For Tara Simmons, it was like going to bed in a world of color and waking up in one that was black and white.
Scooping out her dog’s smelly food — nothing. A handful of minced garlic, right under her nose — nothing. Placing her head into a pot of onions simmering slowly in a pool of butter — nothing.
At first, Simmons didn’t think much of it. Though her job with Southern Glazer’s Wine and Spirits of Florida had her in and out of restaurants frequently, she was always cautious — mindful about social distancing and mask wearing.
But she couldn’t ignore one nagging symptom: her sense of smell had vanished overnight.
A test confirmed that she was positive for COVID-19. That was two months ago, and Simmons says she has yet to fully regain her sense of taste or smell.
“To be able to breathe through your nose and not be able to smell is so weird,” said Simmons, 30. “It is the weirdest symptom of any illness I have ever had.”
By now, a loss of smell — also known as anosmia — has become one of the telltale signs for those who test positive for COVID-19. It’s one of the earliest and most commonly reported symptoms and in many cases, a more reliable indicator of the disease than a fever or cough.
While most people regain their sense of smell within a few weeks, for some the symptoms drag on, sometimes lasting months, a phenomenon that has confounded researchers struggling to make headway in a previously overlooked field.
For Simmons, it’s more than just an inconvenience. As a fine wine rep based in Tampa, it’s her job to pitch and sell wines to clients. It’s her job to pick out the delicate nuances of a given wine with just a swish of a glass and a quick whiff. It’s her job to be able to smell and taste.
“It’s devastating,” Simmons said. “It’s as if you were someone who loved to look at art and you woke up one day and you couldn’t see.”
For those whose livelihoods depend on being able to smell or taste, the loss can feel particularly jarring, and have lasting consequences.
Simmons, who was furloughed for five months last year, was studying for a higher level wine course certificate when she had to postpone the exam because of the pandemic. She’s since had to put off the exam indefinitely because a large portion of the coursework involves smelling and tasting wines.
Though Simmons says she feels lucky she didn’t experience more adverse health effects, the experience has left her shaken. The everyday smells she once took for granted now haunt her. And there is an isolating effect.
“You forget how much smell impacts everything,” she said. “There’s just so much that you feel like you’re missing out on.”
The pandemic has been with us for a year, so the research into smell loss caused by COVID-19 is still new. While scientists scramble to learn more and explain the disorder, social media support groups for those experiencing anosmia have emerged as a resource. One Facebook group has nearly 13,000 members.
Many people have experienced the temporary loss of smell or taste that comes with a stuffy nose or the common cold. But COVID-19 affects the nose differently, said Dr. Mark Tabor, an associate professor who specializes in sinus and skull base surgery at the University of South Florida.
The bulk of a smelling tissue in our noses consists of two different types of cells — olfactory neurons, or smelling cells — and sustentacular cells, also called support cells, Tabor said. Smelling cells will inform the brain what a person is smelling while the support cells help the smelling cells function. So while the common cold or flu may cause inflammation, which can damage the smelling cells, COVID-19 acts differently by attacking the support cells directly.
Many COVID-19 patients can breathe clearly through their nose with little difficulty yet smell nothing.
The good news is that the cells being attacked by the virus can regenerate quickly — within a week or so — and the average COVID-19 patient regains their sense of smell in a short period of time. Tabor says inflammation and damage to the olfactory receptor cells likely is the cause for those who suffer longer.
Tabor says initial studies show that roughly 85 percent of COVID-19 patients who have lost their sense of smell regain it within eight weeks. Within six months, about 95 percent have fully recovered.
But a small percentage of people have yet to regain their sense of smell and taste almost a year later.
“There’s hope for them,” Tabor said. “I wouldn’t give up until, you know, one to two years. The longer you’re without smell, unfortunately, the worse the prognosis.”
An Industry at Risk
Though comprehensive data linking restaurant and hospitality workers to a higher risk of COVID-19 isn’t available, many studies note that food service workers face cramped kitchens, indoor dining spaces and increased exposure to the public. In Tampa Bay it’s rare to encounter a restaurant or bar where a COVID-19 exposure hasn’t taken place. And with the unexplained loss of smell often correlating with scrambled taste buds, experiences with anosmia have become a warning for those in the industry still treating the pandemic lightly.
“It’s literally the first thing we ask: ‘Did you lose your palate?’“ said Andrew Harris, a sommelier and general manager at Rocca in Tampa. “It’s our defining tool, and I think a lot of us are very curious. If you haven’t had it, you’re asking those that did, like, ‘Is this going to ruin my career?’”
