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Anchor lead: Does loss of sense of smell point to the exact tissue where Sars-CoV2 takes hold? Elizabeth Tracey reports

Where exactly does Sars-CoV2 infect the body? It may be the tissue that enables your sense of smell, called the olfactory epithelium. That’s according to Andrew Lane, director of rhinology and sinus surgery at Johns Hopkins.

Lane: People would ask why do you lose your sense of smell with this infection? And people who have viral infections in general might lose their sense of smell as part of it and typically its in the setting of a stuffy nose. In this disease COVID 19 the really interesting part of it is that 5% or less of people with COVID-19 complain of a runny nose or stuffiness or typical cold symptoms. People specifically say oh I’ve only lost my sense of smell but I have no other nasal symptoms suggesting to me and a lot of other people that maybe the virus is actually infecting the olfactory tissue.  :32

Lane says that one receptor known to be used by the virus is present at a much greater concentration in the olfactory epithelium than elsewhere, so the idea that infection takes place there makes sense. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Assessing the severity of loss of smell is possible, Elizabeth Tracey reports

Testing your sense of smell may indicate just how acute the loss might be, and could also have some predictive value when it comes to COVID-19 infection. That’s according to Andrew Lane, director of rhinology and sinus surgery at Johns Hopkins.

Lane: What you’d want to do is to ask people if they’ve had a change in their sense of smell and taste, and you’d also want to do some type of objective testing which can vary from a scratch and sniff type book where you identify the odors to breathing in odors on a almost looks like a marking pen, you can ask people whether or not they can detect it down to a lower level, determine whether someone’s sense of smell if not completely lost is partially lost. In an ideal world you would be able to put people through their olfactory Olympics. From there you could find out what its predictive value is, both for whether you have the disease or for potentially your prognosis.  :34

Lane says people can also informally test their own sense of smell at home using common things like lemons. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: It seems that loss of the sense of smell may be useful in tracking the spread of COVID-19, Elizabeth Tracey reports

When the COVID-19 pandemic began, Google searches showed that people in areas where the virus was spreading were searching for ‘loss of smell.’ Andrew Lane, director of rhinology and sinus surgery at Johns Hopkins, says this led to researchers asking the question directly.

Lane: In doing phone surveys, when you ask people who may or may not have the disease, have you had an acute, sudden loss of your sense of smell? And a surprising number of people, more than you would think under normal circumstances, would say yes. How do you confirm that? The availability of testing hasn’t been enough to be able to then go and confirm that that person has loss of sense of smell due to infection with the Sars-CoV2 virus. You don’t know, but you can say that if normally, some small percentage of the population loses their sense of smell, there are some, it happens, but its not a very large percentage of people.   :32

Lane says as testing becomes more readily accessible, confirmation of the loss of smell as a predictor will be possible. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What does loss of smell tell us about COVID-19? Elizabeth Tracey reports

Loss of smell is one symptom of COVID-19 infection, but it’s unclear whether that takes place early for many and then may continue in those who develop more severe disease. That’s according to Andrew Lane, director of rhinology and sinus surgery at Johns Hopkins.

Lane: As patients begin to describe their symptoms or people weren’t sure if they had the disease or not started to report their symptoms it became evident that there was a lot of olfactory loss going on. That can range from complete loss of smell to something more subtle like sometimes a decrease in your sense of smell or a change in your sense of smell. Currently the numbers are hard to tease apart so of the patients who are very sick who come in to the hospital, a very large percentage of them have olfactory loss, whether or not it was an early symptom is kind of hard to tell at that point they’ve already presented with it.  :32

Lane says loss of smell now is listed as a common symptom of COVID-19 infection by the CDC and that those who experience it should at least self-isolate and pay attention to their symptoms. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Sheltering at home may put children and spouses at risk for domestic abuse, Elizabeth Tracey reports

COVID-19 has driven many people to sheltering at home, but that may not be a safe place for children and spouses, as domestic abuse has increased substantially, recent data show. Rachel Thornton, a pediatrician at Johns Hopkins, says transitioning to televisits presents additional challenges in identifying and helping those at risk.

Thornton: When we’re doing a televisit, and we don’t know who else is overhearing the conversation, we always tread cautiously because we know that we don’t want to put people who are in a compromised or potentially compromised situation further in harm’s way by asking at the wrong time or raising suspicions. We do our best to assess for confidentiality when we’re talking to people in their homes, to ask their comfort level with disclosing sensitive information, to give them a heads up that we’re going to be asking about these things.  :31

Thornton says pediatricians are available to help both children and their parents. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Even when a vaccine against COVID-19 is developed, additional issues will need to be addressed, Elizabeth Tracey reports

At least five vaccine candidates have been chosen by the federal government to move forward into further testing and ramping up for production. Andrew Pekosz, a vaccine expert at Johns Hopkins, says one unknown that will only be revealed with time is how long antibodies in response to the vaccine will persist.

Pekosz: One of the things that will be important is the longevity of these responses. We also have to realize that we’re going from a population which is basically naïve to this virus, and trying to get people with a vaccine to be protected. Oftentimes that’s going to take multiple doses of a vaccine. I think the flu vaccine infrastructure is probably a good model to use, because we try to immunize 100 million people in a short period of time so there are things that we can learn from the way that we try to distribute and give flu vaccines, that might help with the Sars-CoV2 vaccine.  :34

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: The vaccine candidates for COVID-19 offer hope, and may be here sooner than we think, Elizabeth Tracey reports

Vaccines based on proteins and nucleic acids are some of the candidates for a vaccine against COVID-19, and almost all of them utilize technology quite different from that used to make other kinds of vaccines. Andrew Pekosz, a vaccine expert at Johns Hopkins, says this shift is likely to bear fruit, and federal agencies are supporting it.

Pekosz: If you can find a good vaccine that works in 100 people, or 1000 people, how do you get from that to immunizing 10 million people in a reasonable amount of time. I think that’s one credit to the federal government response right now, is that people are thinking a few steps ahead of the time, and they are investing in manufacturing capabilities of some of these companies, it’s a bit of a gamble, it’s a risk. They’re assuming that some of these will work, and so they’re investing in the manufacturing capabilities of some of these companies so that they can scale up.  :29

Pekosz says everyone can also have confidence that oversight is rigorous and that safety as well as efficacy are front and center. At Johns Hopkins, I’m Elizabeth Tracey.