they’ve gotten their second vaccine dose.

Vaccines in use so far require two doses, and experts say especially don’t let your guard down after the first dose.

“You’re asking a very logical question,” Dr. Anthony Fauci, the top U.S. infectious disease expert, responded when a 91-year-old California woman recently asked if she and her vaccinated friends could resume their mah-jongg games.

In that webcast exchange, Fauci only could point to the CDC’s recommendations, which so far are mum about exceptions for vaccinated people getting together. “Hang on,” he told the woman, saying he expected updates to the guidelines as more people get the coveted shots.

What experts also need to learn: The vaccines are highly effective at preventing symptomatic COVID-19, especially severe illness and death — but no one yet knows how well they block spread of the coronavirus.

It’s great if the vaccine means someone who otherwise would have been hospitalized instead just has the sniffles, or even no symptoms. But “the looming question,” Fauci said during a White House coronavirus response briefing last week, is whether a person infected despite vaccination can still, unwittingly, infect someone else.

Studies are underway to find out, and hints are starting to emerge. Fauci pointed to recent research from Spain showing the more coronavirus an infected person harbours — what’s called the viral load — the more infectious they are. That’s not surprising, as it’s true with other illnesses.

Some preliminary findings from Israel have suggested people infected after the first vaccine dose, when they’re only partially protected, had smaller viral loads than unvaccinated people who got infected. That’s encouraging if the findings hold up. Israel has vaccinated a large fraction of its population and scientists worldwide are watching how the outbreak responds as those inoculations increase.

Also critical is tracking whether the vaccines protect against new, mutated versions of the virus that are spreading rapidly in some countries, added Dr. Walter Orenstein, an infectious disease expert at Emory University. He’s been vaccinated and is scrupulously following the CDC guidelines.

There are practical reasons. “It’s hard to tell who got vaccinated and who didn’t if you’re just walking around the grocery store,” noted University of Pennsylvania immunologist E. John Wherry.

And experts like Wherry get asked, repeatedly: Yes, there are rules for being in public, but what’s safe for Grandma to do at home, with family or close friends, after she’s vaccinated?

Not everyone’s immune system is boosted equally from vaccines — so someone with cancer or the frail elderly may not get as much protection as a robust 70-something.

But most people should feel “more confident about going shopping, for example, or going to see your grandkids, or giving your daughter a hug,” Wherry said.

That’s because the chances of a fully vaccinated person getting seriously ill, while not zero, are low.

“Friends coming over for dinner, we should still try to follow the guidelines,” Wherry added. “You never know who is compromised, where the vaccine may not work as well.”

What if the fully vaccinated are exposed to someone who’s infected? The CDC did recently ease those rules: No quarantine as long as the vaccinated person shows no symptoms and it’s been at least two weeks but not longer than three months since their second dose.

Getting on an airplane? Vaccinated or not, the CDC still urges essential travel only.

International travel is an even tougher prospect. Expect countries that already have different quarantine and test requirements to come up with varying post-vaccination guidelines — especially since multiple types of vaccines, some better proven than others, are used around the world. There’s also the concern about carrying those worrisome mutations from one country to another.

Stay tuned for updates to the advice as more people get vaccinated. Meanwhile, don’t underestimate how important it is for the vaccinated to feel less anxiety as they run errands or go to work while still following the public health measures, said Dr. Luciana Borio, a former Food and Drug Administration scientist.

Even with a trip to the grocery store, “there was always this anxiety about, ‘Was that the contact that’s going to make me infected?”‘ Borio said. “That is a very powerful change in one’s living situation.”

Source: https://www.ctvnews.ca/health/coronavirus/what-s-safe-after-covid-19-vaccination-don-t-shed-masks-yet-cdc-says-1.5317221

By Lauran Neergaard

Dr. Lisa Barrett shares her pro tips for taking your mask game from a C or a D to an A+


After a year of the new normal, most people have gotten used to the basics: social distancing, hand washing and wearing a cloth mask.

But now that a more transmissible variant of the COVID-19 virus is spreading, some people want to start taking even more precautions.

The idea of double-masking — literally, wearing two masks instead of one — is already gaining traction. But Dr. Lisa Barrett says that’s just one of the ways to get more out of your mask.

“The masking part is not just sort of important, but imperative now, that people go from a C or a D in their mask wearing, up to an A-plus game,” said Barrett.

