Food Safety and COVID-19: A Guide for Handling Groceries and Takeout

April 26, 2020

Food Safety and COVID-19: A Guide for Handling Groceries and Takeout

When Minneapolis resident Nina Axelson sees her groceries get delivered to the back porch, the first thing she does is fill up two buckets — one with hot, soapy water, and the other with clean water for a rinse. She grabs a couple of fresh towels, tells her 5-year-old daughter to play inside, and then goes out to give every package a quick scrub.

Paranoid germophobe or savvy virus slayer? Axelson, 43, who lives with Hashimoto’s thyroiditis (an autoimmune disorder that commonly leads to hypothyroidism), doesn't mind being called kooky by family members. Instead, she feels the extra layer of precaution is worth the effort. And amid the COVID-19 pandemic, there are many healthcare professionals who agree with her.

"Not only do I have a young child, but I have an autoimmune disorder," she says. "We have taken so many other precautions, including working from home, having groceries delivered so we limit being around other people, and being thoughtful in how we maintain distancing. This is just one more risk-management strategy."

To Sanitize or Not to Sanitize Food Packaging During the Coronavirus Pandemic?

The debate over whether to sanitize grocery and takeout packaging has only just begun, but it's already heated.

On one side is a viral video — as of Monday, it had more than 21 million views — from the Grand Rapids, Michigan–based family practice physician Jeffrey VanWingen, MD. Dr. VanWingen asserts that the findings of a recent study (more on that in a minute) demonstrate COVID-19 infection can stay on packages, like grocery items, for longer than people might think.

Because of that, he suggests strategies like leaving groceries in a garage or on a porch for three days, and immediately sterilizing the packages you can't wait to bring inside.

On the other side are experts like Joseph Allen, DSc, MPH, of Harvard University's T.H. Chan School of Public Health in Boston, who recently wrote an op-ed in the Washington Post that says, essentially: Calm down. He lays out a scenario of package handling that shows why the risk for transmission between food packaging and humans remains very low in nearly all cases.

Both viewpoints are based on the same research, published March 17, 2020, in the New England Journal of Medicine.

How Long the Novel Coronavirus Stays on Surfaces (and in the Air)

The study found that the virus, known officially as SARS-CoV-2, stays on surfaces for various periods of time, depending on the nature of the surface:

Hard surfaces like plastic, steel, countertops, and glass: 72 hours
Porous surfaces like cardboard, paper, and fabrics: 24 hours
Airborne in droplets released by coughing or sneezing: 3 hours

So, who's right? According to several health experts, they both are. Dr. Allen is right that your risk of getting COVID-19 is much higher if you're around an infected person than around a package that may have gotten some droplets on it from someone with symptoms, but VanWingen makes some excellent points about not transferring germs to multiple surfaces inside your home.

"At this point, we are obviously still learning about this virus and how it spreads, but we do know the main transmission is person to person," says Debra Goff, PharmD, the founding member of the antimicrobial stewardship program at the Ohio State University Wexner Medical Center in Columbus, and a recent appointee to the World Health Organization antimicrobial stewardship program in low- and middle-income countries.

"That said, data about how it stays on surfaces should make us pay attention," she says. "If nothing else, that should remind us to keep washing our hands. But making sure surfaces are cleaner can be helpful as well."

How to Minimize Exposure Risk While Grocery Shopping

Risk management starts with safer shopping practices, says Akua Woolbright, PhD, of Detroit, the nutrition program director of Whole Cities Foundation, the nonprofit program of Whole Foods Market.

In addition to maintaining the CDC-recommended distance of six feet between you and other people, washing your hands more often, and not shopping when you are ill, here are some other ways Dr. Woolbright suggests to lower your risk.

Use reusable bags wisely. New Hampshire and Massachusetts now ban these bags because of concerns about viruses clinging to them, but Woolbright says plastic bags aren't a panacea, since you don't know who's been handling them. She suggests using only bags that are washable, and washing them after every trip.
Make a grocery list prior — and stick with it. Not only does this minimize the time you spend in the store, but it reduces your browsing, which means you're not handling multiple items to read labels and then putting them back on the shelf.
Keep your hands sanitized. Most, if not all, grocery stores now have sanitizer near the shopping carts that you can use on your hands as well as the cart handles. Don't skip this step.
Go cashless. Pay with a credit card, because even before this pandemic, research has noted how notoriously germy cash can be. For example, a study in the April 2017 issue of PLoS One found that randomly swabbed $1 bills in New York City had more than a hundred different strains of bacteria. And, interestingly, most had traces of cocaine — but that's a different issue.
Have an "indoor-only" wardrobe. When you get home, take your shoes off, preferably outside. Change into your indoor clothes and put your outdoor clothes in the washer.

