Short Wave - Is This Real? Loss of Smell And The Coronavirus

Episode Date: April 1, 2020

Doctors around the world are sharing stories of patients losing their sense of taste or smell — and testing positive for the coronavirus. Is it a real symptom of COVID-19? There isn't scientific evidence for that. But the American Academy of Otolaryngology-Head and Neck Surgery is gathering anecdotal information to find out more. Short Wave's Maddie Sofia and Emily Kwong talk about science during a pandemic.See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Hey, everybody. Maddie Safaya here with shortwave reporter Emily Kwon. Hey, Maddie. Hey, you. So, Kwong, you have been poking your little nose into something a little strange. Yes. Stories about people suddenly losing their sense of taste and smell. That's right. It's really strange.

So doctors from Italy to China, South Korea to the U.S. are reporting some cases where people are losing their sense of taste and or smell and later testing positive for the coronavirus. Weird. But, okay, these are only stories, right? This is anecdotal at this point. That's right. There's no published scientific literature showing that, A, the coronavirus even disrupts your smell system, and B, the mechanism for how it would even do that. But doctors around the world are trading stories on international messaging boards and in phone calls about rising cases of anosmia, which is the scientific term for loss of sense of smell, and how

some of those anosmia patients are testing positive for the coronavirus. So really the question is, is this connection real? Or is it some artifact or weird coincidence that a few doctors are seeing and reacting to? Exactly. We don't know. This virus is so new that we still have so much to learn about it, which takes time. Right. I mean, science is purposefully deliberate and methodical and honestly, in my experience, slow. It still takes a long time to figure out how to identify. a new virus, the symptoms, get papers published, all that. But right now we're seeing and depending on, honestly, scientific information being released before going through that intense peer-reviewed process,

or in this case, not even that. Right, because there's an urgency right now to getting questions like this answered in a global pandemic. Because if doctors discover that loss of smell is, in fact, a symptom of COVID-19, that could be a helpful piece of information. So today, the show how doctors around the world are now working together to corral evidence about a potential coronavirus symptom and what it all says about how science is done during a pandemic. All right, Kwong, so as of now, loss of smell is not listed as a symptom for COVID-19. Not at all. The World Health Organization lists fever, tiredness, and dry cough as primary symptoms. Right, and shortness of breath, aches and pains and sore throat are listed as other symptoms, along with diarrhea,

nausea and a runny nose, as symptoms reported by a very few people. Right. But not on the list? Anasmia. That's loss of smell. No hyposmia, which is a decreased sense of smell, nor dysgocia, which is changes to your sense of taste. It feels like you just wanted to say all those words right there.

Okay, you're on to me. Anyway, our sense of taste is largely driven by our sense of smell. So the loss of both can sometimes go hand in hand. Got it. But I have noticed, you know, there's a lot. of media outlets speculating on this, wondering if loss of smell and taste is a symptom of this coronavirus. Yeah, Google traffic results for loss of smell jumped around mid-March. So what happened? Like, how did this get so much attention? Well, one of the reasons is that

E&T, UK, a group representing ear, nose and throat surgeons, put out a statement last month that got a lot of attention, saying that if all adults in Britain with anosmia, with loss of smell were to self-isolate, it could potentially be helpful for slowing the spread of the coronavirus. I feel like that's an intense thing to do with not a ton of evidence. Well, that's what's tough about the climate of this pandemic. You know, four months ago, no one knew about this coronavirus. And nowadays experts, they're kind of having to act on incomplete information because the coronavirus has proven so contagious and so deadly.

Yeah, yeah, for sure. And you know, in the letter from ENTUK, it states that previously known coronaviruses are thought to account for loss of sense of smell. Right. But after we reached out to doctors and searched for peer reviewed articles on this, we, meaning you and me, Emily Kwong, couldn't find strong evidence to back that up. No. So the evidence in the current literature for what we could find, the connection between other coronaviruses and the loss of smell isn't very strong. It appears that way. Yeah. But again, with case. is rising in so many countries, a handful of doctors are raising the question based on patients they've seen in their clinics, doctors like Rachel Kay. Right. So I got a lot of, quote,

everything tastes like cardboard and I can't smell anything. I got a lot of those sort of descriptor terms. Rachel is an assistant professor of otolaryngology at Rutgers University. And those doctors specialize in head and neck surgery. They're very cool doctors. They are. Yeah. And in March, Rachel started getting all these calls from other otolaryngologists that matched her experiences, more anosmia cases and more anosmia patients testing positive for this coronavirus. And for her, this raised the possibility that there could be other symptoms that doctors and public health officials aren't aware of. I think, obviously, people who are very symptomatic should be treated and confined in quarantine.

