July 16, 2020

Overcoming Additional Barriers to Care for Deaf and Hard of Hearing Patients During COVID-19

The arrival of the novel coronavirus disease 2019 (COVID-19) to the United States in early 2020 disrupted traditional clinical services and care. Health care institutions largely focused on managing the surge of COVID-19 patients while minimizing the risk of exposure and spread to those without the virus. To protect clinicians and patients, institutions mandated personal protective equipment for everyone, implemented visitation restrictions that bar visitors from assisting their loved ones in medical settings, and eliminated in-person medical interpreters. These safeguards jeopardize the ability of the 17% of all US adults with a hearing loss to effectively communicate with their clinicians,1 thus impeding their quality of care.

Key publications highlight significant communication barriers for deaf and hard of hearing (DHH) patients in normal times. This results in a cascade of negative health and health care outcomes—higher readmission rates, increased medical costs, and lower treatment adherence.2 Age is a strong risk factor for both hearing loss and morbidity and mortality from COVID-19. The dramatic shift in health care norms places these individuals at a great disadvantage for being able to communicate and receive appropriate care. Hospitals and designated clinics set up to manage COVID-19–positive patients have restrictions making it hard for DHH patients to communicate (eg, face masks), usually with little or no proposed solutions. These safety procedures do protect patients and health care workers but interfere with accessible and effective communication for DHH patients as required by the Americans with Disabilities Act.3 We believe this can be addressed to the satisfaction of all. Following, we cite several feasible and already used steps to mitigate this new communication barrier between DHH patients and health care workers.