Wearing Face Masks Strongly Confuses Counterparts in Reading Emotions

(Un)mask yourself! Effects of face masks on facial mimicry and emotion perception during the COVID-19 pandemic

Face masks have been said to impact face-to-face interaction negatively. Yet, there is limited evidence on the degree to which partial face occlusion is detrimental to empathic processes such as emotion perception and facial mimicry. To address this question, we conducted an online experiment (N=200, U.K. sample) that assessed subjective ratings and facial expressions (mimicry) in response to masked and unmasked faces. Perceivers were able to recognise happiness and sadness in dynamic emotion expressions independent of (surgical) face masks. However, perceived emotion intensity and interpersonal closeness were reduced for masked faces. Facial mimicry, the perceiver's imitation of the expresser's emotional display, was reduced or absent in response to happy but preserved for sad mask-covered expressions. For happy target expressions, the face-mimicry link was partially mediated by perceived emotion intensity, supporting the idea that mimicry is influenced by context effects. Thus, these findings suggest that whether face masks impede emotion communication depends on the emotion expressed and the emotion-communication aspect of interest. With unprecedented changes in nonverbal communication brought about by the COVID-19 pandemic, this research marks a first contribution to our understanding of facial mimicry as an important social regulator during these times.

Behind the Mask: Emotion Recognition in Healthcare Students

Current widespread facemask usage profoundly impacts clinical practice and healthcare education where communicational dimensions are essential to the care and teaching processes. As part of a larger study, 208 medical and nursing students were randomly assigned to a masked vs unmasked version of the standardized facial emotion recognition task DANVA2. A significantly higher number of errors existed in the masked vs unmasked condition. Differences for happy, sad, and angry faces, but not for fearful faces, existed between conditions. Misinterpretation of facial emotions can severely affect doctor-patient and inter-professional communication in healthcare. Teaching communication in medical education must adapt to the current universal use of facemasks in professional settings.

COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection

Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk ("Emmentaler cheese model"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.

The Impact of Face Masks on the Emotional Reading Abilities of Children-A Lesson From a Joint School-University Project

Wearing face masks has become a usual practice in acute infection events inducing the problem of misinterpreting the emotions of others. Empirical evidence about face masks mainly relies on adult data, neglecting, for example, school kids who firmly are dependent on effective nonverbal communication. Here we offer insights from a joint school-university project. Data indicate that emotional reading of 9 to 10 years old pupils (N = 57) was similarly impaired as adults on an overall performance level, but that their selective performance on specific emotions was quite different. Kids showed extreme problems in reading the emotion disgust, strong effects on fear and sadness, and only mild effects on happiness, but also even better performances for emotional states anger and neutral when faces were masked. This project did gain not only relevant data about children's perception but also made clear how fruitful seriously conducted school projects can be to encourage the interest and commitment for Science, Technology, Engineering, and Mathematics (STEM)-relevant topics.

How much COVID-19 face protections influence speech intelligibility in classrooms?

The ongoing pandemic caused by the COVID-19 virus is challenging many aspects of daily life. Several personal protective devices have become essential in our lives. Face protections are mostly used in order to stop the air aerosol coming out of our mouths. Nevertheless, this fact may also have a negative effect on speech transmission both in outdoor and indoor spaces. After a severe lockdown, classes have now started again. The adoption of face protection by teachers is either recommended or mandatory even though this is affecting speech intelligibility and thus students' comprehension. This study aims to understand how protections may affect the speech transmission in classrooms and how this could be influenced by the several typologies of face protections. An experimental campaign was conducted in a classroom in two different reverberant conditions, measuring and comparing the variation in speech transmission and sound pressure level at different receiver positions. Furthermore, a microphone array was used to investigate the distribution of the indoor sound field, depending on the sound source. Results clearly show how different types of personal protection equipment do affect speech transmission and sound pressure level especially at mid-high frequency and that the source emission lobes vary when wearing certain types of personal devices.

Communicating During COVID-19: The Effect of Transparent Masks for Speech Recognition in Noise

OBJECTIVE

The purpose of this study was to assess the speech recognition in noise when using a transparent mask that allows greater visibility of the talker's face compared to an opaque mask in persons with normal and impaired hearing via an online format.