But, you know, the way to find the curve is all these asymptomatic people or my They're not only systematic people. It's finding them, right? They're the ice underneath the water of the iceberg. Right. That's the danger. These are the people who are unbeknownst to themselves and unwittingly transmitting the virus.

But there was a problem. Rachel had no way to statistically measure anosmia across a broad sample size of patients and to suss out how many COVID-19 patients have lost their sense of taste and smell. Right. And loss of smell could come from other stuff, other types of viruses like rhinoviruses that are responsible for the common cold. Or allergies?

Oh, I hate allergies, quong. They're not fun. And they're happening right now. It's spring in the U.S. So Rachel took this question straight to the top. She called the American Academy of Otolaryngology, head and neck surgery. They're like a professional association for otolaryngologists. And CEO, Dr. James Denny, to suggest a possible survey of other doctors.

And he listened to her. I don't know many precedents of societies that when they get a cold call from one of their one member, out of their thousands of members, would call them back almost immediately and fully support them in their endeavor and really take the time to listen. And he really did all of that. So on March 22nd, Dr. James Denny and the Academy of Odolaryngology published a statement. They proposed that anosmia, hyposmia, and dyscusia, loss of sense of smell and taste or changes in those senses, be possibly added to the list of screening tools for COVID-19. Wow, so now we have medical groups in two different countries making these statements. Yep, they're trying to essentially protect patients and doctors from the unknowns of this disease

so they can take the appropriate precautions, such as staying at home. So as testing ramps up in the United States, the American. American Academy of otolaryngology is trying to corral these loss of smell stories scattered around the world into an actual data set to figure out if there is evidence for this claim. They made an online reporting tool inviting doctors around the world to share what they're seeing in patients. They want to know, are people with COVID-19 reporting a loss of sense of smell or taste? What other symptoms are they showing? And did the loss of smell happen before or after they were diagnosed with COVID-19? Gotcha.

And they've received over 150 responses so far in the last week. They plan to submit their results to a peer-reviewed journal. James Deneni said he wants to put this information into the hands of the CDC. If this be worldwide, that it may be an additional marker that can be used. And that would be up to them to make that determination. I reached out to the CDC for comment on this, but didn't hear back. And I asked James, you know, if he hesitated in raising this question, ahead of publishing that paper?

No. I mean, I, you know, why? Because I've, some of my colleagues in New York and Seattle and other cities watching what's happened. And even my colleagues in China watching what's happened is this got going. Anything we can do to flatten this curve and not let it get going is critical. And so he made a judgment call. even if, you know, loss of smell doesn't prove to be a symptom of COVID-19. Under the worst scenarios, someone's isolated and it hasn't hurt them.

Under the best, I shouldn't say the best, under a disease control scenario, it may prevent them from spreading it or otherwise propagating the disease. So that's one of those if you make this point. Yeah, I mean, I guess I get what he's saying, kind of, but I will say that, you know, loss. of smell is something that happens somewhat commonly. And if these doctors are wrong, it would give people who are already scared another reason to be scared right now and, you know, second guess, am I sick, am I sick? Which has repercussions. Absolutely. And in a place like the U.S. where tests aren't readily available for just anyone, it's not like you'll be able to find out quickly if you have COVID-19 or not. And right now, the priority has been on symptomatic cases. So if you've

suddenly lost your sense of smell or taste, the best thing to do is to talk to your doctor and not automatically assume you have COVID-19. Right. I think that's good advice. But, you know, in general, this all kind of makes me think about how wild the world of research and science is right now. This pandemic has obviously changed, I don't know, everything it feels like. And one of those is how fast science is and needs to happen. Right. I mean, I spent my, I did my time, Kong, I spent time trying to get published in science. And I just like could never have anticipated what we're seeing right now. Yeah. The amount of studies that are coming out each day, the fact that we have to lean on scientific information that hasn't necessarily been through that long peer reviewed process.

Yeah, you must have whiplash over what's happening right now. I mean, and it's tough because we literally do not have the time to wait for the standard scientific process. And that's why we're chasing down anecdotal evidence like this, more than and we probably would before because we so desperately need to figure out ways to identify and slow down this virus. So in this case, you're seeing this coordinated effort from doctors all over the world coming together to try and figure this out, in the hope that it could maybe save lives. All right, Emily Kwong, what a time to be alive, you know? Seriously.

And I don't mean that in the normal fun way that we say it. I know what you mean, Maddie. Okay, Emily, keep us updated on this. I will. This episode was put together beautifully by Rebecca Ramier. and edited by Viet Le. The facts were checked by Emily Vaughan. Special thanks to Josephine Nia and I

for helping us with that sweet, sweet, sweet sound engineering. I'm Maddie Safaya. I'm Emily Kwong. Thanks for listening to Shortwave from NPR.