CONCLUSIONS
Where attempts to deliberately raise voice or shout through PPE were simulated, understanding significantly improved as expected. Raising of voice for prolonged periods may lead to issues with voice strain and abuse, in addition to frustration or miscommunication. We hope that now communication difficulties have been demonstrated, this will help drive attempts to mitigate these issues for healthcare workers emerging from the Covid-19 pandemic. We hope our findings can inform the ongoing use of PPE once elective healthcare provision is restarted and for the future, facing whatever pandemics may lie ahead.