DESIGN

A repeated-measures design was used to evaluate the auditory-visual recognition of sentences recorded in background noise with transparent and opaque face masks, and without a mask (N = 154). In a smaller follow-up study (N = 29), the same files were presented via auditory-only presentation to determine if differences observed in the transparent and opaque mask conditions were attributable to additional visual cues or to acoustic differences between the recordings of the two mask types. Listeners completed the 40-minute online session on a computer, laptop, or tablet in a quiet room via their personal listening devices (earbuds or hearing assistive device). The adult volunteers who used English as their first language were recruited through social media links and email and categorized into three groups: normal hearing and confirmed or suspected hearing loss either with or without the use of assistive listening devices.

RESULTS

Auditory-visual recognition of sentences recorded with the transparent mask was significantly better (M = 68.9%) than for sentences recorded with the opaque mask (M = 58.9%) for all participants. There was a trend for those who used hearing assistive technology to score lower than the other two groups who had similar performance across all conditions regardless of the mask type. Subjective ratings of confidence and concentration followed the expected pattern based on objective scores. Results of the auditory-only presentation of the sentences to listeners with normal hearing suggested that the transparent mask benefits were not attributable to an acoustic advantage but rather to the addition of the visual cues of the talker's face available through the transparent mask. In fact, performance in the auditory-only presentation was significantly lower with the transparent mask (M = 40.7%) compared to the opaque mask (M = 58.2%).

CONCLUSIONS

Use of transparent masks can significantly facilitate speech recognition in noise even for persons with normal hearing and thus may reduce stressful communication challenges experienced in medical, employment, and educational settings during the global pandemic. To mitigate the spread of COVID-19 and facilitate communication, safety-approved transparent masks are strongly encouraged over opaque masks.

A Game of Covid: Strategic Thoughts About a Ludified Pandemic

Many aspects of handling the COVID-19 pandemic bear a resemblance to patterns found in games. We observe point displays and leader boards, the visible assumption of roles, classic archetypes, the collection of resources, and spatial awareness. We argue that these patterns manifest spontaneously as a form of analogical reasoning, because people lack cultural and individual norms as well as cognitive scripts for a pandemic. Trying to find systematic similarities between a novel and a familiar situation is an essential cognitive strategy and a cultural tool, resulting in a spontaneous ludification of this crisis. Unfortunately, most institutions, the media and policymakers focus on attributes that are easy to communicate, not on relations and causal chains. This results in shallow analogies, where the mechanisms and dynamics of COVID-19 are not addressed. This can cause a sense of helplessness, where many people remain passive viewers. A pandemic, however, calls for cooperative action of people who understand the relations between different factors and stakeholders in order to mitigate several negative effects linked to such a crisis. We propose a psychologically founded “Strategic gamification” (here in the context of a pandemic), a form of sense-making that builds on spontaneously emerging ludic elements. By extending upon those elements through the lens of game design, we can shape the mechanics, dynamics and esthetics of a serious context in a more meaningful way. The resulting analogies have better predictive power and are suited to utilize positive aspects of gamification like engagement, elaboration and collaboration.

The face behind the mask: The future of interpersonal interaction

Worldwide use of face masks as personal protective equipment (PPE) during the COVID-19 pandemic has changed interpersonal interactions in myriad ways, likely permanently. Creative strategies like the PPE Portrait Project serve to mitigate social disconnection resulting from facial feature obstruction.

The Glow Still Shows: Effects of Facial Masking on Perceptions of Duchenne Versus Social Smiles

Facial expressions of emotion have important communicative functions. It is likely that mask-wearing during pandemics disrupts these functions, especially for expressions defined by activity in the lower half of the face. We tested this by asking participants to rate both Duchenne smiles (DSs; defined by the mouth and eyes) and non-Duchenne or "social" smiles (SSs; defined by the mouth alone), within masked and unmasked target faces. As hypothesized, masked SSs were rated much lower in "a pleasant social smile" and much higher in "a merely neutral expression," compared with unmasked SSs. Essentially, masked SSs became nonsmiles. Masked DSs were still rated as very happy and pleasant, although significantly less so than unmasked DSs. Masked DSs and SSs were both rated as displaying more disgust than the unmasked versions.

