COVID 19 and Hearing Care

The COVID-19 pandemic initially disrupted nearly every dimension of life and has led to irreversible changes. These changes are centered around reducing the virus transmission that changed the way we socialize, interact, and access medical care. Although such measures reduced the spread of the virus and saved lives, accumulating evidence indicates the negative impact they have on well-being. These changes have had a direct impact on hearing health. The use of personal protective equipment such as the use of masks and visors have for instance made communication very difficult for those with hearing loss. As several viruses are known to affect the auditory system, questions regarding the impact of COVID-19 on auditory-related symptoms were also raised. To learn more about the effects of the pandemic on hearing-related problems and service provision, we have initiated a series of research studies. These studies were enabled by forming global networks and partnerships.

This project touches on all the five the research themes. Following are the specific studies within this larger project.

Effect of COVID-19 Pandemic and the Virus on Tinnitus

Although the COVID-19 pandemic has had devastating effects, it has also provided the opportunity to learn more about tinnitus. As tinnitus has been known to be initiated or exacerbated during stressful periods, concerns were raised about the impact of the pandemic on people with tinnitus. In an large-scale international survey (n=3,103), we examined the effect of effect of COVID-19 pandemic on tinnitus (Beukes et al., 2020 Frontiers). Using the sub-sample (n=1,522) of this larger study, we examined the help-seeking behavior, which resources individuals utilized to cope during the pandemic, and what additional support is desired by individuals with tinnitus in North America (Beukes et al., 2021 AJA). Also, we examined the perspectives of individuals with tinnitus living in Europe about the support they needed in relation to changes associated with the COVID-19 pandemic as well as suggestions regarding tinnitus care for the future (Beukes et al., 2021 IJCP). As the research in this area is growing rapidly and we need a quick way to synthesize the literature in this area, we also performed a systematic review to examine the impact of COVID-19 pandemic and the virus on tinnitus (Beukes et al., 2021 JCM). In addition, further research is underway to examine the relationship between COVID-19 and tinnitus.

Study Lead: Eldre Beuke

The Impact of the Pandemic on Audiology Care

As the COVID-19 pandemic progressed and resulted in stay-at-home orders were in place, all aspects of life were affected. This also impacted the non-urgent healthcare service delivery including the audiological services. In a series of studies, we examined the impact of COVID-19 pandemic on the audiology care and the workplace. In an international survey, we examined the effect on the workplace (Manchaiah et al., 2021 IJA), use of and attitude to telehealth (Eikleboom et al., 2021 IJA), and effect of mental well-being of audiologists (Bennett et al., 2021IJA). In another study, we also examined the impact of COVID-19 on provision of UK audiology services & on attitudes towards delivery of telehealth services (Parmar et al., 2021 IJA). These studies identified what changes to services were provided such as more remote service provision. It also highlighted difficulties and barriers in provision of some services such as hearing device adjustments and maintenance, impression

taking, wax removal, and hearing aid verification. Ways of adapting service provision were highlighted to ensure sustainable and continued access to care.

Study lead: De Wet Swanepoel

Impact of SARS-CoV-2 Virus Preventative Measures on Communication for People with Hearing Loss and Potential Solutions

Since the start of the Corona Virus Disease (COVID-19) pandemic, there have been multiple studies reporting hearing related symptoms in people that contracted the COVID-19 disease. Sudden sensorineural hearing loss and tinnitus have been reported in adults having a wide range of COVID-19 symptom severity. A recently published review revealed a pooled prevalence of 7.6%, and 14.8% for hearing loss and tinnitus, respectively. However, the impact of the COVID-19 pandemic on hearing, and people with hearing loss has not been limited to these clinical manifestations alone. People with hearing difficulties rely on visual cues and lip reading to enhance their speech understanding. The use of face masks or coverings along with physical or social distancing measures, which are critical to the control the spread of the SARS-CoV-2 virus, distort sounds and conceal visual cues making communication challenging, especially for people with hearing loss, even while using hearing aids. These communication difficulties become even more relevant in health care settings, e.g., when people with hearing loss have to go to an emergency room and communicate with health personnel. The use of transparent face masks or coverings have been proposed as potential solutions to alleviate the problem. However, such face masks or coverings are acoustically more attenuating than non-transparent masks, steam up, and reusability is an issue since it cannot be washed in a washing machine like the cloth counterparts. Therefore, the objective of this study is to investigate the impact of preventative measures against the spread of SARS-CoV-2 virus on communication for people with hearing loss and to document potential solutions currently in use.

Study Lead: De Wet Swanepoel