Saturday, April 18, 2020

COVID-19 & Smell Loss: The Case for Critical Thinking

Sniffing out the truth regarding smell loss requires critical thinking.

When we skim the surface of a news story we risk indifference to the facts. Goldman Sachs allegedly believes that a post-peak reduction in "loss of smell" inquiries on Google Search is "a positive sign for the pandemic" (language embedded in CNBC's hyperlink to the news story). Is this a fact, opinion or clickbait? You need to be a critical thinking ninja to figure it out.

Smell loss and the return of the sense of smell is not a linear process independent of COVID-19 infection. Dr. Eric Holbrook's description in the Harvard Health Blog clarifies this in a pre-COVID-19 perspective of the world as it relates to smell loss:
In some cases, the loss of smell is complete (anosmia), while in other cases there is only a partial loss (hyposmia). In many instances where smell loss occurs, remaining smells are distorted. The distortions are either experienced as odors smelling dramatically different from what was remembered (parosmia) or smelling an odor that isn’t present (phantosmia).                                                      —"Smell Disorders: When Your Sense of Smell Goes Astray," (December 12, 2018)
The first disconnect in "Goldman Says Fewer ‘Loss of Smell’ Google Queries Suggest Better COVID Outlook" is the image used in the article. The caption reads, “A woman wearing a face mask smells flower blossoms.” Let’s put a pandemic perspective on the image because what the caption says and what appears in the picture are slightly different.

A woman wearing a non-medical protective face mask has drawn her mask below her nostrils so she can smell cherry blossoms. The woman will have to touch her face a second time to pull the mask over her nose so it can protect her (assuming it wasn't contaminated the first time she moved it below her nostrils).

Critical thinking begins when we question our perceptions.

Were there other people who smelled the same cherry blossoms before her? Will there be others afterwards? What does that means regarding potential virus transfer? Was the image taken during the pandemic? If it was, where was the photographer? The image that accompanies the article doesn't follow COVID-19 protocol. Strike one.

The picture gets your attention for the wrong reason. It riffs on the desire for post-pandemic normality. This may fuel irrational forecasts on lifting quarantines before science says it's the right time because of the way the picture looks. Strike two.

Let’s revisit the prediction of an organization asserting an opinion that isn't based on the relationship between COVID-19 and smell loss in a controlled study (e.g. the use of Google Trends). It's important to note that CNBC emphasizes this opinion more than Jon Hatzius of Goldman Sachs does when you watch the video embedded in the article.

Goldman Sachs is an American multinational investment bank and financial services company. Is their intention to report news or promote data that encourages investor confidence because it supports their business model? This is the kind of question a critical thinking ninja asks (a recent article on Poynter calls it "growing a third nostril" to sniff out the truth).

Wake up and smell the facts, including opinions masquerading as facts.

Goldman Sachs used one phrase (loss of smell) to generate an outcome on Google Trends. Anyone can use this tool, which provides results based on the country in which a query is made. Anosmia, hyposmia, parosmia and phantosmia aren’t included in the analysis and there are additional words and phrases that can be used to gather results regarding smell loss.

Smell training, which supports patients with smell loss, isn't even investigated and it's an approach supported by scientific research that helps patients with smell loss (lemon, rose, clove and eucalyptus essential oil are commonly used, which is informed by research). That's not a surprise because most of the population knows little about smell and taste disorders and what it's like for patients.

The article referenced in this post appears on CNBC, which is a news source specializing in financial markets. The deduction made by Goldman Sachs doesn’t include expert opinions from scientists as well and multiple points of view. There's nothing “fair and balanced" about it. Strike three (you can S-M-E-L-L it).

Critical thinking is important. It applies to opinions you agree and disagree with when chasing down facts to create an informed opinion. If you believe that people who don't think the way you do are ignorant, check yourself because the ultimate in ignorance is the inability to respectfully weigh facts and opinions. It's how you lie to yourself and others because of what you want to believe. There's another word for this and it's denial. Denial is also a stage of grief and grief is a collective experience during a pandemic like COVID-19.

These are difficult and highly emotional times for everyone. It's tempting to create divisiveness based on personal opinion or that of your pack, but searching for truth and call out misleading statements in your own head helps manage the effects of the pandemic on physical and mental health—your own and that of family, friends and your community. There will be PTSD echo effects when the pandemic is under control and when a cure for COVID-19 is found. The time to build better habits that support clear thinking and common humanity is now.

Smell the May roses at a distance with gratitude and a face mask.

Think before, during after interacting with media. Most importantly, think before you speak (or in the case of the CNBC article, publish a story). Practice being a critical thinking ninja on a daily basis. If you're one of the lucky ones who survive the first cycle of the COVID-19 pandemic in the United States, you might smell the roses in May. Just remember to catch the scent of roses in the breeze and keep your protective face mask on as required.

Some people who contract COVID-19 and become anosmic say they can't taste (ageusia). They may be misarticulating their symptoms without knowing it. I've come across this in off-the-record interviews with people who've had mild symptoms of COVID-19 that presented with smell loss. I am continuing to investigate this.

Smell + Taste = Flavor and we often refer to flavor as taste (e.g. "that tastes delicious"). Taste is sweet, sour, salty, bitter and umami (savory) as well as trigeminal sensations for temperature, texture and spiciness.

If we want to understand patients who lose their sense of smell and/or taste because of COVID-19 we have to go below the surface of what they're saying and ask clarifying questions. This is a doctor's job, but it's also a scientist's job and it's why medical professionals and scientists need to be included in articles that reference medical conditions.