As the medical director of the Smell and Taste Disorders Center at Virginia Commonwealth University, Dr. Evan R. Reiter has been especially busy in the era of Covid-19. He’s currently tracking around 2,000 virus patients as they recuperate, noting how the senses he studies change and, in some cases, disappear. The distortion of smell may be part of the recovery process, he believes, as receptors in the nose reawaken and send signals to the brain that misfire or are misread. The experience can be unexpectedly devastating. “People have a hard time understanding what life would be like if they lose their hearing or their vision,” he says. “But smell? You almost don’t even think about it and kind of toss it aside—until it’s gone.” Here, Dr. Reiter details the ways that smell loss has impacted his patients, and how using other senses can help them cope.

“With Covid, we’re seeing a lot more people than we historically have with scent-related issues. Fortunately, it’s rather short-lived for the vast majority of people. It’s still something we’re studying. But for those who lose their sense of smell, somewhere in the neighborhood of seventy to ninety percent will get it back within weeks. If you look at the converse of that, ten to thirty percent have it long-term.

We’re doing a study now where we’re contacting [some 2,000] patients via email, over an extended period of time, to fill us in on what they’ve been experiencing. A significant percentage of these so-called ‘long haulers’ have had some safety or danger issues where they were unable to smell smoke or a gas leak, or where they ate spoiled food because they couldn’t tell it was bad from its scent.

When people lose their ability to smell, or have a severe loss of it, they notice a dramatic change in their sense of taste. If they put sugar or salt on their tongues, they can detect what it is because their taste buds are working. But, without being able to appreciate the odor of the food at the same time, they’re deprived of the more subtle flavors. So people will say things like, ‘Everything I eat tastes like cardboard,’ or that it all tastes the same because they’re losing so much information.

What we discuss with patients as a compensatory strategy is to try and make food more attractive by using different colors, textures, and to some degree, spices—anything that can entice the senses that are intact, such as the taste buds or even the mere sight of things. Making food more appealing can trick you into thinking that there’s more flavor than you would appreciate otherwise.”