Can the coronavirus disease be transmitted from food? A review of evidence, risks, policies and knowledge gaps

The coronavirus disease 2019 (COVID-19) has brought speculations on possible transmission routes of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of the pandemic. Air pollution has been linked to increased risks of COVID-19 infection and mortality rates in regions with poor air quality, yet no retrospective study has been reported on foodborne transmission of COVID-19. While studies have shown that low temperature could dramatically prolong the persistence on SARS-CoV-2 and other coronaviruses, frozen and refrigerated foods have been widely overlooked as potential vectors in policy frameworks and risk mitigation strategies. Food transmission evidence has been disclosed in China early July 2020 by the detection of SARS-CoV-2 on frozen foods, including their packaging materials and storage environments, with two re-emergent outbreaks linked to contaminated food sources. The contamination risk is augmented by a complex farm-to-table process, which favors exposure to food workers and ambient environments. Moreover, the food cold-chain also promotes contamination because laboratory studies showed that SARS-CoV-2 remained highly stable under refrigerated, at 4 °C, and freezing conditions, from − 10 to − 80 °C, on fish, meat, poultry, and swine skin, during 14–21 days. While data are lacking on long-term survival and infectivity under these conditions, ample evidence has been shown on other coronaviruses, including SARS-CoV-1. We therefore hypothesize that contaminated cold-storage foods may present a systematic risk for SARS-CoV-2 transmission between countries and regions. Here, we review the evidence, risk factors, current policy and knowledge gaps, on food contamination and foodborne transmission of SARS-CoV-2.