WEBVTT - A Covid Early Warning Sign 0:00:05.040 --> 0:00:10.560 Welcome to Prognosis. I'm Laura Carlson. It's day thirty five 0:00:10.760 --> 0:00:15.360 since coronavirus was declared a global pandemic. Our main story 0:00:15.360 --> 0:00:20.200 today and under examined symptom of COVID nineteen could give 0:00:20.239 --> 0:00:25.040 scientists clues about how to contain the virus. But first, 0:00:25.720 --> 0:00:39.920 here's what happened today. The new coronavirus has now infected 0:00:40.120 --> 0:00:44.000 two million people around the world. Hitting that number is 0:00:44.040 --> 0:00:48.199 a grim milestone. It exposes how hard the world has 0:00:48.240 --> 0:00:53.000 struggled to contain the deadly pathogen. It took about four 0:00:53.120 --> 0:00:56.760 months for the virus to infect one million people and 0:00:56.840 --> 0:01:01.120 only twelve days for that number to double. The total 0:01:01.160 --> 0:01:05.520 case count today is likely higher than two millions, with 0:01:05.600 --> 0:01:09.760 some countries, including the US, testing only a fraction of 0:01:09.800 --> 0:01:14.560 their populations. The European Commission is devising a plan to 0:01:14.600 --> 0:01:18.479 get Europe's economy back up and running. The Commission says 0:01:18.640 --> 0:01:22.119 companies and workers won't get back to business as usual 0:01:22.520 --> 0:01:26.120 until there's a vaccine or a cure for COVID nineteen. 0:01:27.040 --> 0:01:31.200 In the meantime, the European Union's Executive arm has created 0:01:31.280 --> 0:01:35.080 a roadmap for partially lifting restrictions in an effort to 0:01:35.160 --> 0:01:40.800 mitigate the economic devastation. The plan, unveiled by Commission President 0:01:40.920 --> 0:01:45.440 Ursula Vonderland on Wednesday, would coordinate a gradual exit from 0:01:45.440 --> 0:01:49.200 the lockdowns that the blocks twenty seven member states imposed 0:01:49.360 --> 0:01:53.240 last month. The Commission has warned that the easing may 0:01:53.240 --> 0:01:56.880 be temporary, as it will unavoidably lead to a spike 0:01:56.960 --> 0:02:00.200 in new cases that could threaten healthcare systems again end 0:02:00.800 --> 0:02:06.040 and lead to a reinstatement of the confinement rules. And 0:02:06.440 --> 0:02:10.960 China criticized US President Donald Trump's decision to halt funding 0:02:11.000 --> 0:02:14.480 to the World Health Organization and said they would support 0:02:14.720 --> 0:02:18.240 the global health body. Trump ordered the move against the 0:02:18.320 --> 0:02:22.560 WHO on Tuesday, saying the organization took China's claims about 0:02:22.600 --> 0:02:28.440 the coronavirus at face value. China's Foreign Ministry spokesperson Jolly 0:02:28.520 --> 0:02:32.440 g n said Wednesday that the decision will quote weaken 0:02:32.520 --> 0:02:42.760 the who's capabilities and undermine international cooperation end quote. And 0:02:42.840 --> 0:02:46.679 now for today's main story, the loss of the ability 0:02:46.720 --> 0:02:49.560 to smell is one of the strangest clues that someone 0:02:49.680 --> 0:02:54.240 may have COVID nineteen. Experts around the world are still 0:02:54.280 --> 0:02:57.960 trying to understand why this symptom pops up and what 0:02:58.080 --> 0:03:01.639 it means for patients. Some are calling on people who 0:03:01.639 --> 0:03:04.160 have lost their sense of smell to get tested and 0:03:04.240 --> 0:03:08.120 isolate themselves, even if they have no other symptoms, to 0:03:08.200 --> 0:03:12.760 slow the spread of the virus. Bloomberg Senior editor Jason 0:03:12.840 --> 0:03:17.320 Gale helps untangle the mystery of how COVID nineteen might 0:03:17.360 --> 0:03:20.839 affect smell and why we might want to pay more 0:03:20.880 --> 0:03:28.040 attention to this obscure