Mar 25, 2020 7:00 AM

Loss of smell, taste, might signal pandemic virus infection

Posted Mar 25, 2020 7:00 AM

NEW YORK (AP) — A loss of smell or taste might be an early sign of infection with the pandemic virus, say medical experts who cite reports from several countries.

It might even serve as a useful screening tool, they say.

The idea of a virus infection reducing sense of smell is not new. Respiratory viral infection is a common cause of loss of smell, because inflammation can interfere with airflow and the ability to detect odors. The sense of smell usually returns when the infection resolves, but in a small percentage of cases, smell loss can persist after other symptoms disappear. In some cases, it is permanent.

Now, there’s “good evidence” from South Korea, China and Italy for loss or impairment of smell in infected people, says a joint statement from the presidents of the British Rhinological Society and of ENT UK, a British group that represents ear, nose and throat doctors. In South Korea, some 30% of people who tested positive for the virus have cited loss of smell as their major complaint in otherwise mild cases, they wrote.

So that might be useful as a way to spot infected people without other symptoms — fever, coughing and shortness of breath — of the new coronavirus, they wrote.

A similar proposal was published Sunday by the American Academy of Otolaryngology-Head and Neck Surgery. It noted “rapidly accumulating” anecdotal evidence from around the world that the pandemic virus can cause not only loss of smell but also a diminished sense of taste. So the appearance of those symptoms in people without another explanation should alert doctors to the possibility of a COVID-19 infection, the group said.

Maria Van Kerkhove, an outbreak expert at the World Health Organization, told reporters Monday that the U.N. health agency is looking into the question of whether the loss of smell or taste are a defining feature of the disease.

Dr. Eric Holbrook, an expert on nasal and sinus disease at the Massachusetts Eye and Ear hospital in Boston, said the reports have been a hot topic among researchers and doctors. But “we don’t have hard evidence right now” about how often smell loss occurs in people infected with the pandemic virus, he said in an interview Monday.

Holbrook said the reports he has seen suggest the sense of smell returns within a couple weeks, but how long it lasts has yet to be firmly established.

He also said it’s difficult to assess reports of a loss of taste because people with an impaired sense of smell often report a loss of flavor, which is technically different from an impairment in taste.

Holbrook said he is trying to set up a study of smell in people being tested for the coronavirus at Boston-area hospitals.

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Mar 25, 2020 7:00 AM
UPDATE: What Kansans need to know about the COVID-19 coronavirus
Health officials say one way to stop the spread of the new coronavirus is to wash your hands for at least 20 seconds. Celia Llopis-Jepsen / Kansas News Service

Kansas News Service

The new coronavirus is spreading quickly around the world, including across Kansas, and setting off a range of responses.

The Kansas News Service is boiling down key developments in the state and updating the status regularly here. To read this information in Spanish, go here. This list was last updated at 2:10 p.m. March 31.

CASES AND DEATHS

430 cases, including two from out of state (see map for counties)

9 deaths (4 in Wyandotte County, 3 in Johnson County, 1 each in Sedgwick and Crawford counties)

NOTE: These figures only include cases confirmed with lab tests and do not represent the real, unknown total. Community transmission is occurring in parts of Kansas.

STATEWIDE ORDER TO STAY HOME

Gov. Laura Kelly is instituting a statewide stay-at-home order as of 12:01 a.m. March 30. It will last until at least April 19. Stay-at-home orders allow people to take care of essential activities (such as grocery shopping or going to work) as well as exercise outside, but otherwise keep to themselves. 

The state’s stay-at-home order supersedes at least 13 county-by-county orders. Should the state’s order lift before a county’s is through, the county can choose to keep its own in effect.

SHOULD I SELF-QUARANTINE?

For the whole state: The Kansas Department of Health and Environment (KDHE) is now mandating home quarantine for 14 days if you've traveled to the places listed below. If you come down with symptoms (such as a fever of 100.4 degrees or higher, coughing or shortness of breath) during those 14 days, contact your health care provider and explain your potential COVID-19 exposure.  

  1. Louisiana or anywhere in Colorado on or after March 27.
  2. States with known widespread community transmission (California, Florida, New York and Washington) on or after March 15.
  3. Illinois or New Jersey on or after March 23.
  4. Eagle, Summit, Pitkin and Gunnison counties in Colorado (if your visit was March 8th or later).
  5. Cruise ships or river cruises on or after March 15. Anyone previously told to quarantine because of their cruise ship travel should also finish out their quarantine.
  6. International destinations on or after March 15. Anyone previously told to quarantine because of their international travel should also finish out their quarantine.