Effects of mask-wearing on social anxiety: an exploratory review

BACKGROUND

A unique feature of the global coronavirus pandemic has been the widespread adoption of mask-wearing as a public health measure to minimize the risk of contagion. Little is known about the effects of increased mask-wearing on social interactions, social anxiety, or overall mental health.

OBJECTIVES

Explore the potential effects of mask-wearing on social anxiety.

DESIGN

We review existing literatures to highlight three preselected sets of factors that may be important in shaping the effects of mask-wearing on social anxiety. These are: (a) people's perceptions of the social norms associated with wearing masks; (b) people's experiences of the degree to which masks prevent accurate interpretation of social and emotional cues; and (c) people's use of masks as a type of safety behavior that enables self-concealment.

METHODS

APA PsycNet and PubMed were searched principally between September and November 2020 for articles describing the relationship between social anxiety, intolerance of uncertainty, ambiguous feedback, and safety behavior use and for research on the relationship between mask-wearing and social norms and social interactions. Information identified as relevant from articles of interest was extracted and included in our review.

RESULTS & CONCLUSIONS

The effects of mask-wearing on social anxiety are likely to be substantial and clinically relevant.

Large Gatherings? No, Thank You. Devaluation of Crowded Social Scenes During the COVID-19 Pandemic

In most European countries, the first wave of the COVID-19 pandemic (spring 2020) led to the imposition of physical distancing rules, resulting in a drastic and sudden reduction of real-life social interactions. Even people not directly affected by the virus itself were impacted in their physical and/or mental health, as well as in their financial security, by governmental lockdown measures. We investigated whether the combination of these events had changed people's appraisal of social scenes by testing 241 participants recruited mainly in Italy, Austria, and Germany in an online, preregistered study conducted about 50 days after the beginning of the COVID-19 outbreak in Europe. Images depicting individuals alone, in small groups (up to four people), and in large groups (more than seven people) were rated in terms of valence, arousal, and perceived physical distance. Pre-pandemic normative ratings were obtained from a validated database (OASIS). Several self-report measures were also taken, and condensed into four factors through factor analysis. All images were rated as more arousing compared to the pre-pandemic period, and the greater the decrease in real-life physical interactions reported by participants, the higher the ratings of arousal. As expected, only images depicting large gatherings of people were rated less positively during, compared to before, the pandemic. These ratings of valence were, however, moderated by a factor that included participants' number of days in isolation, relationship closeness, and perceived COVID-19 threat. Higher scores on this factor were associated with more positive ratings of images of individuals alone and in small groups, suggesting an increased appreciation of safer social situations, such as intimate and small-group contacts. The same factor was inversely related to the perceived physical distance between individuals in images of small and large groups, suggesting an impact of lockdown measures and contagion-related worries on the representation of interpersonal space. These findings point to rapid and compelling psychological and social consequences of the lockdown measures imposed during the COVID-19 pandemic on the perception of social groups. Further studies should assess the long-term impact of such events as typical everyday life is restored.

Seeing faces, when faces can't be seen: Wearing portrait photos has a positive effect on how patients perceive medical staff when face masks have to be worn

Introduction

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, wearing surgical face masks has become mandatory for healthcare staff in many countries when interacting with patients. Recently, it has been shown that wearing face masks impairs social interaction by diminishing a person’s ability to read the emotion of their counterparts, an essential prerequisite to respond adequately in social situations. It is easily conceivable that this may have a tangible negative influence on the communication and relationship between patients and healthcare personnel. We therefore investigated whether it has an effect on how patients perceive healthcare professionals when physicians and nursing staff wear portrait photos with their smiling faces in addition to face masks.

Methods

During the study period of 16 days, the medical staff of our Department wore surgical face masks at all times during any kind of interaction with patients. In a pseudorandomized order, all members of our staff additionally affixed their portrait photos to their work clothes on 8 of the 16 days. After completion of their visit, 226 patients were interviewed anonymously in a cross-sectional study design using a questionnaire in which they rated the following three items: friendliness of staff, medical quality of treatment, and how well they felt taken care of during treatment in our Department.