symptom. Thanks to COVID nineteen, we've 0:03:28.080 --> 0:03:30.760 learned a bunch of new words these past months. A 0:03:30.919 --> 0:03:35.200 nasmia and discusia are a couple of them. A nasmia 0:03:35.280 --> 0:03:38.040 is the medical term for the loss of smell. If 0:03:38.080 --> 0:03:41.520 you have discusia, it means your ability to taste things 0:03:41.640 --> 0:03:44.680 is off. It turns out both can be signs and 0:03:44.800 --> 0:03:48.280 sometimes the first sign of COVID nineteen. What I hadn't 0:03:48.320 --> 0:03:51.600 yet realized is I'd completely lost my sense of small 0:03:51.880 --> 0:03:55.000 add taste. This is Dan Mace, a thirty year old 0:03:55.040 --> 0:03:58.600 vlogger from Cape Town, South Africa, who told his seven 0:03:58.800 --> 0:04:03.480 and fifty thousand UT subscribers about his experience of COVID nineteen. 0:04:04.160 --> 0:04:07.800 He got diagnosed on March twenty one. He felt pretty 0:04:07.840 --> 0:04:11.240 lousy for a while, but wasn't hospitalized. In fact, a 0:04:11.240 --> 0:04:13.640 couple of doctors who reviewed him didn't think he had 0:04:13.680 --> 0:04:17.520 the coronavirus, but still some of his symptoms persisted, because 0:04:17.520 --> 0:04:20.120 when I made myself breakfast that I realized I had 0:04:20.200 --> 0:04:23.800 absolutely no taste and no smile, and that I hadn't 0:04:23.839 --> 0:04:26.880 had these two senses since the day that I became ill. 0:04:27.279 --> 0:04:30.960 Dan Mace isn't alone. His symptoms have been experienced by 0:04:31.120 --> 0:04:34.800 patients all over the world, and eos and throat surgeons 0:04:34.800 --> 0:04:38.279 have likewise been noting such cases and alerting their colleagues 0:04:38.279 --> 0:04:41.560 to them. I spoke recently with Dr Jim Denaney, who's 0:04:41.600 --> 0:04:44.040 been working in the field for forty two years and 0:04:44.200 --> 0:04:46.400 is on the faculty at Johns Hopkins and the University 0:04:46.440 --> 0:04:50.520 of Missouri. He's also the executive vice president and CEO 0:04:50.640 --> 0:04:54.360 of the American Academy of odo Laryngology. Had a neck surgery. 0:04:55.040 --> 0:04:58.240 Jim told me the loss of smell isn't uncommon when 0:04:58.240 --> 0:05:01.960 someone has a cold. COVID nine tame patients seem to 0:05:02.000 --> 0:05:05.440 be getting it more. I would say that a higher 0:05:05.480 --> 0:05:09.520 percentage of people seem to be getting it. There's still 0:05:09.560 --> 0:05:14.360 a good recovery rate, but there's a higher percentage of 0:05:14.400 --> 0:05:19.040 people than you'd expect from a common cold are getting 0:05:19.200 --> 0:05:25.039 some real anosmia or hyposmia. Partial smell and the accompanying 0:05:25.080 --> 0:05:27.320 this goosey. It means your taste is a little off, 0:05:27.920 --> 0:05:30.520 and you can make that happen yourself just by pinching 0:05:30.560 --> 0:05:33.839 your nose when you're eating. So there's a normal relation 0:05:33.960 --> 0:05:37.560 between those two. Doctor saw a similar phenomenon with size 0:05:37.720 --> 0:05:41.840 or severe acute respiratory syndrome, a related coronavirus I think 0:05:41.880 --> 0:05:44.919 caused an outbreak in two thousand and three. This seems 0:05:44.960 --> 0:05:47.640 to be a little more prevalent than that one was, 0:05:48.120 --> 0:05:51.080 at least from what I've read. But I don't think 0:05:51.120 --> 0:05:54.599 anyone has access to the total number of cases because 0:05:55.040 --> 0:05:59.000 many providers don't ask that question, and a lot of 0:05:59.040 --> 0:06:01.839 people are are so worried they don't come out and 0:06:01.880 --> 0:06:04.560 say and by the way, I can't smell or taste. 