It’s hard to say hello to a passing human these days in the store, on the beach or on the sidewalk.

First, with our masks, we may not recognize each other. Second, the masking has created a barrier to reading the usual social cues, a nod, a smile, a specific look in the eye, an openness to relate. Now that masks are an essential part of our personal and public health, let’s discuss some related issues.

According to a recent article in Scientific American, “Faces are a complex and rich source of social, emotional and linguistic signals. We rely on all of these signals to communicate with one another through a complex and dynamic dance that depends on each partner being able to read the other’s signals. Interestingly, even when we can see whole faces, we often have trouble telling what other people are feeling.”

An article in the Journal of Neonatal Nursing raises concerns about masks worn by caretakers impacting infants’ ability to recognize and respond to those around them, to bond, to attach and to feel safe. Babies start reading faces at the moment of birth as a matter of tracking, attachment and survival. Hindering that may impact their neurological development. Long-term language skills may be impacted by masks as babies start lip-reading as early as 8 months.

Early on in the COVID-19 era, I quickly discovered many of my patients, particularly older ones, were highly dependent on lip-reading for meaning and context. The masks not only muffled sound but blocked their ability to read lips on which they had unwittingly become dependent as their hearing had slowly diminished.

Wearing a clear mask or face shield helped enormously in the communication process. Psychologists have recommended clear masks especially for those caring for small children to accelerate language, social and emotional learning.

Recommendations for parents are to emphasize face-to-face communication to overcome the gaps children may have at school, day care, the pediatrician’s, even the park in terms of learning to absorb the social and emotional signals of the whole face.

With Zoom and such, we still miss many subtleties of facial expression, tones and body language.

Pete Buttigieg recently wrote an article about how masking has required us to learn a new language: “I became an expert reader of eyebrows, extrapolating whole facial expressions like a scholar reconstructing ancient texts from a fragment.”

As a university teacher at Notre Dame, he had to try to figure out what students were conveying in their responses behind the masks. Eyes, mouth, nasal area, brows, all telegraph our emotions and meaning.

Will this era of evolution of the human race with masked people alter our fundamental ability to grow in childhood and beyond, connect, communicate, build relationships, develop empathy and understanding? We would hope not.

Perhaps it’s an opportunity to enhance our awareness of just how important the nuances of communication are, how we can improve them, as well as learning to overcome all kinds of barriers to understanding each other.

Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB.

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