Loss of taste and smell will not be added to Covid-19 symptoms list

Loss of taste and smell will ‘absolutely not’ be added to the list of symptoms people should watch for when measuring their potential for having Covid-19, the Government has confirmed.

The announcement comes after Health Secretary Matt Hancock revealed he lost his sense of taste when he was struck down by coronavirus last week.

He made his first public appearance on Thursday after self-isolating for seven days following a positive test for the virus.

Speaking at a press conference in Downing Street on Friday, Mr Hancock said: ‘For me personally, I did lose my sense of taste but it has come back though.

‘I can assure people who have lost their sense of taste that the good news is that, in my case, it wasn’t permanent.’

Researchers at King’s College London this week published evidence, based on UK data, which indicated that almost 60% of coronavirus patients experienced a loss of taste and smell.

But Professor Jonathan Van-Tam, deputy chief medical officer for England, said the advice from experts was that such developments should not be considered tell-tale symptoms to watch for.

The advice had been issued to the Government by the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), Prof Van-Tam told the Number 10 press briefing.

‘On the point about loss of taste and smell, we have actually asked our expert advisory committee, Nervtag, to look at this,’ he told reporters.

‘And there is some anecdotal data in the published domain that there is a proportion of people who do indeed lose their sense of taste and smell.

‘However, we have looked at the data there is, in relation to whether that on its own is a symptom that would be important to add to the case definition, and the answer to that from our experts is absolutely not.’

Prof Van-Tam’s comments come after scientists at King’s College, who have been tracking symptoms via their specially-created app, said smell and taste were experienced by the majority of those diagnosed with Covid-19.

By March 31, the Covid Symptom Tracker App had more than 1.8 million users signed up to log their symptoms, or lack thereof, daily.

Some 59% of the 1.5 million people who had signed up by March 29 and tested positive reported a loss of smell and taste, compared with 18% of those who tested negative, analysis of the data showed.

The researchers said the reports of those symptoms were much stronger in predicting a positive Covid-19 diagnosis than self-reported fever – a symptom Prime Minister Boris Johnson, who remains ill in self-isolation following his initial seven day quarantine, is currently experiencing. 

The scientists concluded that losing smell and taste should be enough of a reason for people to self-isolate as a precation.

Professor Carl Philpott, an academic at the University of East Anglia and consultant ear, nose and throat surgeon, said lost smell was a common impact of viral infection.

‘With viral shedding highest in the nose, it is not surprising that the “unprotected” smell receptor tissue at the top of the nose is vulnerable to infection,’ he said.

Viral shedding is the process of viruses being essentially dumped out of the body after they have reproduced and is what makes people infectious.

Professor Philpott said the loss of sense of smell appeared to affect women more than men, but it wasn’t clear why.

He added: ‘Coronaviruses have been associated with what we refer to as post-viral olfactory loss previously – this is smell loss that persists after a cold.

‘There are many respiratory viruses that can potentially cause problems with the smell receptors.

‘So far with COVID-19, the smell loss appears to be transient [temporary] but only as time elapses will we know how many people have a more permanent loss.

‘It is certainly helpful data to reinforce the call for the World Health Organisation and Public Health England to add this symptom as a warning sign for individuals to self-isolate.’

Data gathered by the organisation ENT UK, which represents ear, nose and throat specialists, suggests the inability to smell — and often taste — may be the very first symptom of COVID-19 and start within hours of infection. 

Many people appear not to develop any further signs, making a full recovery without even realising they had the coronavirus. They are thought to be mostly healthy young adults whose immune systems react sufficiently to the virus to contain it within the nose, preventing it spreading to the lungs, where it can cause potentially fatal pneumonia.

As a result, warns ENT UK, some COVID-19 patients are not being identified as infected or advised to self-isolate – and may well be spreading the virus to others.