0:06:05.160 --> 0:06:11.200 They're worried whether they're going to survive or not. Jim's 0:06:11.200 --> 0:06:14.120 Academy started an online and knows me, a reporting tool 0:06:14.120 --> 0:06:17.080 for doctors to share information about the condition. In much 0:06:17.640 --> 0:06:21.400 it's gathering important insights into patients with COVID nineteen who 0:06:21.400 --> 0:06:24.440 are experiencing a complete or partial loss of their senses 0:06:24.480 --> 0:06:27.719 of smell and taste. I think the most interesting piece 0:06:27.839 --> 0:06:31.480 in this first hundred and fifty there was over thirty 0:06:31.560 --> 0:06:34.480 percent that it was the only symptom they had before 0:06:34.520 --> 0:06:37.640 the diagnosis. It was the first symptom. Jim thinks it 0:06:37.720 --> 0:06:40.920 makes sense for health workers to queery patients about sensory 0:06:41.040 --> 0:06:43.760 changes when they decide if someone should be tested for 0:06:43.800 --> 0:06:47.400 the coronavirus. In my mind, it's a what have you 0:06:47.480 --> 0:06:51.279 got to lose? Situation? If you ask the question and 0:06:51.320 --> 0:06:53.640 they don't have it, you have lost nothing. Because it's 0:06:53.640 --> 0:06:57.200 not an additional test. It doesn't put anyone at more risk, 0:06:57.640 --> 0:07:01.360 but it may actually get someone into self isolation earlier, 0:07:02.040 --> 0:07:06.200 or be tested earlier than or is already happening. If 0:07:06.240 --> 0:07:09.600 you have these symptoms, how long will they last? We 0:07:09.680 --> 0:07:13.200 don't know. Some of these cases aren't that far, but 0:07:13.360 --> 0:07:16.160 the ones who are a lot of these don't last 0:07:16.240 --> 0:07:19.680 more than five to seven days was the average time 0:07:20.360 --> 0:07:23.880 in our in our studies, So most people will get 0:07:24.280 --> 0:07:28.280 most people get it back the majority, and most of 0:07:28.280 --> 0:07:30.920 it comes within the first week to ten days. I 0:07:30.960 --> 0:07:39.080 guess as the takeaway point, the loss of smell might 0:07:39.080 --> 0:07:42.680 sound like a quickie symptom of COVID nineteen, but its 0:07:42.720 --> 0:07:46.800 effects can be profound, especially for those people whose sense 0:07:46.840 --> 0:07:50.080 of smell is lost forever. Dr Bob Data is an 0:07:50.080 --> 0:07:54.080 associate professor of neurobiology at Havard Medical School in Boston. 0:07:54.640 --> 0:07:58.200 His laboratory studies the function of neural circuits and how 0:07:58.240 --> 0:08:01.840 they drive behavior. Hey is particularly interested in the sense 0:08:01.880 --> 0:08:05.679 of smell, how animals detect smells, and how that changes 0:08:05.720 --> 0:08:08.520 brain activity. I very much think the hope is that 0:08:08.760 --> 0:08:11.440 only a small fraction of these people will permanently lose 0:08:11.440 --> 0:08:14.600 their sense of smell, Bob says. When that happens, the 0:08:14.640 --> 0:08:18.120 permanent loss of the ability to smell is far from trivial, 0:08:18.480 --> 0:08:20.960 and it's important to remember that from a medical perspective. 0:08:21.000 --> 0:08:23.320 You know, as humans were used to thinking of smell 0:08:23.360 --> 0:08:26.040 as being kind of a bonus sense um, and it's 0:08:26.040 --> 0:08:28.760 really critical to know that that's that's not what smell is. 0:08:29.000 --> 0:08:34.559 So smells essential for detecting dangerous odors, smoke from fires, 0:08:34.720 --> 0:08:39.560 spoiled food, natural gas, but and so we think of 0:08:39.600 --> 0:08:43.000 smelling that way, But it smells also incredibly important for 0:08:43.080 --> 0:08:47.880 our well being. People who have nuance that permanent osmia 0:08:48.200 --> 0:08:50.880 often describe themselves as being depressed, and they're really at 0:08:51.000 --> 0:08:54.280 risk of developing depression because we're so