23 May,2021 07:07 AM IST | Mumbai | Anju Maskeri
Culinary consultant and sensory panelist Saee Koranne-Khandekar lost her sense of smell and taste after contracting COVID-19. Because working in the kitchen is her “bread and butter”, she describes the experience as devastating. Pic/Sameer Markande
Earlier this year, when culinary consultant and chronicler Saee Koranne-Khandekar experienced trouble with tasting what she cooked, she assumed that it was another bout of sinusitis. It is when she got herself tested for Covid-19, and tested positive, that she realised that unlike the usual nasal congestion she experienced, this time, the palate deprivation was far more intense. She couldn't tell sweaty socks from a fragrant flower. The anxiety of possibly never being able to smell or taste again was mortifying for the Mumbai resident, who enjoys a loyal following of home chefs and food enthusiasts who look to her for authentic data and recipes from Maharashtrian cuisine. "This is pretty much my bread and butter. To lose these faculties was devastating. I had a meltdown."
At the time, her family, including three children and husband had contracted the virus. "I had to continue cooking for the home. And to do that without being able to smell was challenging," she recounts.
To help retrain the nose, Khandekar would obsessively smell a variety of ingredients, from herbs to curry powder and spices. After 15 days of home quarantine, she realised that she was gradually regaining her lost faculty. "But, it's not completely back to normal yet."
While loss of smell has entered drawing room conversations since the Coronavirus pandemic hit last year, millions around the world have lived without this faculty. Chrissi Kelly, founder of AbScent.org, estimates that almost five per cent of the world's population has little or no olfactory function. The UK charity she heads assists people with smell disorders and has been at the centre of research into smell-loss before and throughout the pandemic. "Infection, head injury and neurological diseases like Parkinson's and Alzheimer's also affect the sense of smell, but a poor sense of smell is commonly experienced in the older population, affecting one in four people above the age of 50," she tells mid-day. The prevalence of smell loss in people who have struggled with the Coronavirus infection has been high. Estimates vary, but experts believe that 60 to 80 per cent of those testing positive are also are also experiencing a loss of smell and taste. "The symptom is short-lived for most patients, returning naturally to normal within two or three weeks. Unfortunately, around one in 10 people will experience long-term smell loss. They could take 12 months or more to recover."
Dr Sheetal Radia, consultant otorhinolaryngologist, who is associated with the head and neck oncosurgery department at Wockhardt Hospital, Mira Road, has seen a steady stream of patients battling loss of smell since last year. "Earlier, patients who came in with the condition were those with swollen sinuses and nasal polyps," says Radia. Since Covid-19, she has been administering nasal sprays, vitamins and medication to help them heal. "Most of them are able to bounce back within 10 days, but among my clients are four patients who have been living with the condition for 10 months."
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The human ability to identify various smells is the result of a complex neurological process. When the molecules released by substances around us, enter the nostrils, they stimulate the receptors located on the olfactory sensory neurons at the back of the nose. It is these neurons that send messages to the brain, helping us identify a particular smell, and therefore, substances and objects. Research suggests that the Covid-19 virus disrupts cells in the nasal cavity, which could result in inflammation that impairs the function of olfactory receptor neurons.
While most smell disorders may not necessarily be linked to not being able to taste, Dr Radia says the two problems seem intertwined for most of those infected
with the virus.
Her colleague and fellow consultant otorhinolaryngologist and and head and neck onco surgeon, ChandraVeer Singh, released a scientific paper on the subject earlier this year. "The base of the skull is actually the upper part of the nose; here plays out a complex partnership between the nose and brain. When SARS-CoV-2 invades the body, it impacts the neurons by causing inflammation and oedema [swelling of tissue] that knock out our smell function. These neurons go straight to the brain. In severe cases, due to olfactory neuritis [inflammation], those nerves don't grow back." The team has been relying on the fluticasone nasal spray, which they say shows results within five days of administering it. While, anosmia refers to the complete absence of smell, hyposmia is the term used to refer to a reduced sense of smell. "What we are also seeing among Covid-19 patients is parosmia, which is a distorted sense of smell. People have said that a cup of freshly brewed coffee smells like garbage, or that they can't eat their favourite foods anymore because they don't taste pleasant like they did."
The emotional and psychological toll of this physiological change can be grave, say experts. Dr Radia has come across mothers who are stressed because they can't tell when their infant needs a diaper change. "It also affects your sex life because we may not realise it, but scent plays an often under-appreciated role in sexual attraction." In a paper titled, Archives of Sexual Behaviour, researcher Johanna Bendas at the Technical University of Dresden, Germany, writes, "The perception of body odours such as vaginal fluids, sperm and sweat seems to enrich the sexual experience by increasing sexual arousal."
Rajiv Sheth is what they call the "nose" and creative director of All Good Scents. He also represents Cinquième Sen, an acclaimed perfumery school with centres in 18 locations, including Paris and New York. Every year, they provide olfactory training to 500 enthusiasts, including executives, marketers, trainers, sales representatives and production technicians. "Through our network, we have come across cases of perfumers too, who have lost their sense of smell. We have been actively addressing this through webinars and live sessions. It's not uncommon for a patient to slip into a depressive state because of this change." The good thing, Seth shares, is that since the Coronavirus outbreak, people have realised the importance of smell. "We used to consider it a âpassive' sense, something we took for granted. Not anymore."
