Two and a half years ago my nose stopped working.
That’s when I realized how often smells pop up in everyday conversation: “This Uber smelled funny” or “This woman wore way too much perfume” or “Someone is definitely smoking weed nearby”.
I have anosmia, a symptom of long COVID. I contracted the virus early in the pandemic and had horrific symptoms, but after a week of bed rest I was ready to resume my life. It wasn’t my nose.
With the pandemic now well into its third year, anosmia – once an obscure problem – has become increasingly prevalent.
according to dr Bradley J. Goldstein, an ear, nose and throat doctor at Duke University Hospital, about 5% of people who experience smell loss during COVID-19 will develop long-term anosmia.
The effects are more drastic than most people realize.
“Smell is one of our most important sensory systems, constantly providing the brain with information about our environment, about the world around us,” Goldstein said. “A lot of this happens passively with us. We don’t always think about snooping on purpose, but we get a lot of input all the time.”
I’m a junior in college now and I have no idea what my campus smells like. I’m constantly afraid that I’ll smell bad, that the food I’m going to eat will be rancid, or that my dorm will be on fire. I can’t remember what I smelled last.
“We tend to rely on sight and hearing, maybe a little more directly, but smell is still a really important sensory system. And when it doesn’t work, people really realize that something important is missing,” Goldstein said.
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People like to tell me that sometimes it can be good to have a dysfunctional nose. And sure, I can cook broccoli in my one-bedroom apartment and use public restrooms without gagging. I was unimpressed during a 14-hour drive from North Carolina to Louisiana with four boys (and their Moe’s Southwest Grill orders).
But then there are the other times. Like the gas leak in my dorm building – I wasn’t aware of the smell while watching TV when my RA banged on my door in shock to find I hadn’t been evacuated yet.
The sudden increase in patients losing their sense of smell has also hit smell researchers hard.
“It’s really radically changed the lives of a lot of olfactory researchers who were doing something different and are now studying the effects of COVID,” said Dr. Danielle R. Reed, Associate Director of the Monell Chemical Senses Center in Philadelphia.
“It was really amazing to suddenly be the center of attention around the world.”
Reed and her colleagues knew before the pandemic that viral infection can cause smell loss, but not much attention has been paid to how and why. Now, answering those questions is paramount — and researchers have been thrust into the spotlight.
Early on, Reed’s lab developed a test to try to standardize smell loss diagnoses in doctors’ offices. It asks patients to locate odors on a leaf, rate their intensity, and try to identify them. This allows patients to see the severity of their condition and allows their doctors to easily measure improvement.
Now the lab is working on taking cells from tissue in the nasal cavity and growing them in a Petri dish. They plan to expose these cells to SARS-CoV-2 and other viruses to find out why COVID-19 has a unique impact on smell.
“There are biological processes that we are working to understand. And if we can understand it, we can hope to rectify it,” she said.
Researchers in Goldstein’s lab have done similar work. Beginning in 2020, they began biopsying nasal tissue from patients with post-COVID anosmia to see if they could figure out what was responsible for the loss of smell.
“We’re still learning more about what exactly is damaged or where exactly the damage is,” he said.
Still other researchers are studying how the virus attacks the olfactory nerve, which transmits olfactory sensations to the brain.
As researchers search for a cure, the internet fills with suggestions—sometimes well-intentioned, but most often ineffective.
People like to tell me about the latest healing they’ve seen on TikTok. I’ve tried them all: the burnt orange trick, the back of the head trick, aromatherapy with essential oils, and a daily nasal steroid. I went to Goldstein’s clinic for an odor identification test and nasal endoscopy.
So far there is no cure.
But there are ways to deal with it.
Early on, I smiled and nodded when people unaware of my anosmia asked me things like to confirm that their Bed Bath & Beyond candle smelled good. I was embarrassed to tell them I really didn’t know. Like it somehow makes me seem smaller.
“Oh shit, I’m sorry,” my father began to say every time he instinctively commented on a passing smell.
But I actually like it when people address ambient scents.