dependent on our 0:08:54.280 --> 0:08:56.520 sense of smell for our kind of sense of well 0:08:56.559 --> 0:09:01.640 being and situating ourselves emotionally in the world. And so 0:09:01.720 --> 0:09:03.880 I think it's a community where we're really taking it 0:09:04.000 --> 0:09:08.120 seriously because we're hoping that I can understand this process 0:09:08.120 --> 0:09:11.719 and maybe in the future. Interview, Bob says, basic scientific 0:09:11.840 --> 0:09:15.400 understanding about the new coronavirus is just emerging, which is 0:09:15.440 --> 0:09:18.600 why lamps are like his of only hypotheses around why 0:09:18.640 --> 0:09:20.880 infections may cause and nose meet and so that really 0:09:20.920 --> 0:09:24.319 strongly suggests that what's not happening is that the virus 0:09:24.600 --> 0:09:27.679 is directly affecting the cells in your nose that are 0:09:27.679 --> 0:09:31.160 responsible for smell. Okay, so what else could possibly be 0:09:31.200 --> 0:09:34.200 going on? They've looked at other possibilities. The virus could 0:09:34.200 --> 0:09:37.040 be affecting cells that surround key neurons in the nose, 0:09:37.400 --> 0:09:40.920 stopping them from sending electrical signals to the brain. Or 0:09:40.960 --> 0:09:43.600 it could be damaging a layer of stem cells under 0:09:43.640 --> 0:09:46.000 the neurons, which then need to recover. You know, we're 0:09:46.000 --> 0:09:48.680 dealing with a very unusual situation. In which you know, 0:09:48.760 --> 0:09:50.440 the science is coming out as fast as we can 0:09:50.480 --> 0:09:52.719 generate it. What are the amazing things about the way 0:09:52.720 --> 0:09:54.439 that science firs today Is that we can communicate a 0:09:54.480 --> 0:09:56.840 result of very quickly, and that means that there are 0:09:56.840 --> 0:09:58.920 a lot of preliminary results flooting around, But it also 0:09:59.000 --> 0:10:00.560 means that it's gonna take some time for us to 0:10:01.040 --> 0:10:03.760 organize an information. It really makes sense of it. The 0:10:03.840 --> 0:10:06.800 mystery of why many COVID nineteen patients lose their sense 0:10:06.840 --> 0:10:10.440 of smell and taste hasn't been solved yet, but finding 0:10:10.440 --> 0:10:13.160 the answer may lead to ways of treating the condition 0:10:13.480 --> 0:10:17.400 and hopefully shorten the time it takes to resolve. Perhaps 0:10:17.400 --> 0:10:21.680 more important, if doctors begin to systematically screen for this symptom, 0:10:21.720 --> 0:10:24.679 not just the more common ones like coffin fever, they 0:10:24.720 --> 0:10:27.880 could test and isolate people with the coronavirus sooner. That 0:10:27.960 --> 0:10:31.680 could eventually make a big difference in containing the disease. 0:10:43.240 --> 0:10:49.320 That was Jason Gale in Melbourne. And that's it for 0:10:49.360 --> 0:10:53.080 the Prognosis Daily edition. For more on the pandemic from 0:10:53.120 --> 0:10:57.040 our bureaus around the world, visit Bloomberg dot com slash 0:10:57.080 --> 0:11:01.480 coronavirus and one small favor if you like what we're doing, 0:11:01.840 --> 0:11:04.319 Please take a second to rate the podcast and leave 0:11:04.400 --> 0:11:08.400 us a review on Apple Podcasts or Spotify. It helps 0:11:08.480 --> 0:11:13.200 more listeners find our global reporting. The Prognosis Daily edition 0:11:13.280 --> 0:11:16.120 is hosted by Me. The show was produced by Me 0:11:16.520 --> 0:11:22.079 Topher foreheads, Jordan Gaspoure and Magnus Hendrickson. Today's main story 0:11:22.360 --> 0:11:26.679 was reported by Jason Gale. Original music by Leo Citrian. 0:11:27.640 --> 0:11:32.760 Our editors are Francesca Levy and Rick Shine. Francesca Leviy 0:11:32.800 --> 0:11:35.959 is Bloomberg's head of podcasts. Thanks for listening.