“…Physicians in Switzerland interacted with elderly patients with hearing aids who had difficulty understanding masked voices [ 93 ]. A second communication barrier during the COVID-19 pandemic is that patients are anxious and fearful because they are left alone to face illness and their family cannot be physically present [ 52 , 53 , 58 , 64 , 73 , 77 , 79 , 82 , 83 , 85 , 88 , 89 ]. For example, COVID-19 patients with a diagnosis of end stage renal failure were challenged to make dialysis decisions without their family members present to help comprehend language and provide emotional support [ 79 ].…”