- Anosmia is third symptom – in addition to cough and fever – justifying a test under revised guidance
The Guardian (UK)
People who experience a loss of smell or taste are being advised to get tested for Covid-19, in a change of guidance from the UK government that experts say is well overdue, warning that thousands of cases have already been missed.
Anosmia – the medical term for loss of smell – is now the third symptom of the coronavirus infection that will justify a test, in addition to a persistent cough and high temperature. The four chief medical officers of the UK have said that people with loss of smell or loss of taste should now self-isolate or get tested, even without the other symptoms.
The announcement came as experts said that thousands of cases of Covid-19 had gone undetected because of the focus on cough and temperature alone.
Prof Tim Spector from King’s College London, who has been collecting data on people who downloaded its symptom app, said 50,000 to 70,000 people in the UK with Covid-19 were wrongly not being told to self-isolate.
He blamed Public Health England (PHE) and the wider tracking strategy. He told BBC Radio 4’s Today programme that 1.5 million people were logging on to the King’s app.
“It tells us that we’ve got at least 100,000 cases at the moment of people who are infected and this is from our data, although the NHS would underestimate that because they’re not counting all the symptoms. We list about 14 symptoms which we know are related to having a positive swab test, and these are not being picked up by the NHS.”
Spector said 17 other countries including the US had altered their list of symptoms, but not the UK. “At the moment, people are being told to go back to work if they’re a care worker, and they’ve got something like loss of smell or taste or severe muscle pains or fatigue – things that we know and we’ve shown are related to being swabbed positive,” he said.
“This country is missing the ball in underestimated cases but also putting people at risk, and continuing the epidemic. So we really do need to tell Public Health England to get in line with the rest of the world, and make people more aware.
“Someone has got to urgently ask this question of why we’re the only country in this crisis that isn’t really widening our group of symptoms and get on with it and do something.”
Spector’s group was warning as early as 1 April that people losing their sense of smell or taste should self-isolate.
England’s deputy chief medical officer, Jonathan Van-Tam, said the government’s new and emerging respiratory virus threats advisory group(Nervtag), began looking at the data on 27 March.
Spector’s research showed that between 24 and 29 March, 59% of users who tested positive for Covid-19 experienced loss of smell and taste compared with 18% of those who tested negative.
“When combined with other symptoms, people with loss of smell and taste appear to be three times more likely to have contracted Covid-19, according to our data, and should therefore self-isolate for seven days to reduce the spread of the disease,” he said at the time.
Van-Tam said the data had been kept under regular review but there were questions as to how significant the symptom was. “There are multiple occasions when Nervtag has concluded the data are very preliminary and not the basis for action,” he said.
“As soon as they felt they had a position, they put it to the chief medical officers’ group and action has been taken within a few days.”
Van-Tam said they did not know how many people experienced this symptom, nor whether it is more common in some groups than others. “We have seen some signalling in some of the literature that anosmia may be more frequent in females,” he said. There are also suggestions of higher proportions of young people experiencing it.
“Prof Spector’s estimate was over 50%, but that is certainly not true of all the reports I have read,” he said.
The timing of the announcement is significant, as lockdown restrictions ease and it become increasingly important to detect infections as early as possible and track contacts.
“Clearly we are moving into a period thankfully where we have much lower disease activity in the UK,” said Van-Tam. “At a time when disease activity is going to be lower, it is going to be even more important to keep it that way by picking up all the cases we can.”
He acknowledged that the three symptoms are not the only ones, but said fatigue and muscle pains, for instance, are too common to be included as triggers for tests at this point.