In 2018, an American survey asked participants which sense they would miss the most and found that sight was at the top (70 per cent). Smell (2 per cent) ranked last, after hearing (7 per cent), taste (5 per cent) and touch (3 per cent). Ankit Agrawal, director at Zed Black, an agarbatti brand from Mysore Deep Perfumery House (MDPH), says interestingly, they have noticed a surge in demand since the pandemic. "Now that people are working from home, they have more time to light agarbattis. Traditionally, we associated incense sticks with religious rituals, but it's becoming more of a lifestyle product that some feel puts them in a better place, making them less anxious and sleep better." Despite rising demand, Agrawal admits they are feeling straightjacketed since supply chains have been disrupted in the second wave, as the transmission of virus pattern is moving from urban to rural parts of India. "A bulk of the production is managed by staff that comes from villages. Our factory is in Indore which has seen a sharp rise in COVID-19 cases."
The way that Agrawal's customer would approach smell is different from a perfumer. "I don't judge a smell as good or bad. For me, it's an odour. Even in perfumery, you have natural ingredients that could smell unpleasant if sniffed individually, but when added to a concoction, they react in a different way," says Sheth. According to him, a keen sense of smell is something that can be cultivated with training. "When I did my perfumery training in France, we had to smell 1,000 odours and identify 10 from the lot. This was our evaluation. They would even give us 10 orange essential oils and we'd have to identify which part of the world the orange in a particular oil came from."
Khandekar has in fact, completed a course on aromas and is a qualified sensory panellist. "This basically means that I can taste things for food manufacturers and offer my opinion. You learn things like how aroma is extracted from a single pod of cardamom or how you do blind tastings for a range of products with miniscule differences between them."
Amrita Deora, founder of The Designera, says scents trigger memories and emotions. She recently launched Scentorial Art, a trademarked medium of art. Here, the glass candles are encased in intricate artwork done by home-grown artists under the brand's incubation portfolio, combining sight and smell to help you experience art in all its sensory glory. "Traditionally, we have experienced art through all four senses, but never through smell. During our research, we were able to establish that when it comes to triggering emotions, smell is in fact, more potent than sight. After we had concocted each scent combination, we asked people to tell us the first word that came to mind when they took a whiff. Each of them almost always referred to a feeling or memory. No one ever said, this is rose or vanilla. We learnt what science had already proven: the strongest sense tied to our subconscious mind, memories and emotions is smell, which can therefore be used to enhance wellbeing."
Deora's team has attempted to capture the "feeling" of what a piece of art depicting visual memories on a canvas could smell like. "Through a QR code on the candle jar, we're taking our consumers deeper into the world of art, appeasing all their senses for a multi-dimensional immersive experience."
Meanwhile, smell training is emerging as a simple and side-effect free treatment to tackle post-viral smell distortions. This involves mindfully sniffing the same four scents every day, spending around 20 seconds on each. AbScent, too, has curated smell training kits which have been so far delivered to USA, Australia, New Zealand and South Africa, proceeds from which go back to helping those living with smell disorders.
Simultaneously, the charity has launched the Sense of Smell Project (SoSP), a collaboration between scientists and patients with smell disorders. Through this, the organisation is trying to learn more about what it is like to live with this condition and how people's lives change as a result. "The objective was to build a picture of patient experience from multiple causes of smell loss that would help us raise awareness about the impact of the condition. The data is currently being analysed and we are awaiting results. One particular study into parosmia in collaboration with the University of Reading, Berkshire, has identified the molecular triggers for this distressing condition, which could eventually pave the way for potential treatments."
Despite this increased level of interest, she says there continue to be many unanswered questions around olfactory disorders. "Sustained research is needed if we are to help people to overcome the challenges of eating disorders and depression, some of which result from long-term smell disorders."
1/10
Number of patients who take 10 months or more to see their sense of smell return post-COVID
5 per cent
Estimated ratio of the world's population that has little or no olfactory function according to AbScent,org
Dr Caro Verbeek is a researcher of olfactory heritage at Vrije Universiteit, Amsterdam, the Rijksmuseum and International Flavours & Fragrances. Trained as an art historian, she specialises in sensory art and education in museums, art academies and universities. According to her, what few people talk about in relation to anosmia is "olfactorisation". Ep Köster, a retired professor of experimental psychology at Utrecht University, who specialised in the sense of smell and odour memory, researched how one out of three people can imagine or âolfactorise' scents. To those that can't, anosmia is even more devastating because smells disappear from their lives entirely. We can train to olfactorise. At this point, may be we should invest in this training," says the curator in chief of the olfactory culture programme, Odorama, at Mediamatic Amsterdam. Dr Verbeek explores this subject in an interview with Marije Vogelzang, for futuristscents.com. Vogelzang is a Dutch "eating" designer who focuses on how people design their food habits, ways and rituals. "I tried to imagine smells. In the shower, I had an imaginary Coca Cola shower which worked very well. Some scents were very easy to imagine and it seemed to me that was because I had a clean slate to work from," says Vogelzang.
