You are in a large, spacious room filled with people.
Everyone is speaking and all seems perfectly normal, but you can't understand what anyone is saying.
A woman approaches you with a quizzical look and appears to be trying to communicate with you, but you have no idea what she is trying to say and you don't know how to tell her what is wrong.
Frustrated, angry and perhaps a little sad, you finally leave.
For the deaf and hard of hearing who rely on reading lips to communicate, this can be what life is like during the coronavirus pandemic and the proliferation of people wearing masks in public.
Jann Prail, 50, has been deaf since she was young.
Masks, she says, "are definitely not friendly to people who are deaf or are hard of hearing."
Speaking in American Sign Language through interpreter Beth Smith at her home in Alexander, Prail talks about an incident she had while visiting her doctor in June at UAMS Outpatient Center.
Along with signing, Prail reads lips to understand what is being said to her. The person screening her before her visit was wearing a mask, she says, and it was impossible to understand her.
"She was talking to me, but I motioned to her and tried to use my body language to motion that I am deaf."
The person continued talking to her, but would not remove her mask, says Prail, a paraprofessional at the Arkansas School for the Deaf.
A nurse finally intervened and explained that Prail was deaf and could not understand.
"The mask was a big issue," Prail says. "I rely on sign language and lip-reading ... the person who screened me did not slide her mask down or anything."
UAMS spokeswoman Leslie Taylor says the hospital "wants everyone to be able to access our services." UAMS has interpreters on call and video remote interpreting for the deaf and hard of hearing, Taylor says. "Pocket talkers," which amplify sound, are also available, she adds.
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To help curb the spread of the novel coronavirus, the Centers for Disease Control and Prevention recommends that "all people 2 years of age and older wear a cloth face-covering in public settings when around people outside of their household, especially when other social distancing measures are difficult," according to its website.
While Gov. Asa Hutchinson has been resistant to make wearing masks or face coverings mandatory, Fayetteville passed an ordinance June 16 requiring people to wear masks while at businesses, and on June 25, Little Rock required mask or other face coverings in public spaces where social distancing can't be maintained.
Prail's husband, Jeff, has been partially deaf since contracting German measles as an infant.
"I really understand what my deaf parents went through," Jeff, 49, says as Smith interprets. "Discrimination, barriers. It's not easy. I rely on two things to communicate: facial expressions and body language. If I can't see the face, I can't see to lip read."
During a recent trip to a pharmacy in Little Rock, he says, a worker would not remove her mask even though there was a clear, plastic barrier between them.
He eventually had to use the Notes application on his phone to communicate.
"I told Jann, this is so wrong," says Jeff, who is first vice president of the Arkansas Association of the Deaf Inc. "I was in shock ... I've become my parents, you might say. For deaf people, we are going back to the 1950s."
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Beth Lambert, 54, is an artist and ceramics department chair at the Arkansas Arts Center.
She has sensorineural hearing loss, a high-frequency, progressive hearing loss that was diagnosed when she was in high school.
"I learned to lip-read because I had to," she says on the porch of her Little Rock home. "My hearing continued to get worse, but [the deterioration] tapered off in my 30s. Then I had another big drop, and now I'm considering getting cochlear implants."
A cochlear implant is an electronic device that stimulates the cochlear nerve. The implant picks up sounds with a microphone and processes them to stimulate the nerve.
Hearing aids don't work for her, she says.
"My ears are so far gone, they can't make hearing aids loud enough for me to hear."
She's not deaf. Through sounds, reading lips and observing facial expressions, she can understand what is being said to her — if, of course, she can see the speaker's face.
When she teaches at the arts center, she lets her students know upfront about her hearing loss and adds a bit of humor.
"On the first day of class I tell them that I am severely hearing impaired, but I've been teaching here for 15 years and if you'll be patient with me, I'll be patient with whatever is wrong with you."