TESTING AVAILABILITY

As of March 27, Kansas health secretary Lee Norman said the state lab was handling 175 samples a day. But Kansas will receive more equipment within about a week that will let it handle 700 to 1,000 samples daily, though shortages of specialized supplies such as nose swabs may still hamper work at times. 

Norman said there’s enough capacity in the state, now that testing has ramped up through commercial labs and hospitals. State testing is reserved for high-risk groups, such as sick nursing home residents and health care workers. Others can ask their doctor or nurse practitioner to order through private labs.

What Kansas still lacks is enough testing material to study COVID-19 rates among people without symptoms.

KANSAS HAS DECLARED A STATE OF EMERGENCY. WHAT DOES THAT MEAN?

It gives the state government more power to marshal resources and triggers the state's response plan. The state Legislature has extended Kelly's declaration through May (and can extend it), with the aim of giving her the ability to make certain decisions when lawmakers aren’t in session.

On March 22, Kelly eased state rules to expand the use of telemedicine, to temporarily license more health workers and to allow heavier trucks on Kansas highways hauling relief supplies. On March 23, she ordered a ban on evictions if a tenant was unable to pay because of the coronavirus crisis. And she extended the income tax filing deadline to July 15, in line with a delay for filing federal tax forms.

HOW ARE UNIVERSITIES RESPONDING?

K-State, University of Kansas and Wichita State: All of them will go fully online for the end of the school year. Students at K-State and KU will need special exemptions to remain in dorms.

Other colleges: Washburn and Fort Hays State are online. Newman University expanded spring break for two weeks (March 14 to March 29). Johnson County Community College will close campus from March 14-29, and all courses will restart online March 30. Pittsburg State started break a day early and will resume classes indefinitely online on March 30.

HOW ABOUT K-12 SCHOOLS?

Gov. Laura Kelly and Kansas Education Commissioner Randy Watson have shut down all K-12 schools, public, private and parochial, for the rest of the 2019-20 school year. They had initially issued a strong recommendation that schools close March 16 through 20. 

Some county health departments had already issued similar orders. 

A Kansas State Department of Education task force has issued guidance to school districts on how to continue some amount of student learning. 

WHAT’S BEEN CANCELED OR SUSPENDED?

The governor’s executive order temporarily banning landlords from evicting businesses or residential tenants is effective until May 1. That same order put in a moratorium on any mortgage foreclosures through the same period.

The governor mandated on March 23, through an executive order, that gatherings be restricted to less than 10 people.

Kansas state workers: Access to the Statehouse is limited to official business only, and lawmakers went on break early. Kelly wanted most state employees to stay home for at least two weeks starting March 23.

State prisons: The Kansas Department of Corrections ended visitation at all state facilities, and will “re-evaluate on an ongoing basis.” It urges families to talk to inmates through email, phone calls and video visits. 

Electric companies: Evergy, which serves 950,000 customers in Kansas, will not disconnect residential or business services for an unspecified amount of time due to the “unprecedented challenge” of coronavirus that “may result in customers facing unexpected or unusual financial strain.”

Casinos: All four state-owned gaming facilities will close at the end of business on March 17, and remain so until at least March 30.

Public events: Many events and public places around the state have been canceled until at least the end of March. 

Sports: The Kansas State High School Athletics Association canceled the state basketball tournament midway through it. And the Big 12 suspended spring sports until March 29.  

HOW BAD IS THE VIRUS? 

COVID-19 usually causes mild to moderate symptoms, like a fever or cough. Most people with mild symptoms recover in two weeks. More severe cases, found in older adults and people with health issues, can have up to six weeks’ recovery time or can lead to death.

HOW CAN YOU AVOID IT?

  1. Wash your hands for at least 20 seconds. Frequently.
  2. Cover your coughs.
  3. If you’re an older Kansan or medically fragile, put off any vacations and limit your trips to the grocery store or any public space.
  4. Stay home if you are sick — this goes for all ages.

FOR MORE INFORMATION ON COVID-19

Kansas Department of Health and Environment: http://www.kdheks.gov/coronavirus/

The Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-nCoV/index.html

The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.