“It’s okay, just describe it to me,” I reply.
I want to know that the Subway sandwich shop across from my apartment is still pouring out warm, weirdly sweet bread. Or that the pasta my sister ordered for dinner made the whole table smell like truffles.
Sometimes, when I first walk into a restaurant or store, I say out loud, “What’s that smell?” Just in case there’s one that someone can tell me about. I don’t want to be left out.
I learned that the English language lacks descriptions of smells. Most of the time people just choose “good” or “bad”.
If they really try, people will add a ‘y’ to the end of another word. earthy. Mint. Fruity. These are better than “good,” but I still have a hard time turning my head around. (Tropical fruity and wild berry fruity are two very different scents – I remember that.)
Eventually I started saying “compare the smell to something” instead of “describe it”. I find it much easier to imagine a scent when someone compares it to, for example, a wet dog or strawberry jelly.
My close friends understand the need to say that bakeries we pass smell like caramelized sugar and college parties we attend smell like sweaty boys and old beers. Those are smells I know.
Luckily, my sense of taste isn’t dramatically affected. I ran blind tasting tests with different potato chip flavors to confirm this.
A person can taste with a dysfunctional nose, Goldstein said. Taste bud sensations in the mouth are only part of how we perceive taste. The mouthfeel of the sensory nerves and the airborne substances that make their way to the olfactory cells in the nose “give you a lot of information about the chemical properties of food,” Goldstein said.
“When someone completely loses their sense of smell, they miss a lot of that input,” he said. “Yes, they can still taste salty, or they can still taste sour or bitter, but some of the other qualities conveyed by the olfactory sensation are kind of missing.”
In my case, while I’m sure my tastes are less refined than they were before COVID-19, the dining experience has never become a chore. I’ve never had to rely on texture more than flavor or douse my food with hot sauce to feel anything.
This type of loss is just one of the additional problems faced by some people who have lost their sense of smell. For some, the effects can include depression and anxiety, Reed said.
“No one really wants to talk about the mental health aspect,” she said. “But that’s definitely something that keeps coming up.”
Chrissi Kelly, who now works to treat olfactory disorders in the UK, lost her sense of smell in 2012 after suffering from a sinus infection. Soon after, she began to feel intense depressive effects.
“I wasn’t prepared for that and didn’t really know where to look for advice,” Kelly said. “It really changed my life. It was just a very, very dark time for me.”
Kelly founded AbScent shortly after her diagnosis, when anosmia was not so well known. The organization, which provides support and information for those affected by olfactory disorders, has experienced rapid growth with the outbreak of COVID-19. Before the pandemic, it had around 1,500 members; now it serves more than 85,000 people worldwide.
Explaining the condition to those unaffected is one of the hardest parts of advocacy, Kelly has found.
“You don’t even know where to start,” she said. “I think it’s because smell is so fundamental to all organisms. And that’s why it’s just unthinkable to imagine life without it. It’s like saying, “Okay, I want you to imagine life without gravity. Or how about imagining life without time?’”
It’s hard to describe “how weird it is, how suffocating it is,” she said.
“Recovery is messy,” Kelly tells AbScent members. Anosmia can change from day to day and requires patience. In her case, the recovery took eight years.
As for me, I’ll catch a whiff here and there. A whiff of my dog’s food as I pour it into her bowl, or a whiff of smoke from a passing cigarette.
I can’t say whether these are phantom scents. But they give me hope.
The other day I was sitting in bed with my computer when something wrinkled my nose. I ignored it at first. Then I remembered two slices of bread I put in the toaster 15 minutes earlier.
Running into the kitchen, I found two smoking, charred squares. A few expletives later, as I threw the disks in the trash, I audibly gasped.
I didn’t jump out of bed because I saw the burning bread. I hadn’t heard the machine beep. I smelled the smoke. Or perceived it with another developing sixth sense.
Anyway, it was the most excited I’ll ever have over burnt toast.
https://www.latimes.com/science/story/2022-09-29/covid-lose-sense-of-smell-coping How I cope after losing my sense of smell to COVID