Coronavirus

When COVID-19 Robs Your Sense Of Smell, Train The Brain To Get It Back

No specific treatment or medication exists to treat anosmia. And yet, a patient's brain can be trained to accelerate the recovery of the lost sense of smell.

In some cases,  anosmia can last for several months
In some cases, anosmia can last for several months
Anne Sophie Goninet

One of the most common symptoms of COVID-19, along with the even more common fever, dry cough and tiredness, is what is called anosmia: the sudden loss of the sense of smell. In some cases, this symptom can last for several months. And the longer it endures, the more of a psychological challenge it becomes. That is why doctors are recommending "olfactory training" to help patients recover their sense of smell more rapidly.

A frequent symptom: Studies suggest that the loss of the sense of smell is a pathognomonic symptom, meaning it is characteristic of a particular disease, in this case, coronavirus. "No other virus known until now has had this effect on the olfactory activity," Hirac Gurden, research director in neuroscience at the French National Center for Scientific Research, told the French daily Les Echos. "If someone catches the flu, anosmia can persist in rare cases in the long term, but never appear overnight."

  • Approximately four out of every five coronavirus patients in France and Belgium experience problems with their sense of smell. In the United States, the numbers are higher still (86%).
  • In France, while 70% of affected patients recover from anosmia one month after the infection, at least 8% of patients who lost their sense of smell during the first wave of infections still have not recovered it, raising concern that the condition may even be definitive.
  • The exact cause of anosmia is still being studied, although neuroscientists at Harvard Medical School have discovered that the olfactory cell types in the upper nasal cavity are particularly vulnerable to infection by COVID-19.

Senses add richness and texture to everyday life; they are intricately tied in with our emotions

Psychological impact: While anosmia may not seem as disabling as other COVID-19 symptoms, it can still cause psychological distress, affecting a patient's appetite and causing weight loss.

  • Recent studies have associated the loss of the sense of smell with "depressed mood and anxiety," much more than other symptoms experienced by patients.
  • As Leo Newhouse, a senior social worker at Beth Israel Deaconess Medical Center who had first-hand experience with anosmia, wrote in the journal Harvard Health Publishing: "Our senses — smell, vision, hearing, taste, and touch — are bridges that connect us to the world we live in, to life itself. Knock out two of the five bridges, and 40% of our sensory input is gone. Senses add richness and texture to everyday life; they are intricately tied in with our emotions."

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Patients suffering from anosmia should train themselves to smell odors from everyday life — Photo: Association Anosmie.org

Train your brain: No specific treatment or medication exists to treat anosmia. And yet, it is possible to train a patient's brain to accelerate the recovery of the lost sense of smell.

  • Before COVID-19, some already suggested that patients suffering from anosmia train themselves to smell odors from everyday life. The principle of mindfulness plays an important role. "If someone is used to drinking coffee in the morning, then he should train himself to smell it, by looking at it, focusing and taking a deep breath," Dr Jérôme Lechien told Les Echos.
  • The association Anosmie.org offers a free re-education protocol designed by German professor Thommas Hummel, the leading researcher in the field. It consists of two daily sessions for 12 weeks during which patients must try to recognize four to six odors of various essential oils (lemongrass, clove, eucalyptus, peppermint, etc). According to the protocol, it is also important for the patient to relax while doing the exercise, letting the odor come to her rather than trying to force it. "Our state of mind has a big influence on our olfactory perception," according to the protocol.
  • "Smelling all five scents twice, once after waking and once before sleep, started to feel less like training and more like a ritual, like lighting a stick of incense in church, calling up the origins of perfume itself," Leslie Jamison, who followed a similar protocol after losing her sense of smell to COVID-19, writes in Vogue magazine.
  • To accelerate the process, patients should also eat a lot of fruits and vegetables, which contain antioxidants and vitamin B and improve neural recovery.

Long-term takeaway: Patience and regularity are keys. Doctors have observed a quicker recovery for patients who followed the protocol — and stick with it for several months if necessary.

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Geopolitics

Erdogan And Boris Johnson: A New Global Power Duo?

As Turkey fears the EU closing ranks over defense, Turkish President Erdogan is looking to Boris Johnson as a post-Brexit ally, especially as Angela Merkel steps aside. This could undermine the deal where Ankara limits refugee entry into Europe, and other dossiers too.

Johnson and Erdogan in NYC on Sept. 20

Carolina Drüten and Gregor Schwung

-Analysis-

BERLIN — According to the Elysée Palace, the French presidency "can't understand" why Turkey would overreact, since the defense pact that France recently signed in Paris with Greece is not aimed at Ankara. The agreement covers billions of euros' worth of military equipment, and the two countries have committed to come to each other's aid if they are attacked.

Although Paris denies this, it is difficult to see the agreement as anything other than a message, perhaps even a provocation, targeted at Turkey.

