The COVID-19 pandemic has had far-reaching negative impacts, including devastating the restaurant and foodservice industry in the United States. Loss of sales in this space were reported by the National Restaurant Association to surpass $185 billion between March and August of 2020 alone.1 In order for things to return to “normal” for the industry, customers will need to feel safe returning and the chance of this happening again significantly reduced. 

Pharmaceutical interventions (i.e., vaccines and antiviral drugs) are finally more permanently reducing the impact that the pandemic has had on lives and the economy. Complimented with the stepped-up sanitation efforts that have been taken on by many establishments still in business, hope is on the horizon. What will a return to business as usual mean in the ever-present fight against foodborne illnesses and what impact has the pandemic had on this battle to date?

In general, hygiene and sanitation practices and procedures, some of the chief nonpharmaceutical interventions (NPIs) in the battle against SARS-CoV-2, together with social distancing and masks, have been elevated by all businesses during the pandemic, and especially those in the retail foodservice industry. Those that did not have procedures and plans in place quickly developed new Standard Operating Procedures (SOPs), adopting evolving best practices and products to help control the spread of the virus in their environments. There is significant evidence that the use of NPIs to prevent the transmission of SARS-CoV-2 from person to person has reduced the number of illnesses and deaths from this virus during the pandemic.2 Likewise, these NPIs have been suggested to reduce the incidence of influenza in the United States and other countries,3 as significant drops in illnesses and deaths in the United States have been observed during the pandemic. What about foodborne illnesses?  

Outbreaks of norovirus, the most common cause of foodborne illness in the United States, declined by over 80 percent between April and July of 2020 compared to the same date range in previous years, according to data reported to the National Outbreak Reporting System (NORS) at the U.S. Centers for Disease Control and Prevention.4 A recent study to better understand this drastic decline also observed norovirus outbreaks during this same time period in 2020 to be 61 percent smaller compared to prior years.5 Although underreporting of norovirus outbreaks was initially suspected to be the cause of this decline, investigators determined that the more likely scenario was that the adoption of NPIs for SARS-CoV-2 prevention during this time period had an added effect of controlling norovirus outbreaks. 

It’s clear that adopting expansive COVID-19 NPIs has had positive public health benefits beyond controlling SARS-CoV-2 alone, which is exactly why it’s worth taking a deeper look at some of the specific control measures to better understand just how these have had the added benefit of controlling foodborne illnesses, such as norovirus. Here are several specific COVID-19 NPIs that an establishment can adopt to enhance their food safety plan and reduce their risk of causing a foodborne illness outbreak: 

  1. Keeping sick individuals out of an establishment – Adoption of sick leave policies and employee wellness screens to ensure employees are not reporting to work while sick with foodborne illness, such as norovirus, will reduce the risk of a facility causing a foodborne illness outbreak. In fact, in 2017, a risk assessment study by the U.S. Food and Drug Administration found the excluding employees from reporting to work when they are ill with norovirus was one of the most effective ways of reducing a restaurant’s risk for causing a norovirus outbreak.6
  2. Emphasizing frequent and proper hand hygiene – Some have remarked that COVID-19 has caused society to enter a “golden age” of handwashing. While this may have been said in jest, it is important to remind ourselves of the clear public health benefits of hand hygiene practices. With these benefits in mind, many NPIs rooted in hand hygiene have been adopted and should remain in effect as proper handwashing with soap and water is a major way of reducing a facility’s risk for causing a norovirus outbreak.6 Therefore, establishments should always emphasize frequent and proper hand hygiene as a major aspect of their food safety plan. 
  3. Elevating sanitation practices, including touchpoint disinfection – There are many COVID-19-related temporary guidance policies where enhanced touchpoint disinfection practices are adopted as NPIs, with direct carryover to controlling foodborne illnesses, especially norovirus. Norovirus can persist on surfaces for weeks if not properly cleaned and disinfected, with many examples of norovirus outbreaks where the cause was ultimately determined to be a contaminated surface or touchpoint that was not cleaned and disinfected properly. Product choice has mattered as well—when possible, choose products with short kill claims for the organisms of interest for your establishment. By keeping contact times short, compliance with enhanced sanitation protocols can increase, which helps reduce risk of an outbreak within a facility. Turnkey programs such as the NOROVIRUS HOT SPOT™ Program also exist, where a disinfectant is combined with a set of procedures and SOPs that a facility can quickly adopt and integrate into their food safety plan.  

It’s important that a return to normal does not mean going back to old habits, risking a reemergence in the frequency of deadly foodborne illness outbreaks. Of course, breaking the chain of human infectious disease transmission has always been a challenge, especially so when there is no vaccine to prevent a foodborne illness like norovirus.  But mitigating the pandemic has taught the industry a lot of about fighting infectious diseases in general, wisdom that should be carried into the future. Retail food and foodservice establishments that master the long-term incorporation of these controls into their facility’s overall safety plan will be able to support the ongoing health and posterity of their customers and employees and positioned for success in the future, well after COVID-19 has become a bad memory. 

After all, the only consistent means to end infectious diseases must be the use of multiple controls.

Knowing an enemy is the first step towards defeating it—which is why building an understanding of pathogens is paramount to any prevention strategy. Learn more about norovirus, as well as prevention solutions, with the latest research and insights by signing up to download this new research bulletin.

To find out more about the NOROVIRUS HOT SPOT™ Program from Active Food Safety in partnership with PURELL®, please visit the portal here.

References

1.  https://restaurant.org/articles/news/consumers-respond-to-new-off-premises-options

2.  https://jamanetwork.com/journals/jama/fullarticle/2776937

3.  https://www.cdc.gov/mmwr/volumes/69/wr/mm6937a6.htm 

4.  https://www.cdc.gov/norovirus/reporting/norostat/data.html 

5.  https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiab093/6145007

6.  https://onlinelibrary.wiley.com/doi/full/10.1111/risa.12758