Results

On days, on which staff wore photos, mean scores of the questionnaires were significantly higher than on non-photo days (p = 0.013; mean ± standard deviation = 92.8 ± 11.3 vs. 91.0 ± 12.6; median (range) = 97 (98) vs. 96 (76)). When analyzed separately, the increased scores were only significant for the item friendliness of staff (p = 0.009; mean ± standard deviation = 95.8 ± 6.3 vs. 92.2 ± 11.5; median (range) = 98 (39) vs. 97 (54)).

Conclusion

Our study suggests that the use of portrait photos with smiling faces has a positive effect on how patients perceive healthcare staff.

Trustworthiness appraisals of faces wearing a surgical mask during the Covid-19 pandemic in Germany: An experimental study

BACKGROUND

During the Covid-19 pandemic, the negative effects of wearing a mouth-nose cover (MNC) on interpersonal functioning have been discussed in public media but empirical studies on how wearing MNCs affect social judgements are sparse. In the present study, we investigated the effects of MNCs on trustworthiness appraisals, the influence of changes due to MNCs in evaluating joy, and the relationship between a social-cognitive appraisal bias and a participant's characteristics.

METHODS

All participants (N = 165) judged the intensity of happiness and trustworthiness in calm facial stimuli presented with and without a surgical mask covering part of the face. We analysed the relationship of changes in judgements evoked by MNCs to participants' evaluations of MNCs as protective tools and explored their associations with the burden experienced by wearing MNCs, compliance to behaviour recommendations, their risk associated with the pandemic, and their levels of psychological distress.

RESULTS

Overall, calm facial stimuli covered with MNCs were evaluated as less trustworthy and, to an even stronger extent, less happy than uncovered facial stimuli. However, participants varied in whether they showed a negative or positive evaluation of faces with MNCs; the negative bias was stronger in those participants who attributed lower protective potential to MNCs, experienced a higher burden while wearing MNCs, wore MNCs less often, and experienced a higher level of psychological distress.

CONCLUSIONS

A negative bias in trustworthiness appraisals of faces with a positive emotional expression covered by MNCs is linked to a participant's evaluation of MNCs as inefficient and burdening and their experience of high psychological distress.

Vocal tract discomfort in caregivers for the elderly during an interval of the COVID-19 pandemic

BACKGROUND

During the coronavirus disease 2019 (COVID-19) pandemic, professional caregivers caring for the elderly may experience more vocal tract problems in addition to regular high vocal demands while wearing face masks/coverings.

METHODS AND PARTICIPANTS

Vocal tract discomfort (VTD) was assessed in 64 caregivers in one home for the elderly (64% participation rate) in June 2020 using the German version of the VTD scale.

RESULTS

More than one-half of the participating caregivers experienced VTD, described mostly as dryness, irritability, and tightness. Approximately, 80% reported that sensations were not perceived before enhanced infection prevention standards were implemented.

CONCLUSIONS

Among caregivers caring for the elderly during the COVID-19 pandemic, special care should be focused on the voice and vocal tract well-being.

How great is the negative impact of masking and social distancing and how can we enhance communication skills in the elderly people?

During COVID-19 pandemic, protective measures such as social distancing and face masks posed a challenge in daily communication, in this context the elderly are one of the most at risk categories as widely exposed to hearing loss. This article focuses on how the COVID-19 pandemic affected verbal communication, especially on those people that even in normal conditions present an increased difficulty in speech perception. Special attention has been paid to hearing aids and cochlear implant users, these devices indeed can be affected by a speech intelligibility reduction and could be uncomfortable if used together with face masks. Possible alternatives and solutions will be proposed to reduce the negative impacts of face coverings on communication, to enhance speech intelligibility and to manage wearability of hearing rehabilitation devices.

Face masks reduce emotion-recognition accuracy and perceived closeness

Face masks became the symbol of the global fight against the coronavirus. While face masks' medical benefits are clear, little is known about their psychological consequences. Drawing on theories of the social functions of emotions and rapid trait impressions, we tested hypotheses on face masks' effects on emotion-recognition accuracy and social judgments (perceived trustworthiness, likability, and closeness). Our preregistered study with 191 German adults revealed that face masks diminish people's ability to accurately categorize an emotion expression and make target persons appear less close. Exploratory analyses further revealed that face masks buffered the negative effect of negative (vs. non-negative) emotion expressions on perceptions of trustworthiness, likability, and closeness. Associating face masks with the coronavirus' dangers predicted higher perceptions of closeness for masked but not for unmasked faces. By highlighting face masks' effects on social functioning, our findings inform policymaking and point at contexts where alternatives to face masks are needed.