Officially, the Turkish government is unruffled, saying the pact doesn't represent a military threat. But the symbolism is clear: with the U.S., UK and Australia recently announcing the Aukus security pact, Ankara fears the EU may be closing ranks when it comes to all military issues.

What will Aukus mean for NATO?

Turkey has long felt left out in the cold, at odds with the European Union over a number of issues. Yet now President Recep Tayyip Erdogan is setting his sights on another country, which also wants to become more independent from Europe: the UK.

Europe's approach to security and defense is changing dramatically. Over the past few months, while the U.S. was negotiating the Aukus pact with Britain and Australia behind the EU's back, a submarine deal between Australia and France, which would have been worth billions, was scrapped.

The EU is happy to keep Erdogan waiting

Officially, Turkey is keeping its cards close to its chest. Addressing foreign journalists in Istanbul, Erdogan's chief advisor Ibrahim Kalin said the country was not involved in Aukus, but they hope it doesn't have a negative impact on NATO. However, the agreement will have a significant effect on Turkey.

"Before Aukus, the Turks thought that the U.S. would prevent the EU from adopting a defense policy that was independent of NATO," says Sinan Ülgen, an expert on Turkey at the Brussels think tank Carnegie Europe. "Now they are afraid that Washington may make concessions for France, which could change things."

Macron sees post-Merkel power vacuum

Turkey's concerns may well prove to be justified. Outgoing German Chancellor Angela Merkel always argued for closer collaboration with Turkey, partly because it is an important trading partner and partly because it has a direct influence on the influx of migrants from Asia and the Middle East to Europe.

Merkel consistently thwarted France's plans for a stricter approach from Brussels towards Turkey, and she never supported Emmanuel Macron's ideas about greater strategic autonomy for countries within the EU.

But now she that she's leaving office, Macron is keen to make the most of the power vacuum Merkel will leave behind. The prospect of France's growing influence is "not especially good news for Turkey," says Ian Lesser, vice president of the think tank German Marshall Fund.

Ankara fears the defense pact between France and Greece could be a sign of what is to come. According to a statement from the Turkish Foreign Ministry, the agreement is aimed "at NATO member Turkey" and is damaging to the alliance. Observers also assume the agreement means that France is supporting Greece's claims to certain territories in the Mediterranean which remain disputed under international law, with Turkey's own sovereignty claims.

Paris is a close ally of Athens. In the summer of 2020, Greece and Turkey were poised on the threshold of a military conflict in the eastern Mediterranean. Since then, Athens has ordered 24 Rafale fighter jets from France, and the new pact includes a deal for France to supply them with three frigates.

Photo of French President Emmanuel Macron and Greek Prime Minister Kyriakos Mitsotakis on September 27 in Paris

French President Emmanuel Macron and Greek Prime Minister Kyriakos Mitsotakis on September 27 in Paris

Sadak Souici/Le Pictorium Agency/ZUMA

Erdogan’s EU wish list

It's not the first time that Ankara has felt snubbed by the EU. Since Donald Trump left the White House, Turkey has been making a considerable effort to improve relations with Brussels. "The situation in the eastern Mediterranean is peaceful and the migrant problem is under control," says Kalin. Now it is "high time" that Europe does something for Turkey.

Erdogan's wish list is extensive: making it easier for Turks to get EU visas, renegotiating the refugee deal, making more funds available to Turkey as it continues the process of joining the EU, and moderniszing the customs union. But there is no movement on any of these issues in Brussels. They're happy to keep Erdogan waiting.

Britain consistently supported Turkey's ambition to join the EU

Now he is starting to look elsewhere. At the UN summit in September, Erdogan had a meeting with British Prime Minister Boris Johnson at the recently opened Turkish House in New York. Kalin says it was a "very good meeting" and that the two countries are "closely allied strategic partners." He says they plan to work together more closely on trade, but with a particular focus on defense.

 Turkey's second largest export market

The groundwork for collaboration was already in place. Britain consistently supported Turkey's ambition to join the EU, and gave an ultimate proof of friendship after the failed coup in 2016. Unlike other European capitals, London reacted quickly, calling the coup an "attack on Turkish democracy," and its government has generally held back in its criticism of Turkey.

At the end of last year, Johnson and Erdogan signed a new free trade agreement, which will govern commerce between the two countries post-Brexit. Erdogan has called it "the most important treaty for Turkey since the customs agreement with the EU in 1995."

After Germany, Britain is Turkey's second largest export market. "Turkey now has the opportunity to build a new partnership with the United Kingdom and it must make the most of it," says economist Ali Kücükcolak from the Istanbul Commerce University.

Erdogan is well aware of this, as Turkey is in desperate need of an economic boost. Inflation currently stands at 19%, and the currency's value is consistently falling. Turks are feeling the impact on their daily lives: food and rent are becoming increasingly expensive, while salaries remain unchanged.

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