When the pandemic took hold in March, Lambert wasn't going out much. She'd been temporarily furloughed from her job, and a lot of her communication was done online. She even coordinated a Facebook group of volunteers who made masks.
An attempt to donate blood at the Arkansas Blood Institute in North Little Rock amplified for her just how difficult it is to communicate with someone wearing a mask. The mouth of the person working with her was hidden behind a cloth mask, which made the pre-donation screening interview difficult.
"I couldn't tell what they were asking me," she says. She left without donating but plans to try again.
Even in the best of circumstances, understanding what someone is telling her can be difficult, she says.
"It's an effort. Listening is something that takes a lot of concentration. Sometimes you're trying so hard to hear, but no matter how hard you try, you just can't do it."
Lambert has started using Hearing Helper, a free app for Apple devices that transcribes conversations in real-time. During a recent appointment, her doctor offered to lower his mask, but because she uses the app, he was able to keep his mask on. He was able to speak normally while the app converted his words into text that she could read.
She has also started using Otter Voice Meeting Notes, another app that records and transcribes.
"You just have to be creative and keep at it until you find something that works," she says.
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Through his work with the Arkansas Association of the Deaf, Jeff Prail says, he has heard from a hearing-impaired woman in Fayetteville who could not communicate with her mask-wearing caregivers.
"It's incredibly frustrating," he says.
Prail says that he has asked people to remove their masks as they speak to him, but they don't always comply.
"That is a violation of my rights under the Americans with Disabilities Act," he says. "I have a right to clear and effective communication through the ADA."
The act requires that state and local governments and businesses and nonprofits that serve the public "communicate effectively with people who have communication disabilities. The goal is to ensure that communication with people with these disabilities is equally effective as communication with people without disabilities," according to the U.S. Department of Justice.
In hospitals and other medical facilities, it can be necessary to use sign language interpreters to communicate with deaf patients under ADA requirements.
Some hospitals use video remote interpreters, but depending on the quality of the video feed, they aren't always clear, says Prail, a certified ADA specialist.
"The coronavirus does not supersede the ADA," he says. "It doesn't give [anyone] the right to suppress our rights for effective and accurate communication."
Rep. Charlene Fite, R-Van Buren, a former sign language interpreter who taught deaf students at Northside High School in Fort Smith, has worked on deaf concerns in the Legislature, including sponsoring HB 1471, which established a mental health bill of rights for deaf and hard of hearing patients and was signed into law by Hutchinson last year as Act 644.
She has spoken with the Arkansas Hospital Association and the Arkansas Pharmacy Association about Prail's concerns.
"I got a very positive response from them," she says. "They want to talk with their associations and make sure things are in place for individuals having trouble communicating [with mask wearers]."
Fite says she would sponsor legislation if needed, but that getting the word out about the needs of the hearing impaired and deaf might suffice.
"We could do an awareness campaign and make sure businesses are aware that you have people who are at a great disadvantage when they can't see the mouth of the person talking to them," she says.
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In the CDC's recommendation on mask-wearing, there are exceptions for those who rely on lip-reading.
"In this situation, consider using a clear face covering. If a clear face covering isn't available, consider whether you can use written communication, use closed captioning, or decrease background noise to make communication possible while wearing a cloth face covering that blocks your lips."
Fite says she spoke with a teller at an Arvest Bank branch in Van Buren who wore a "plastic-type headgear that covered the entire face."
At UAMS, Taylor says the hospital now offers masks with clear windows for their employees "and we're ordering more."
Jeff says that he and Jann wear masks when they are in public and that communicating doesn't have to be that difficult.
"The pandemic has put the fear in people that we must wear masks, we must have social distance," Jeff says. "I can totally understand. They are protecting themselves. We are protecting ourselves, as well.
"But if you see a deaf person, or a person with hearing aids, lower your mask. It's not going to hurt. It will show respect to that deaf person and builds confidence that you are making accommodations for us. We are not asking too much."