Recognition and naming test of the Portuguese population for national and international celebrities

Research on familiar faces has been conducted in different countries and resort to celebrities faces, stimuli that are highly constrained by geographic context and cultural peculiarities, since many celebrities are only famous in particular countries. Despite their relevance to psychological research, there are no normative studies of celebrities' facial recognition in Portugal. We developed a database with 160 black and white pictures of famous persons' faces in this work. The data collection took place in two different studies. In study 1, participants were asked to recognize and name celebrity faces; while in study 2, celebrity names were rated for AoA, familiarity, and distinctiveness. Data were gathered from two different samples of Portuguese young adults aged between 18 and 25 years old, and both procedures were performed online through a questionnaire created in Qualtrics software. This database provides ratings of AoA, familiarity, facial distinctiveness, recognition rate, and naming rate for each celebrity, which will allow further selection of celebrities, based on these five attributes, for studies using Portuguese samples. Also, possible relationships between these five variables were analyzed and presented, highlighting facial distinctiveness as a predictor for both naming and recognition rate of celebrity faces.

Partition walls as effective protection from bio-aerosols in classrooms - an experimental investigation

Introduction: During a pandemic, protective measures to prevent bio-aerosol based infections, such as Corona Virus Infection Disease 19 (COVID 19), are very important. Everyday face masks can only partially block aerosols, and their effectiveness also depend on how well the person is wearing it. They are recommended for classroom situations during high pandemic activity. However, 'unprotected' communication with and among children is fundamental from the pedagogical and psychological point of view for normal psychosocial development and teaching. Partition walls around the persons can theoretically provide substantial standardized mechanical protection against the spread of droplets and aerosols, either as additional protection to face masks or as an alternative. Methods: In the present research, the protection effectiveness of partition walls was investigated. With mannequin heads, fog generators, line lasers and a classroom-like setup with protective walls, flow visualization and aerosol concentration measurements were performed. Additionally, an active fan-suction system was tested to remove the channelled aerosols on top of the partition walls before they reach other persons in the room. Results: It was found that partition walls protect neighbours from bio-aerosol contact regardless of whether they wear masks or not. The combination with standardized room ventilation enforces this effect. Moreover, the experiments performed here clearly showed that partition walls may protect neighbours from bio-aerosols better than suboptimally fitting everyday face masks only. Conclusion: Partition walls are the most effective protection against infectious bio-aerosols in classroom settings and should be combined with standardized ventilation as the preferred method for classrooms during the current COVID 19 pandemic.

Masks and Face Coverings for the Lay Public : A Narrative Update

Whether and when to mandate the wearing of facemasks in the community to prevent the spread of coronavirus disease 2019 remains controversial. Published literature across disciplines about the role of masks in mitigating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is summarized. Growing evidence that SARS-CoV-2 is airborne indicates that infection control interventions must go beyond contact and droplet measures (such as handwashing and cleaning surfaces) and attend to masking and ventilation. Observational evidence suggests that masks work mainly by source control (preventing infected persons from transmitting the virus to others), but laboratory studies of mask filtration properties suggest that they could also provide some protection to wearers (protective effect). Even small reductions in individual transmission could lead to substantial reductions in population spread. To date, only 1 randomized controlled trial has examined a community mask recommendation. This trial did not identify a significant protective effect and was not designed to evaluate source control. Filtration properties and comfort vary widely across mask types. Masks may cause discomfort and communication difficulties. However, there is no evidence that masks result in significant physiologic decompensation or that risk compensation and fomite transmission are associated with mask wearing. The psychological effects of masks are culturally shaped; they may include threats to autonomy, social relatedness, and competence. Evidence suggests that the potential benefits of wearing masks likely outweigh the potential harms when SARS-CoV-2 is spreading in a community. However, mask mandates involve a tradeoff with personal freedom, so such policies should be pursued only if the threat is substantial and mitigation of spread cannot be achieved through other means.