‘I have seen a huge increase in the number of patients attending my clinic with a sudden loss of smell,’ says Professor Nirmal Kumar, president of ENT UK and an ear, nose and throat specialist at Wrightington, Wigan and Leigh NHS Trust.

‘It’s up to about four patients a week, mostly under 40 and with no other COVID-19 symptoms. I usually see no more than one a month.’

Professor Kumar is advising patients with no obvious explanation for their loss of smell to self-isolate for at least seven days in case they have Covid-19, even though this is not the current government recommendation. 

ENT UK has called on officials in the UK to recognise the symptoms as signs of coronavirus infection. 

Past president of ENT UK, Dr Tony Narula, added: ‘Normally, when you get a cold or flu virus, you get a blocked nose and lose some smell because you can’t get air (which carries smells with it) into the nostrils,’ he says.

‘With Covid-19 it’s different. The virus seems to strike directly at the olfactory nerve at the roof of the nose, just between the eyes.

‘One reason so many people are suffering is that this nerve is not covered in protective tissue, so the virus attacks it and causes inflammation which stops smell signals reaching the brain.’ 

The little ships sailing to the rescue: Prestigious Oxford University department famed for helping to create penicillin, the world-leading Francis Crick Institute and a private lab in Oxfordshire claim they could carry out thousands of tests a day  

Number 10 yesterday abandoned the centralised testing approach of control freak health chiefs and urged the wider science industry to help boost capacity.

Matt Hancock declared the UK will conduct 100,000 coronavirus tests a day by the end of the month as he finally signalled a U-turn on the UK screening regime.

It came amid warnings ‘time is running out’ to scale up mass coronavirus testing to allow Britain to get a grip of the escalating crisis – which has killed almost 3,000 people.

The chief executive of one of the UK’s leading laboratories urged the Prime Minister to summon the Dunkirk spirit and let ‘small ship’ labs start screening for the deadly infection spreading rampantly on British soil.  

The Francis Crick Institute has started swabbing NHS staff at one trust and aims to ramp up to 500 per day by next week and expand to other overwhelmed hospitals across the capital. 

Other smaller laboratories say they have volunteered to help with testing, too, among them the Sir William Dunn School of Pathology at Oxford University and the Jack Birch Cancer Research Unit in York.

Another – Systems Biology Laboratory in Abingdon – is testing local GP staff already and Cancer Research UK said it is also providing equipment and expert staff to help with swabbing Britons.

But scientists say there are dozens of laboratories in the UK that already have the equipment needed to process coronavirus tests, and that any ‘self-respecting’ facility would be equipped to start immediately.

So where are the little ships that are sailing to the rescue? And how many tests can they carry out every day? 

Francis Crick Institute, London 

The Francis Crick Institute, a leading biomedical science lab in London, has already started using its facilities to test NHS staff from the University College London Hospitals NHS Trust.

It hopes to scale up to 500 tests per day by early next week with the ultimate aim of doing 2,000 every day – the equivalent of around 14,000 each week. 

The institute – a partnership of leading charities and universities – will aim to provide results within 24 hours, to enable NHS staff to return to work as quickly as possible.

In comparison, only around 10,000 patients are being tested every day in Public Health England’s centralised approach. 

Sir Paul Nurse, director of the Crick, said: ‘Testing is an essential part of the national effort to tackle the spread of COVID-19. We wanted to use our facilities and expertise to help support NHS staff on the front line who are battling this virus.

‘Institutes like ours are coming together with a Dunkirk spirit – small boats that collectively can have a huge impact on the national endeavour.’ 

Cancer Research UK has scientists at the Crick Institute who are involved with carrying out the tests and is also using its staff and equipment around the country to help test medical workers so they can continue working on the frontline without fears they are spreading the infection.

Executive director of research at the charity, Iain Foulkes, said: ‘They are providing desperately needed capacity at a time of national crisis, and testing NHS staff quickly so they can decide if they can return to their life-saving work. 