Barrett is an infectious disease researcher and clinician at Dalhousie University in Halifax. She grew up in Old Perlican, N.L., and trained with none other than Dr. Anthony Fauci at the U.S National Institutes of Health in Maryland.

Now that her home province has seen an explosion of cases caused by a more transmissible variant of COVID-19, Barrett says we can no longer afford to be a little lax in the mask department: it’s time, she warns, to tighten up.

Here are three ways to do it.

Tip #1: Mask plus distance

“The best thing you can do is distance, plus a mask.” said Barrett. “Because sometimes we put on our mask and we feel like we’re completely protected. Not the case. The advice has always been, wear a mask and keep distance wherever you can.”

Barrett says she’s quite comfortable reminding anyone who gets too close that distancing is still important. “I’m not backing away from you because I don’t like you, I’m just going to keep my six feet, a little closer to two metres these days. And that’s really important, particularly inside, even when masked.”

Tip #2: What about double-masking?

“There’s a lot of debate as to whether or not double masking is the key,” she said. The idea is gaining some traction, but Barrett says the most important thing is to make sure your main mask is being worn properly.

“Before we go any further and add in two, three, four, five masks, none of them work unless they fit right.” said Barrett. Pay special attention to the sides of your mask. The fabric should be tight to your face, not loose and bunched up, leaving little holes on the sides where particles can go in and out (Barrett has a pro tip for keeping those edges tight. It’s a bit tricky, but check out the video above to see a demonstration).

Tip #3: One mask or two: It’s up to you

Barrett says better masking (and maintaining distance at the same time) is our best strategy against the new variants. But don’t let the debate around double-masking distract from what’s really important: That everyone wears at least one mask well.

“Just don’t yell at each other if one person’s wearing a double mask and one person’s not,” said Dr. Barrett. “We need everyone to feel comfortable with their own personal level of protection.”

In particular, Barrett says people with respiratory issues may find it difficult to wear two masks, each with several layers of fabric.

The bottom line? For Barrett, it’s much more important to pay attention to the fit than the number of masks you’re wearing.


Source: https://www.cbc.ca/news/canada/newfoundland-labrador/up-your-mask-game-1.5915539

By Zach Goudie


Should I be wearing a mask outdoors?

It depends on the circumstances. Federal public health officials recommend wearing a non-medical mask or face covering when:

  • You’re in public and you might come into close contact with others.
  • You’re in shared indoor spaces with people from outside your immediate household.
  • Advised by your local public health authority.

So if your circumstances meet any of these conditions — whether indoors or out — you should probably be wearing a mask.

However, if you’re doing something like walking in a quiet neighbourhood then the risk of transmission is very low, said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University.

If you are going in and out of stores, or getting on and off transit while doing errands, it is best to just keep your mask on the whole time, to minimize touching it and potential contamination, Chagla advised in December.

And If you’re interacting with others outside you should wear your mask, while also staying two-metres apart, Chagla said.

More recently, Chagla called three-layer, non-medical masks a good “minimum standard.” He suggested Canadians should opt for masks that offer better protection whenever possible.

The rapid spread of more contagious coronavirus variants across the country has led people in some hard-hit regions to question whether national public health guidelines go far enough to protect Canadians.

The concern is that people could be at risk of getting the virus from very little exposure to it.

Public Health Ontario (PHO), an arm’s-length, provincial government agency, recently told health units across the province they should reduce their thresholds for classifying all COVID-19 exposures given the emergence of variants.

If a person infected with COVID-19 and a contact are both wearing masks, but the contact isn’t wearing eye protection, PHO said they should be considered “high-risk” if they were within two metres for at least 15 minutes.

If neither of them is wearing a mask or eye protection — PHO said any amount of exposure time is risky, aside from briefly passing by each other.

In York Region, just north of Toronto, public health officials made headlines after releasing startling new information on individuals infected with the variant first identified in the United Kingdom.

Dr. Karim Kurji, the region’s medical officer of health, said the new variant spread despite people taking precautions.

“Some of these people who caught it were just doing essential visits and not for very much time, just a minute or two,” he said in a statement to CBC News.

As for mask-wearing tips, if you’re wearing a high-quality mask that fits well, then air will go through the material, rather than escaping out the sides. A properly fitted mask will expand and collapse with each breath.