The impact of facemasks on emotion recognition, trust attribution and re-identification

Covid-19 pandemics has fostered a pervasive use of facemasks all around the world. While they help in preventing infection, there are concerns related to the possible impact of facemasks on social communication. The present study investigates how emotion recognition, trust attribution and re-identification of faces differ when faces are seen without mask, with a standard medical facemask, and with a transparent facemask restoring visual access to the mouth region. Our results show that, in contrast to standard medical facemasks, transparent masks significantly spare the capability to recognize emotional expressions. Moreover, transparent masks spare the capability to infer trustworthiness from faces with respect to standard medical facemasks which, in turn, dampen the perceived untrustworthiness of faces. Remarkably, while transparent masks (unlike standard masks) do not impair emotion recognition and trust attribution, they seemingly do impair the subsequent re-identification of the same, unmasked, face (like standard masks). Taken together, this evidence supports a dissociation between mechanisms sustaining emotion and identity processing. This study represents a pivotal step in the much-needed analysis of face reading when the lower portion of the face is occluded by a facemask.

Unmasking the Difficulty of Listening to Talkers With Masks: lessons from the COVID-19 pandemic

Interactions with talkers wearing face masks have become part of our daily routine since the beginning of the COVID-19 pandemic. Using an on-line experiment resembling a video conference, we examined the impact of face masks on speech comprehension. Typical-hearing listeners performed a speech-in-noise task while seeing talkers with visible lips, talkers wearing a surgical mask, or just the name of the talker displayed on screen. The target voice was masked by concurrent distracting talkers. We measured performance, confidence and listening effort scores, as well as meta-cognitive monitoring (the ability to adapt self-judgments to actual performance). Hiding the talkers behind a screen or concealing their lips via a face mask led to lower performance, lower confidence scores, and increased perceived effort. Moreover, meta-cognitive monitoring was worse when listening in these conditions compared with listening to an unmasked talker. These findings have implications on everyday communication for typical-hearing individuals and for hearing-impaired populations.

Facemasks and face recognition: Potential impact on synaptic plasticity

Visual recognition of facial expression modulates our social interactions. Compelling experimental evidence indicates that face conveys plenty of information that are fundamental for humans to interact. These are encoded at neural level in specific cortical and subcortical brain regions through activity- and experience-dependent synaptic plasticity processes. The current pandemic, due to the spread of SARS-CoV-2 infection, is causing relevant social and psychological detrimental effects. The institutional recommendations on physical distancing, namely social distancing and wearing of facemasks are effective in reducing the rate of viral spread. However, by impacting social interaction, facemasks might impair the neural responses to recognition of facial cues that are overall critical to our behaviors. In this survey, we briefly review the current knowledge on the neurobiological substrate of facial recognition and discuss how the lack of salient stimuli might impact the ability to retain and consolidate learning and memory phenomena underlying face recognition. Such an "abnormal" visual experience raises the intriguing possibility of a "reset" mechanism, a renewed ability of adult brain to undergo synaptic plasticity adaptations.

Facial Recognition: More Than Just a Phone Problem

Mask-to-mask encounters are the norm in every health care setting these days. In some ways, as everyone is forced to develop communication strategies for building rapport without the benefit of friendly smiles, our job as pediatricians communicating with children and parents is no more difficult than for everyone else. However, pediatricians are a special kind of physician who generally hone nonverbal communication skills early in our training, and the face is one of the earliest developmental social cues in infancy. Furthermore, especially in the medical home, it is our privilege and duty to foster a sense of safety and confidence in seeking medical care. In this column, we review what the current research has to say about the impact of masks on physician-patient relationships and communication, as well as the science of other nonverbal communication strategies and social cues. [Pediatr Ann. 2021;50(2):e52-e54.].

