Smell therapy: How Spaniards are retraining their noses after Covid-19

Doctors in Spain are trying to help people who had Covid-19 months ago to regain the sense through "smell training", a long and slow process that involves sniffing different odours to retrain the brain to recognise different smells.

Smell therapy: How Spaniards are retraining their noses after Covid-19
Spaniard Cristina Valdivia, 47, affected by smell loss due to Covid-19, uses her smell training test kit in Barcelona on September 30, 2021. Photo: Pau BARRENA / AFP

At a hospital in Spain, a doctor holds a test tube under Encarna Oviedo’s nose to see if she can smell anything — a full 18 months after she had Covid.

“Honey, vanilla, chocolate or cinnamon?” he asks her in the smell unit at the Mutua Terrassa Hospital northwest of Barcelona.

“Vanilla?” the 66-year-old replies, her tone unsure.

Oviedo is one of an estimated half a million people who lost their sense of smell in Spain after contracting the virus.

She caught a mild case of Covid-19 in March 2020 as the virus overtook the country, which soon became one of the hardest hit in Europe.

Doctors are trying to help Oviedo and others to regain the sense through “smell training”, a long and slow process that involves sniffing different odours over a period of months to retrain the brain to recognise different smells.

“Loss of sense of smell affects around 70 percent of patients who had Covid,” says Joaquim Mullol who heads up a smell clinic in Barcelona’s Hospital Clinic.

A quarter of all people who have lost their smell because of Covid do not fully recover it long after falling ill, he added.

‘Everything smelled burnt’

Oviedo is one of around 90 people, mostly “long Covid” patients, who have been treated for loss of smell at the Mutua Terrassa clinic since it opened in February.

After a first assessment, they begin a four-month rehabilitation programme, which involves a weekly session with a therapist who helps patients to try to identify odours.

Oviedo finished the programme earlier this year and returns to the smell clinic periodically to see if there has been any improvement.

But so far there has been no change.

“I would like to be the way I was before, that I could come home and be able to say how nice my house smells,” she says.

She now showers more often since she can’t tell if she has body odour.

For others who lost their smell after catching the virus, when it comes back, it’s not quite right.

“I started to find that everything smelled burnt, like my nose was over a deep fryer,” said Cristina Valdivia, who got sick in March 2020 and lost her smell completely for three months.

smell training test kit after Covid in Spain
Valdivia using her smell training test kit. She caught the Covid-19 in March 2020, when the disease was still just a little-known virus. She lost her sense of smell for three months, and when it returned it was out of whack. Photo: Pau Barrena/AFP

After endless anguish and several specialist consultations, she went to the Hospital Clinic where she was diagnosed with parosmia, a distorted perception of smell.

It was a common diagnosis for recovering Covid patients, and she was told she would have to undergo therapy to fix her sense of smell.

Depression, weight loss

Twice a day Valdivia sticks her nose into six boxes of different odours, taking in their smells to try to regenerate her olfactory connections.

She has regained the ability to smell some things such as citrus fruits but others remain elusive.

“Coffee is dreadful, it is a mix between gasoline and something that is rotting,” Valdivia, 47, says.

Patients say lack of smell complicates their daily lives more than people imagine.

Valdivia misses the smell of her son. But odours from others register as vile for her.

“If I hug my mother-in-law, my mother, the smell is horrible… it’s hard to deal with all of this,” she says.

Mullol said loss of sense of smell triggers depression and weight loss in some patients.

“The nose allows us to smell what we eat, what we drink, to connect with the outside world,” he said.

“We detect things that can be dangerous, like gas, spoiled food. When we remove that, the person is cut off from the world.”

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Spain rules out EU’s advice on compulsory Covid-19 vaccination 

Spain’s Health Ministry said Thursday there will be no mandatory vaccination in the country following the European Commission’s advice to Member States to “think about it” and Germany’s announcement that it will make vaccines compulsory in February.

Spain rules out EU's advice on compulsory Covid-19 vaccination 
A Spanish man being vaccinated poses with a custom-made T-shirt showing Spain's chief epidimiologist Fernando Simón striking a 'Dirty Harry/Clint Eastwood' pose over the words "What part of keep a two-metre distance don't you understand?' Photo: José Jordan

Spain’s Health Minister Carolina Darias on Thursday told journalists Covid-19 vaccines will continue to be voluntary in Spain given the “very high awareness of the population” with regard to the benefits of vaccination.

This follows the words of European Commission chief Ursula von der Leyen on Thursday, urging Member States to “think about mandatory vaccination” as more cases of the Omicron variant are detected across Europe. 

READ ALSO: Is Spain proving facts rather than force can convince the unvaccinated?

“I can understand that countries with low vaccine coverage are contemplating this and that Von der Leyen is considering opening up a debate, but in our country the situation is absolutely different,” Darias said at the press conference following her meeting with Spain’s Interterritorial Health Council.

According to the national health minister,  this was also “the general belief” of regional health leaders of each of Spain’s 17 autonomous communities she had just been in discussion with over Christmas Covid measures. 

READ MORE: Spain rules out new restrictions against Omicron variant

Almost 80 percent of Spain’s total population is fully vaccinated against Covid-19, a figure which is around 10 percent higher if looking at those who are eligible for the vaccine (over 12s). 

It has the highest vaccination rate among Europe’s most populous countries.

Germany announced tough new restrictions on Thursday in a bid to contain its fourth wave of Covid-19 aimed largely at the country’s unvaccinated people, with outgoing Chancellor Angela Merkel speaking in favour of compulsory vaccinations, which the German parliament is due to vote on soon.

Austria has also already said it will make Covid-19 vaccines compulsory next February, Belgium is also considering it and Greece on Tuesday said it will make vaccination obligatory for those over 60.

But for Spain, strict Covid-19 vaccination rules have never been on the table, having said from the start that getting the Covid-19 jabs was voluntary. 

There’s also a huge legal implication to imposing such a rule which Spanish courts are unlikely to look on favourably. 

Stricter Covid restrictions and the country’s two states of alarm, the first resulting in a full national lockdown from March to May 2020, have both been deemed unconstitutional by Spain’s Constitutional Court. 

READ ALSO: Could Spain lock down its unvaccinated or make Covid vaccines compulsory?

The Covid-19 health pass to access indoor public spaces was also until recently consistently rejected by regional high courts for breaching fundamental rights, although judges have changed their stance favouring this Covid certificate over old Covid-19 restrictions that affect the whole population.

MAP: Which regions in Spain now require a Covid health pass for daily affairs?

“In Spain what we have to do is to continue vaccinating as we have done until now” Darias added. 

“Spaniards understand that vaccines are not only a right, they are an obligation because we protect others with them”.

What Spanish health authorities are still considering is whether to vaccinate their 5 to 11 year olds after the go-ahead from the European Medicines Agency, with regions such as Madrid claiming they will start vaccinating their young children in December despite there being no official confirmation from Spain’s Vaccine Committee yet.

READ MORE: Will Spain soon vaccinate its children under 12?

Spain’s infection rate continues to rise day by day, jumping 17 points up to 234 cases per 100,000 people on Thursday. There are now also five confirmed cases of the Omicron variant in the country, one through community transmission.

Hospital bed occupancy with Covid patients has also risen slightly nationwide to 3.3 percent, as has ICU Covid occupancy which now stands at 8.4 percent, but the Spanish government insists these figures are “almost three times lower” than during previous waves of the coronavirus pandemic.