Communication during a Pandemic: How we can endure the pandemic together

COVID-19 has impacted enormously on mental health and our ability to communicate with others. We are hugely grateful for the contribution of the following article written by Teresa Valenzano and Patty Matsuo on behalf of the Ontario Association of Speech-Language Pathologists and Audiologists (OSLA). Teresa Valenzano, M.HSc. (S-LP), Reg. CASLPO, is research manager of the Interprofessional Practice Based Research program at St. Michael’s Hospital. Patty Matsuo, M.A., SLP(C), M.H.Sc., CHE, brings 24 years of experience as a hospital-based clinician and 16 years as a professional practice leader. She currently works at Trillium Health Partners in Mississauga/Toronto. They are, respectively, member and past president of the OSLA Board of Directors.

It’s been over a year since COVID-19 has been on Canadian soil – a tumultuous year requiring adaptation to guidelines, restrictions, and policies, all in a concerted effort in the battle against COVID-19.  While the impact is varied for each of us, every citizen of the world has been affected by our ability to communicate.

Communication, both verbal and non-verbal, underlies most of our daily actions. Whether it’s the first “good morning” we say to our roommate as we hand them a cup of coffee, or a nod to the TTC driver as we step onto the bus, we send communicative signals all the time, often consciously and subconsciously. And as frequently as we send those signals, we receive them and interpret them just as often – if not more! While some signals are the simple relaying of information, others encompass the social interaction between human beings – emotional responses given and received through all our senses.

Whatever the content, these connections are hindered by masking and distancing because of COVID-19. These day-to-day limitations with whom we can gather, the two-metre distance we hold between each other, physical barriers that keep us apart and how we must cover our faces in public cannot overstate the impact on quality of life for all individuals, some more than others.

In October 2020, it became mandatory to wear face coverings in public indoor spaces across Ontario. With this came sales of medical and cloth masks and signs posted outside of the TTC advertising how to make your own mask from a T-shirt. It has been proven in the scientific literature that face coverings help in the fight against the spread of COVID-19 – that is not up for debate. But what we often dismiss is the impact of wearing these face coverings on communication. With over 50% of Canadians 40 years and older with hearing impairment and over 90% of those over the age of 70 with hearing loss, masks hinder their ability to understand conversation, obscuring both the sound and the visual cues from lip movements and facial expressions.

For individuals with dementia and other cognitive challenges who rely on non-verbal communication through touch, physical guidance, facial expression, body language and tone of voice, with less face-to-face interaction, they have lost essential communication opportunities.  Not only has the frequency of contact been restricted, but communication is also shrouded by gowns, gloves, masks and shields.  Familiar faces are less recognizable. Confusion and anxiety are increased. Emotional well-being and ability to cope are compromised.

Physical distancing requirements have changed our communication style. No longer do we shake hands when we meet someone new or share a high five to celebrate successes. Physical distancing not only limits communication but lack of affective touch impacts our relationships, socioemotional health and even physical well-being. Connectedness is key to communication, and physical closeness and touch play a large part. For those who have experienced having a loved one hospitalized during the pandemic, not being able to hold their hand due to visiting restrictions or isolation room guidelines can feel staggering. The inability to provide comfort through touch, to communicate our caring, can be devastating for the person needing comfort while leaving the other feeling guilty for not being able to do more.

Humans are social beings who rely on one another for survival. While some adapted to using technology to maintain contact with their social circle, this is not possible for all, nor did it replace in person gatherings. Many have felt socially isolated during the past year leading to loneliness, and depression.

There are things we can do to help one another weather the impacts of communication challenges as we endure the remainder of this pandemic. As we speak through our masks, we can remember to speak louder, speak slower, and check in to ensure our conversation partner understands what we are saying. To facilitate communication with individuals with cognitive challenges, allow extra time for information processing, keep using facial expressions (real smiles are read in your eyes), and show your emotion through your voice. Mostly take the time and use simple phrases to support their comprehension and ability to express their wants and needs. Using personal protective equipment and infection control practices safely, make physical contact and provide that essential touch when needed. Take the time to make social contacts in other ways – by phone, by mail or visual call when you can.

Defeating this virus requires us all to work together. How we endure the battle requires us to remain mentally and physically strong. Persevere through the pandemic guidelines and restrictions using communication strategies to connect to each other. It’s a message we should all take to heart.