Can imported cold food cause COVID-19 recurrent outbreaks? A review

The coronavirus disease 2019 (COVID-19) pandemic is still spreading all over the world. Although China quickly brought the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) under control in 2020, sporadic outbreaks have recurred from time to time. Outbreaks since June 2020 have suggested that the imported cold food supply chain is a major cause for the recurrence and spread of COVID-19. Here we review recurrent outbreaks in China from June 2020 to March 2021, and we analyse the main causes for recurrence and transmission by the supply of imported cold food from port to fork. Contaminated cold food or food packaging material can transmit the virus through ‘person-to-thing-to-person’, by contrast with the classical ‘person-to-person’ pathway. We decribe safety precautions for the food system, operating environment and people along the cold chain logistics. Surface disinfection and nucleic acid inspection are needed in each stage of the logistics of imported cold food supply.