The consequences of COVID-19 on social interactions: an online study on face covering

The COVID-19 pandemic has dramatically changed the nature of our social interactions. In order to understand how protective equipment and distancing measures influence the ability to comprehend others' emotions and, thus, to effectively interact with others, we carried out an online study across the Italian population during the first pandemic peak. Participants were shown static facial expressions (Angry, Happy and Neutral) covered by a sanitary mask or by a scarf. They were asked to evaluate the expressed emotions as well as to assess the degree to which one would adopt physical and social distancing measures for each stimulus. Results demonstrate that, despite the covering of the lower-face, participants correctly recognized the facial expressions of emotions with a polarizing effect on emotional valence ratings found in females. Noticeably, while females' ratings for physical and social distancing were driven by the emotional content of the stimuli, males were influenced by the "covered" condition. The results also show the impact of the pandemic on anxiety and fear experienced by participants. Taken together, our results offer novel insights on the impact of the COVID-19 pandemic on social interactions, providing a deeper understanding of the way people react to different kinds of protective face covering.

Face Masks During the COVID-19 Pandemic: A Simple Protection Tool With Many Meanings

Wearing face masks is recommended as part of personal protective equipment and as a public health measure to prevent the spread of coronavirus disease 2019 (COVID-19) pandemic. Their use, however, is deeply connected to social and cultural practices and has acquired a variety of personal and social meanings. This article aims to identify the diversity of sociocultural, ethical, and political meanings attributed to face masks, how they might impact public health policies, and how they should be considered in health communication. In May 2020, we involved 29 experts of an interdisciplinary research network on health and society to provide their testimonies on the use of face masks in 20 European and 2 Asian countries (China and South Korea). They reflected on regulations in the corresponding jurisdictions as well as the personal and social aspects of face mask wearing. We analyzed those testimonies thematically, employing the method of qualitative descriptive analysis. The analysis framed the four dimensions of the societal and personal practices of wearing (or not wearing) face masks: individual perceptions of infection risk, personal interpretations of responsibility and solidarity, cultural traditions and religious imprinting, and the need of expressing self-identity. Our study points to the importance for an in-depth understanding of the cultural and sociopolitical considerations around the personal and social meaning of mask wearing in different contexts as a necessary prerequisite for the assessment of the effectiveness of face masks as a public health measure. Improving the personal and collective understanding of citizens' behaviors and attitudes appears essential for designing more effective health communications about COVID-19 pandemic or other global crises in the future.    To wear a face mask or not to wear a face mask?    Nowadays, this question has been analogous    to the famous line from Shakespeare's Hamlet:    "To be or not to be, that is the question."    This is a bit allegorical,    but certainly not far from the current circumstances    where a deadly virus is spreading amongst us... Vanja Kopilaš, Croatia.

Wearing a face mask against Covid-19 results in a reduction of social distancing

In the context of the Covid-19 pandemic, barrier gestures such as regular hand-washing, social distancing, and wearing a face mask are highly recommended. Critically, interpersonal distance (IPD) depends on the affective dimension of social interaction, which might be affected by the current Covid-19 context. In the present internet-based experimental study, we analyzed the preferred IPD of 457 French participants when facing human-like characters that were either wearing a face mask or displaying a neutral, happy or angry facial expression. Results showed that IPD was significantly reduced when characters were wearing a face mask, as they were perceived as more trustworthy compared to the other conditions. Importantly, IPD was even more reduced in participants infected with Covid-19 or living in low-risk areas, while it was not affected by the predicted health of the characters. These findings shed further light on the psychological factors that motivate IPD adjustments, in particular when facing a collective threat. They are also of crucial importance for policy makers as they reveal that despite the indisputable value of wearing a face mask in the current pandemic context, their use should be accompanied by an emphasis on social distancing to prevent detrimental health consequences.

How to communicate effectively while wearing face masks

The COVID-19 pandemic has radically changed communication in nursing. Aby Mitchell and Barry Hill provide recommendations for improving communication when wearing a face covering

Communication is an essential part of nursing care and practice. The COVID-19 pandemic has radically changed communication in healthcare. The 2 metre social distancing rule combined with the need to wear face masks has made communication more challenging. Wearing masks reduces the ability to access the non-verbal facial expressions and cues, such as lip movements, that are so vital to daily communication. Practice nurses rely on non-verbal communication as part of a complete holistic assessment and to build therapeutic relationships. This article provides some recommendations for improving communication when wearing a face covering.