‘As a scientific research community, we need to beat the pandemic together – the sooner we do that the sooner our researchers can get back to beating cancer.’

Sir William Dunn School of Pathology, University of Oxford 

Some scientists with the right facilities have already volunteered to help the government effort but not had their offers taken up.

Matthew Freeman, at the Sir William Dunn School of Pathology at Oxford University, said in a tweet: ‘We have many people experienced in PCR.’ 

The PCR machines examine DNA taken from a nose or throat swab to look for signs of viral genetic material (RNA) left behind by the coronavirus. 

This is the kind of testing currently being used by Public Health England, which has eight of its own laboratories and access to 40 in NHS hospitals around the country.  

Mr Freeman added: ‘We’d love to help and have been trying to volunteer for weeks. Must be many university departments and institutes in similar position. 

‘I’d love to know more about why we can’t be used. Would be interested to hear if others have been more successful in offering services.

‘I understand how complex it is: quality control, biosafety, ethics… But can’t help feeling that in an emergency these could have been sorted. Less complex than constructing a 5,000 bed hospital in two weeks.’

The department – famed for the development of penicillin – would normally use its machines to examine the minute workings of human infections and diseases. 

Another lab at Oxford – the Butt Group, which studies genetics – added on Twitter: ‘I echo this sense of frustration: we volunteered on day 1 and beyond being asked 3 times to list our expertise, have heard nothing.’ 

Marc Dionne, a researcher at Imperial College London, replied: ‘Many from Imperial in the same position. I’ve heard that one of the personnel shortages now is not people capable of running PCR but people capable of directing them’.

Systems Biology Laboratory, Abingdon, Oxfordshire

Systems Biology Laboratory, a not-for-profit science company, has taken local matters into its own hands and is already testing staff at 14 GP surgeries in Oxfordshire twice a week.

The tests – it is doing around 100 per day, according to The Times – mean staff can continue to work safe in the knowledge that they don’t have the coronavirus so aren’t passing it on to patients.

Director of the lab, Mike Fischer, said he started buying the testing kits online around two weeks ago and they cost about £10 per time. He hopes to scale up to be able to do 800 tests every day. 

Mr Fischer said the lab was also using PCR tests and had ordered another 15,000. It is unclear who they bought them from or how much they cost.

He said: ‘I wouldn’t be surprised if there are 1,000 labs like that. We actually have this incredibly valuable strategic resource distributed around the country.’ 

Although Mr Fischer doesn’t have official approval as a testing centre he said the Government was aware of what he was doing and was ‘supportive’. 

Mr Fischer, who also co-founded the stock imagery company Alamy, said his team of five people could scale up tests to 500 each day once they have honed the process. 

Jack Birch Cancer Research Unit, York

One of the founders of the Jack Birch Cancer Research Unit in York yesterday claimed the facility – which mainly focuses on studying bladder cancer – was capable of carrying out potentially thousands of tests every day.

Professor Colin Garner, who said the UK must take war-time measures to fight the outbreak, claimed ‘every self-respecting laboratory will have the equipment to conduct hundreds, if not thousands, of these tests every day’.

In a call to action, he said: ‘My understanding is that the UK is building a large testing centre in Milton Keynes. Why wait for this to be built when there are labs and people sitting idle around the UK who could conduct these tests now?’

Professor Garner urged the Government to create an immediate task force comprised of the university medical and bioscience sector, cancer research labs, pharma giants, the NHS and other bodies. 

He said: ‘Just as the government called for volunteers to help vulnerable people and got 750,000 people applying, they should now put out an immediate call to all UK lab scientists and enlist them in this national effort.’

‘It is heart breaking that we are putting our medical front-line staff at risk when there is a national testing capability that could be used now.

‘A centralised lab is not the answer. Regional labs should be created and all the above organisations enlisted… The UK has some of the best scientists and facilities in the world. Let’s get them working to beat COVID-19.’