Harris, 42, tested positive for COVID-19 at the beginning of October. He described spending two weeks in bed where just getting up and walking to the bathroom would leave him exhausted. But he only experienced a mild loss in his smell, and it returned within a week.
Harris felt like one of the lucky ones. But then, he noticed nuances and quirks in wines he had never experienced before: Tannins, the tactile elements in wine derived from seeds and grape skins, now jumped out at him. Rieslings with slight petrol, or gasoline notes, were all of a sudden overpowering.
Harris’s experience of parosmia — an altered sense of smell — is another challenge for some COVID-19 survivors, in particular those who experience an extended period of smell loss, said Tabor. In those cases, the smells return differently and sometimes register as unwelcome or negative scents like rot or decay — which can be both frustrating and confusing.
It’s been four months, and Harris’ palate and sense of smell with certain wines is still altered, an experience the tenured sommelier described as jarring.
“It’s a very strange sensation if you’ve been doing something for 20 years and then have to do it differently,” Harris said.
A Question of Taste
For chefs and those who work directly with food, the corresponding loss in taste that often accompanies anosmia can be even more disruptive to their work.
“For someone who is so in touch with smell and taste, it was definitely a mind game,” said Rooster & The Till owner Ferrell Alvarez, who contracted COVID-19 last year and said he lost both his sense of taste and smell for about five days.
Alvarez and others have pointed out that, within the culinary community, a strong stigma exists when it comes to the public perception of the virus and reported exposures at restaurants. Owners are fearful of diners lashing out on social media websites like Yelp with complaints. And for any chef, admitting that their ability to taste may have been altered — regardless of how temporary — can be daunting.
“I think a lot of people are apprehensive about sharing their experience,” Alvarez said. “Most people keep it under wraps.”
For most chefs, the biggest challenge is how to approach their day-to-day work once their sense of taste has been altered.
For Michael Buttacavoli, the executive chef of Cena in Tampa and someone with more than two decades in the industry, losing the ability to taste came as a huge shock.
Right before testing positive for COVID-19 last June, Buttacavoli recalled ordering a to-go meal from a local Vietnamese restaurant — a flavorful bun dish fiery with chiles and fish sauce — when he realized that he couldn’t taste anything.
Buttacavoli and his business partners decided to close down the restaurant while the staff quarantined and got tested. By the time they reopened a month later, Buttacavoli’s sense of taste still hadn’t returned.
“It could be the worst thing and I wouldn’t know the difference,” he recalled. “It could be anchovies, raw garlic — it was all the same.”
After three months, the chef’s smell and taste gradually came back although even now — eight months later — Buttacavoli says he still has some difficulty with salt. But, he says, he feels lucky: he’s been in the business long enough to be able to season dishes mostly from memory, or with the help of his staff. The experience has left him weary of the virus and its long-term effects for others in his industry — especially for younger chefs who are still figuring out their palates.
For those who have lost their sense of smell, a therapy known as olfactory training is recommended.
Tabor describes it as akin to “physical therapy for the nose,” where a patient will smell four essential oils at least twice a day for 20 seconds to a minute. While the patient is smelling the oils, they should think of the item associated with that scent. It will help retrain the brain to recognize the odors.
The way smells and taste return seems to vary from person to person. In January, New York Times restaurant critic and recipe columnist Tejal Rao chronicled her experience with the virus. Spice, in particular the spice from Sichuan peppercorns and chiles, was among the first tastes to register for the writer. For Buttacavoli, spicy foods and acidic flavors — vinegar and chiles — were also the tastes that returned to him first.
Tabor explained that this is likely because flavors with a lot of spice or acid register differently — through what he called the “pain pathway” — rather than through smell or taste cells.
Would eating spicy or acidic foods help someone’s taste return in a similar way to olfactory training? Maybe, Tabor said. “We don’t know how it works. But we do know that stimulating a nerve sometimes helps it regenerate.”
Perhaps the most confounding part for many who end up losing their sense of smell is that there doesn’t appear to be any uniform experience; the cases range from mild to severe with no apparent rhyme or reason. Kaitlyn Duke, a beverage director and sommelier at Bascom’s Chop House in Clearwater, lost her sense of smell and taste for a couple of weeks. Harris and Alvarez regained theirs within a week. It took Buttacavoli three months.
Now going on her third month, Simmons hopes she’ll be next.
Slowly, certain tactile elements in wines like tannins and acidity have returned. Simmons says she can now taste some salt and sugar. She’s hopeful it’s just a matter of time before the rest of it comes back.
“I want to turn on a lightswitch and have my smell back,” she said. “My big fear is that I might be one of the super unlucky ones who never get it back.”