B.C. Provincial Health Officer Dr. Bonnie Henry told CBC News there have been several cases of outdoor transmission between spectators “clustering and talking with each other” during soccer games and wedding receptions where people gathered under tents, but not from brief outdoor encounters.

However, Dr. Vera Etches, Ottawa’s medical officer of health, suggested that with infection rates climbing, residents in the capital should wear masks outdoors at all times.

“People should wear masks when they’re outside of their house as much as possible,” Etches said in a recent CBC Radio interview. “It’s an added barrier. You don’t know if you’re going to come into close contact with someone or not.”

“Outdoors is much safer than indoors, but if you are right beside someone, you could breathe in their respiratory secretions,” she said. “We’re in a situation now where we need to have stronger protections.”

Places such as San Francisco and New Brunswick have mandated outdoor mask use, and Toronto recently made wearing face masks for outdoor activities such as skating mandatory.

Source: https://www.cbc.ca/news/health/ask-cbc-masks-outdoors-1.5900678

By CBC News


The issue of whether to wear a face mask to protect against COVID-19 has come a long way since the virus first took hold in Toronto in March.

Official advice moved from “you don’t really need a mask unless you have COVID-19, save them for front-line medical workers” to “please wear a mask in enclosed public spaces,” to “wearing a mask is the law in Toronto,” and then it was mandated across the province.

A new, more contagious variant of the virus is confirmed to be circulating locally — one that could undermine the recent progress made in bringing down the number of daily new cases.

Residents are being asked to wear masks outdoors in crowds. Several European countries are recommending surgical masks in public.

The local supply of masks for health care is not the problem it was in March: There are now more than 31 million Level 2 surgical masks for front line workers in inventory in Toronto and additional contracts are in place, according to the city.

Dr. David Williams, Ontario’s chief medical officer of health said Friday that provincial and federal medical experts are looking at whether the advice on masks needs to be updated.

The Star spoke to Toronto associate medical officer of health Dr. Vinita Dubey about whether residents should buy medical masks if they can.

What’s the difference between a medical mask and a surgical mask?

In general, a medical mask is the same as a surgical mask or procedural mask. Medical masks come in three grades. A Level 1 medical mask has different properties compared to a Level 3 medical mask, which is just under an N95 mask, for example. The Level 3 mask also protects against splashes, like splashes of blood, which is not necessarily something that we need for COVID. So usually when we talk about a medical mask, we’re talking about a Level 1 medical grade, which includes surgical and procedural masks.

How do people know that they are buying a proper surgical mask?

The best way is to check it against Health Canada’s list to see that it has been approved as a medical-grade mask.

Other countries are recommending medical masks in public. What is the current thinking at Toronto Public Health around medical masks?

I think it’s important to recognize that COVID has evolved and so has the evidence to protect against it. We follow the guidelines provincially and nationally. The Public Health Agency of Canada recommends a three-layer mask (which can be a two-layer mask with a filter). That is where we’re at right now. We will certainly update our guidelines as the science recommends.

Dr. Eileen de Villa has always been clear about this: If you’re out in public and you pass someone on the street, you’re very unlikely to get COVID. Is the new variant so transmissible that you can get infected that way?

I don’t think we know for sure. What we know is that the U.K. variant for example is 30-50 per cent more transmissible. What does that mean? I don’t have any answers to that. But when you think about increased transmissibility, we have to think about all the ways in which the virus spreads.

So I guess it’s fair to say you’re still grappling with what that increased transmissibility means and how to protect against it?

Yes, I think the one thing that is clear though, is that the measures that we do have in place, let’s do those properly. How many times have we seen that mask under the nose? Even before we start talking about medical masks, lets talk about wearing masks properly. There was some evidence that three layer masks — two layers and filter — might provide similar type protection as a medical grade mask, and if that’s more comfortable, if you can get it to fit without gaps, you’ll keep it on for longer. Well, maybe that’s the better way to go. Compliance is actually a really important piece here, not just the mask.

Should the public wear N95 masks?

N95 is a very particular medical mask. You need to be fitted for it, to ensure that ambient air doesn’t get into the mask. They are actually quite difficult to wear, because they are not breathable the way a medical mask is. It’s not even recommended for everyone in the hospital. I only wear the N95 if it’s a code blue and I’m intubating someone for example.

Source: https://www.thestar.com/news/gta/2021/01/29/q-and-a-toronto-public-healths-latest-advice-on-masks.html