Tips for Safely Handling Groceries at Home

Once you have the food in your home, either from delivery or shopping yourself, that's when you can put a few cleaning steps into place, suggests Felicia Wu, PhD, a professor in food safety, toxicology, and risk assessment at Michigan State University in East Lansing, and an adviser on food issues to the World Health Organization and United Nations. Dr. Wu recommends these five steps:

If you bought anything that is acceptable to keep in your car or garage for over three days (toilet paper, potatoes, onions, etc.), do so. Coronavirus should no longer remain on those surfaces after 72 hours.
For items that need to be brought inside and frozen, refrigerated, or eaten quickly: First wash your hands carefully. Designate counter or floor space and cover it with cloth or paper towels to denote uncleaned versus cleaned foods. Put all your grocery items first on the uncleaned surface. Have either Lysol or Clorox in spray form, and paper towels or wipes.
One by one, clean the surfaces of each of these items: bread wrapped in plastic, yogurt containers, etc.
After each item is cleaned, move it to the "clean" surface.
Finally, discard all remaining plastic bags, and then wash your hands carefully again.

Don’t Use Dish Soap to Clean Fresh Produce

For produce that's unwrapped, you may see some suggestions to wash it in soapy water, but don't, says Woolbright. Ingesting dish soap, even if it's been "rinsed off," is simply not a good idea and may cause digestive issues. Definitely don't use chemical disinfectants or bleach either, she adds.

"Honestly, washing produce effectively is a good practice even when there's not a pandemic," she advises. "So, see this as a way of establishing the right habits when it comes to cleaning your fruits and vegetables."

She recommends these simple strategies:

Clean your hands both before and after handling produce, especially if you're reaching into a bag of prewashed salad (which you actually don't have to wash again, she says).
Make your own produce wash: Get a BPA-free spray bottle and fill it with 2 parts water and 1 part apple cider vinegar. Spritz your fruits and veggies thoroughly and then rinse very well.

What About Sanitizing Takeout?

COVID-19 has been shown to live for a day on porous surfaces, and that includes takeout containers, says Katie Heil, a certified professional in food safety for StateFoodSafety in Orem, Utah, which provides training and safety certifications for the hospitality industry.

Here are Heil’s tips for handling takeout:

As long as the container is impermeable or nonabsorbent — including plastic, polystyrene, and waxed cardboard — you can wipe it down with any of the CDC's recommended disinfectants. But the CDC advises sticking with a chlorine bleach, iodine, or quaternary ammonium solution (found in some types of disinfectant wipes) because that's what the FDA recommends for food-contact surfaces.
Because most takeout containers are intended to be single-use, transferring the food to a dish that you know has been thoroughly cleaned is not a bad idea. Just wash your hands thoroughly after handling the takeout containers. To ensure your dishes are thoroughly disinfected, they need to be cleaned and sanitized. The cleaning step involves removing leftover bits of food or food juices from the dish and then washing it with soap and water, which helps remove germs.
The sanitizing step kills remaining bacteria using a chemical solution or high heat. If you have a dishwasher, the easiest way to sanitize your dishes is to run them through the dishwasher. If you don't have a dishwasher, you can make a sanitizing solution by combining one tablespoon of chlorine bleach with a gallon of cool water (hot water prevents the bleach from sanitizing properly). Soak for one minute, and then rinse with clean water.
It's also wise to keep your counter clean and sanitized. You could have the cleanest dishes in the world, but if you set them onto a contaminated surface, germs can move from that surface to your dish. Wipe off your counter after you use it to keep it clean.

The Bottom Line on Food Safety Amid COVID-19: Be Like Nina

As with many other strategies around COVID-19, decisions about protection come down to a personal level.

Nina Axelson says her grocery wash process takes her 10 minutes. Before embarking on the effort, she read the research, considered different opinions, and finally came up with a plan that made sense for her and her family.

The fact that she has an autoimmune disorder puts her more at risk for infection, so her protective efforts are likely more involved than they might be for someone at low risk. She also "quarantines" packages and nonperishable items for a couple days in the garage, but she says if she heard compelling evidence that it's unnecessary, she'd stop doing it.

"I believe we all need to adapt as the science does, and use those insights in a way that's meaningful," she says. "And if that means spending a few minutes wiping things down more and then washing hands again, it's worth it."

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