COVID Restaurants: Could COVID Be the New Hep A?

We put a lot of trust in others when it comes to people preparing our food.  At a restaurant, we expect that clean utensils are used, hands are washed, appropriate temperature control is maintained, the space is free of grime, rodents, and bugs.  What about the supply chain and those conditions?  Chances are you haven’t considered these things.  You can dig deeper and deeper into the realm of what we trust when it comes to those preparing and serving our food in a restaurant. COVID Restaurants could be alike to Hep A outbreaks.

In most cases you cannot see what is going on behind that closed doors of the kitchen.  We might look around for how hygienic the staff appear to be.  We can observe how clean the restaurant appears to be.  If the cutlery looks clean.  Is the food served hot?  These are all things we have the power to see.  Beyond that, we are blind.  We blindly trust that the food is free of harmful contaminants, that it is served at the appropriate temperature, and that it is delicious.  It is a gamble we often make and generally win on.

COVID Restaurants Dining – a Source of Many Communicable Illness

It is no surprise that transmission of communicable illness can occur in a restaurant setting.  Food service workers in the back of the house (kitchen) and the front of the house (servers) all come in contact with the food consumed.  If one of them is sick, they can infect each other and potentially contaminate hundreds of dishes per shift on a busy day.

Norovirus, Hepatitis, and now COVID-19 are some of the baddies that consumers should worry about.  While a vaccine and herd immunity will likely quell the pandemic, many believe that COVID will be around in the background for the long run.  So, what does this mean for the restaurant industry?

 Study Suggests Higher Risk of Contracting COVID After Dining at a Restaurant

Many parts of the country have limited or eliminated dining inside restaurants since the beginning of the pandemic.  As things begin to reopen – restaurants included, many feel a bit hesitant eating out again.  Often with good reason.

A July 2020 study indicated that participants with confirmed COVID-19 infection were more likely to report dining at a restaurant or going to a bar/coffee shop than were control-participants.  The study explains that “exposures and activities where mask use and social distancing are difficult to maintain, including going to places that offer on-site eating or drinking, might be important risk factors for acquiring COVID-19.”

But COVID is not the only virus with that same claim to fame.

Most Hepatitis A Transmission Occur by Food Service Workers

The CDC reports that “the source of most reported foodborne hepatitis A outbreaks has been HAV-infected [Hepatitis A Virus] food handlers present at the point of sales (such as in a restaurant) or who prepare food for social events (such as a wedding).” In fact, “a single HAV-infected food handler can transmit HAV to dozens or even hundreds of persons and cause a substantial economic burden to public health.”

And What About Norovirus?

Norovirus, a source of diarrheal illness, is the leading cause of food-related outbreaks in the United States, with most occurring in food service setting like restaurants.  “Infected food workers are frequently the source of outbreaks in food-service settings often by touching ready-to-eat foods, such as raw fruits and vegetables, with their bare hands before serving them.”

Restaurant Response to Sick Employees

While COVID is an entirely new animal when it comes to infection and response, the food service industry and regulators are taking a nod from the known threats – Hepatitis A and Norovirus with regards to handling an infected employee and the restaurant following diagnosis.

Restaurant Response to Hepatitis A Infected Employee

Response to a COVID-19 positive employee is not all that different from that of a Hepatitis A positive employee.  Hepatitis A, like COVID, is a reportable diagnosis.  This means that food establishments must report any Hepatitis A diagnosis to the proper regulatory authority.

Employee and the food service’s “Person in Charge” are expected to know the symptoms and monitor for them.  If Hepatitis A infection is suspected, the employee is restricted from food handling activities.  Food handling status can only be reinstated after medical documentation of being free of Hepatitis A virus infection, an employee with infection resulting in jaundice can be released after 7 calendar days, an employee with infection not resulting in jaundice can be released after 14 calendar days, and those working for a highly susceptible population may be released after 30 calendar days.

Restaurant decontamination is performed, and remediation efforts are made prior to re-opening.

Restaurant Response to COVID Infected Employee

Like Hepatitis A, employees and the food service’s Person in Charge are expected to know the symptoms of COVID infection and monitor for them.  If COVID-19 infection is suspected, appropriate regulatory agencies should be contacted and the employee must be sent home.

Employees who are sick or exposed to someone who is sick should stay home.  Employees who have tested positive for or are showing symptoms of COVID-19 are expected to follow the current CDC guidelines for returning to work.

Additionally, just as with potential Hepatitis A exposure, the restaurant should undergo appropriate decontamination procedures as outlined by the CDC and/or FDA.

COVID Restaurants: Where Do We Go from Here?

Both patrons and food service employees rely on each other.  Patrons rely on food service employees to provide quality food free of contamination.  Food service employees rely on patrons to visit their establishments and keep them open.  There is a shared trust between the two groups.

While exposure is increased when dining inside a restaurant where mask wearing activities and social distancing are not as easy to maintain, the risk of food handling does not change for curbside and takeout activities.  The risks of norovirus, Hepatitis A, and COVID exposure remain a threat during this pandemic and beyond.

Are you ready to eat out again?

By: Heather Van Tassell