This COVID symptom really stinks, even if you can’t smell

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I didn’t know quite how to say what I needed to say without offending the person on the other end of the hotel phone so I just went the direct path.

Could they please tell me what they had brought me for dinner because, having just eaten it, I simply didn’t know what it was. “It’s Mexican,” came the polite reply.

The previously dominant strains, Alpha and Delta, caused a loss of smell and taste in 40 to 90 per cent of cases. Omicron seems to be less likely to attack these senses.Credit: Dionne Gain

Mexican? I could tell that it was red and likely chicken. I could tell that it was warm. But Mexican? Not so much.

Being a hotel quarantine room the staff may have been used to this line of questioning from their COVID-positive guests.

I opened a yoghurt from the bar fridge and took a big whiff. Nothing. I ate some M&Ms, nothing but crunch.

The absolute clincher that coronavirus has stolen my sense of smell came a couple days later when a man blew cigarette smoke in my face on the street and… nothing.

We all know that coronavirus can affect smell and taste but researching it and explaining the experience to others revealed that most people don’t appreciate why it happens or that it can last weeks after you’re released from isolation to come back.

It, reasonably, takes a backseat to the prospect of being unable to breathe in the symptom hierarchy but experts are certainly taking notice not least because one-in-10 people affected by the pre-Omicron strains around the world report still having problems six months later.

And with daily case numbers now into six figures in this country there’s going to be many people losing touch with their nose. So what’s behind it, how long will it last and what can you do about it?

Smell, taste and flavour

To understand what’s going on you need to get your head around smell, taste and flavour. Smell is managed through cells and receptors in your nose. Taste is all about your tongue and it’s where you get sweet, sour, salty, bitter and umami.

Flavour is a combination of both with smell playing the dominant role. In my case I lost my smell but not my taste – my tongue was working but my nose wasn’t. It was really weird. I could feel the burning chilli of a curry and get a sense of the saltiness of it but I couldn’t tell you if it was vindaloo or rogan josh.

How common is it and what causes it?

Deakin University’s Russell Keast says COVID-19’s previously dominant strains, Alpha and Delta, caused a loss of smell and taste in somewhere between 40 and 90 per cent of cases.

The data is still patchy but the good news is that Omicron seems to be less likely to attack these senses with the rate down to between 5 per cent and 10 per cent. Research out of the United Kingdom suggests up to 13 per cent of people might have their smell and taste affected with Omicron.

Unfortunately, as we know, Omicron is affecting many more people so there are likely thousands of Australians suddenly finding they can’t taste their dinner or smell their partner.

Keast says the way coronavirus has attacked smell and taste is quite unique and disconcerting for those affected.

The reason it’s different to a blocked or runny nose you might get with a cold is that the coronavirus damages the cells that play crucial support roles for the receptors in your nose and on your tongue. A cold might just create a mucus barrier to the chemicals you want to smell rather than damaging the receptor support cells.

Keast says that while smell is relatively fragile and can be affected by many things, the loss of taste is something particularly unusual about COVID-19.

Those who lose their sense of smell are suffering anosmia while those who find that once pleasant smells are now deeply unpleasant or altered have parosmia.

Will it come back?

The good news is, for the vast majority of people, that yes your sense will recover.

The receptor support cells that the virus damages naturally regenerate – in fact they turn over about every two weeks under normal circumstances. This is why if you burn your tongue things recover after a little while.

How long that takes varies. If you research this you’ll find a widely quoted figure suggesting that 90 per cent of people have smell and taste back within six months.

Keast estimates 75 per cent to 80 per cent of people recover their senses within four to five weeks. This was my experience too and I have to tell you that a month without your mouth sending lovely messages to your mind about the food you’re eating is a long time.

“In the absence of smell and taste you need to concentrate on [making] the eating experience exciting rather than suffer a loss of appetite.”

For an unlucky few – perhaps as many as 10 per cent – the problems linger much longer.

“When it comes back it may not come back as you want it, it can be quite distressing,” he says.

This is very much a developing field, Swedish scientists recently published a paper, that is yet to be peer-reviewed, pointing to long-term damage for a significant proportion of people who recover from COVID-19.

Is it serious?

To be without taste or smell for a couple of weeks is disconcerting and can add to the misery of feeling sick and isolation but for those who have to live with it for longer there is real concern.

“It is not only about food. We are documenting people who are becoming malnourished,” says Duika Burges Watson, from Britain’s University of Newcastle.

“It’s not just food, it’s an altered experience of the world and experience of intimacy was a big issue.”

She says she has seen relationships on the brink because a person finds their partner’s smell completely repulsive.

There are also the obvious safety risks for people who do not pick up smells such as smoke or gas. On top of that, the loss of these senses can lead to serious mental health problems including depression and anxiety.

What can you do about it?

Most people will notice their senses returning gradually over weeks so it’s about trying to get through a few unpleasant weeks (see some eating tips below).

“In the vast majority of cases things will return to normal, you have just got to do what you can to get through the short term and hope it doesn’t last too long,” Keast says.

Based on scientific evidence, Dr Burges Watson recommends smell training for those who suffer longer symptoms. You do this by repeatedly sniffing smells to reinforce your body’s interpretation of them.

The hand of Dr Clair Vandersteen wafts a tube of odours under the nose of a blindfolded patient, Gabriella Forgione, during tests in a hospital in Nice to help determine why she has been unable to smell or taste since she contracted COVID-19.Credit:AP

“But you have to stick with it, it doesn’t happen overnight – you need to do it for several months,” she says. “It’s a bit more complex than just sniffing.”

There are several charities and research bodies that help people with these issues such as AbScent, Monnell Centre and Stana which have additional resources on how to tackle the problem.

The key thing is to find support from other people who are experiencing the same dislocation as you because long-term loss of smell and taste is a “very, very serious issue”, says Burges Watson.

So I can’t taste food, what should I eat?

Flavour combines smell – information from your nose – and taste – information from your tongue. Coronavirus can affect one or the other or both.

In my case, with my tongue still telling me about spicy, sour, salty – curries were great.

Fizzy, cold, bitter beer was a winner. Textures and temperature help too as the trigeminal nerve in your mouth should still become stimulated by temperatures and spice.

Bring more to the plate

• Texture: Crunchy, sticky, crispy, chewy, crumbly, hard or suprising 
• Visually appealing: Make dishes look appetising, pretty and colourful
• Flavourful: Use many layered ingredients for more complex tastes
• Zing: Bring hot and cold to your mouth both using temperature or the ingredients (think chilli, wasabi, mint and cinnamon)

Source: Centre for Cancer Nutrition

Alexandra Stewart runs a business which, before the pandemic, was focused on helping cancer patients deal with the impacts of treatment on their sense of smell and taste.

Since then she has seen a huge spike in coronavirus-driven interest. She says the important thing is to lean in on all the other ways you experience food.

“In the absence of smell and taste you need to concentrate on those more to make the eating experience exciting again rather than suffer a loss of appetite,” she says.

“Things that really work are: planning your meal, planning to put in the different components rather than just trying your favourite foods. You have to try to construct a meal that has more interest in it.

“In the absence of taste, your brain is craving alternate forms of stimulation and feedback about food in the mouth. Really cold foods will do this, adding some crunch on top will help add extra texture. Toasted muesli or granola would work or popping candy.”

She says it is important to try swapping foods for substitutes particularly for those with parosmia who might now find staples such as garlic or onion revolting.

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