Pinellas County Sheriff Bob Gualtieri woke up one morning in August 2020 to an experience familiar by now to thousands of Floridians.
He couldn’t taste his toothpaste.
“I guess in our world you call that an investigative clue,” Gualtieri said recently.
He knew things were amiss when he couldn’t taste his morning coffee. He went to a health clinic for a coronavirus test and wasn’t shocked when it came back positive. The next few weeks were filled with fatigue, the worst sore throat he’s ever had, and pounding headaches that had him popping Advil and Tylenol every couple of hours.
Most of the symptoms lasted about two weeks, the tiredness a little longer. But one symptom didn’t go away for weeks, then months: His loss of taste and smell.
More than a year after his diagnosis, Gualtieri has regained some of his senses through treatment by an ear, nose and throat specialist. But he still has a ways to go. A recent study from Washington University suggests many people are in the same position. The research estimated that as many as 1.6 million Americans have lost or had a change in their sense of smell for at least six months due to the virus.
What’s it like to live without full smell and taste all this time? Gualtieri, 60, emphasized that he is grateful he didn’t have the more severe respiratory symptoms associated with the virus and has otherwise made a full recovery.
“You can live without your taste and smell,” he said. “It’s not pleasant, but it’s not the serious stuff.”
Still, it can be pretty miserable. There’s no pleasure in eating, he said. It’s strictly for subsistence. He gave up the pasta and bread he often ate, a sacrifice for a man who loves Italian food. His family’s Friday night dinners at Vetture’s Pizzeria and Restaurant in East Lake were toast. He largely stopped eating cakes and doughnuts and lost about 25 pounds.
An especially sobering moment came earlier this year when he made his teenage daughter bacon macaroni and cheese and couldn’t taste the bacon at all.
“It was like eating nothing,” he said. “When you can’t taste bacon, something’s wrong.”
Gualtieri looked into specialists who might help him and was connected to Dr. Trina Espinola, chief medical officer at Bayfront Health St. Petersburg and an ear, nose and throat specialist.
Coronavirus can cause swelling in the support cells around the olfactory fibers that transmit smells to the brain, Espinola said. That’s where the change in smell comes in. Eighty percent of flavor comes from your sense of smell, she said, so any change in that sense will also affect what you taste. The tongue can only discern salt and sugar, and bitter and sour flavors.
Conditions that cause the inside of your nose to swell up, such as sinus infections or allergies, can also affect smell. But that’s because the droplets that contain aroma can’t get high enough in your nose to process the smell. COVID-19 is unique because it affects the neurotransmitters that send the message to the brain, she said.
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Loss of smell and taste was the first presenting symptom in about 30 to 50 percent of virus cases, although it’s a little lower in those infected by the omicron variant, Espinola said. In many cases, the senses come back on their own. But if the symptom persists, the key to recovery is to seek treatment as soon as possible, she said.
“The longer you wait, the more compromised the outcome,” she said.
Gualtieri came to her about six weeks after his infection, said Espinola, who talked about the sheriff’s case with his permission. She put him on oral steroids to get the swelling down as well as a nasal steroid spray. She also assigned him to what she called smell challenges, which help retrain your brain. Typically she tells patients to sniff subtle things, like lavender and vanilla, then to end with coffee, one of the strongest smell triggers.
“He was very diligent about it because he was very, very upset about losing his sense of smell,” she said. “Things just didn’t taste good to him.”
The treatment has helped, the sheriff said. He can taste some things, such as salmon, or food that’s really spicy. He can tell the difference between sweet and savory. But then, a few weeks ago, he took a chance and tried a cheeseburger — with onions.
“It was like eating cardboard,” he said.
That’s likely because the taste of onion is smell-driven, Espinola said. Red meat largely derives its taste from smell, too. With salmon, the seasoning could possibly be triggering a memory.
“The whole experience of the taste of something that also includes sense of smell — you’re triggering an area in your brain that makes it taste by memory, as it has in the past,” she said.
The best way to prevent the symptom is to avoid getting COVID to begin with, she said. That means getting vaccinated and wearing a mask.
Gualtieri was infected before vaccines were available and now he’s gotten the vaccine and a booster shot. He plans to continue treatment up until two years or so after his diagnosis. At that point, Espinola said, “if you don’t get it back, you’re probably not going to get it back.”
While he waits, Gualtieri plans to eat a lot of salmon.
• • •
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The COVID-19 vaccine for ages 5 and up and booster shots for eligible recipients are being administered at doctors’ offices, clinics, pharmacies, grocery stores and public vaccination sites. Many allow appointments to be booked online. Here’s how to find a site near you:
Find a site: Visit vaccines.gov to find vaccination sites in your ZIP code.
More help: Call the National COVID-19 Vaccination Assistance Hotline.
Phone: 800-232-0233. Help is available in English, Spanish and other languages.
Disability Information and Access Line: Call 888-677-1199 or email DIAL@n4a.org.
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