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    In infectious disease outbreaks, mundane chores like food shopping may become much more exciting (but not in a good way).  Yet, these activities are necessary to keep a family going. How can you avoid getting infected in the midst of a coronavirus pandemic?

    SARS-CoV2, the virus that causes COVID-19 disease, is spread from person-to-person. Usually, this occurs due to contamination with virus-laden respiratory droplets when a sick person coughs or sneezes. Sometimes, however, it’s thought that touching a contaminated surface and then touching your nose, mouth, or eyes may transmit the disease.

    Note: Food itself is not considered an issue. COVID-19 is not a foodborne illness.

    There’s a lot of opportunity for both methods of transmission when you visit the grocery store. Staying away from someone who is obviously sick is important, of course, but 25-50% of COVID-19 positive cases have no symptoms at all. It’s possible that certain individuals can pass the illness before they show signs like fever or cough; others may still carry the virus for a time after apparent recovery.

    Which makes going grocery shopping seem like a crapshoot. L.A. County Public Health director Dr. Barbara Ferrer even made the statement that citizens should stay away from grocery shopping for the next “critical” week to slow the spread of COVID-19.

    It doesn’t have to be that way most of the time, however. Stores have taken special precautions to decrease exposure. These include:

    • Encouraging customers to wear face coverings
    • Limiting the numbers of people in the store at any one time
    • Disinfecting cart handles after each use
    • Placing tape to indicate proper social distancing
    • Making one-way aisles to decrease people passing each other too closely
    • Having staff use hand sanitizer or wash hands much more often
    • Installing plastic shielding between customers and cashiers
    • Instituting special hours for elderly and other high-risk persons

    These measures are helpful, but you must also help to decrease your chances of catching COVID-19 or passing it to those who may be older or have medical issues.

    BEFORE YOUR SHOPPING TRIP

    Before you even head out to the store, you should ask yourself “Is this trip necessary”? What are you missing that you can’t live without? If you can lower the number of visits to get groceries, you are dropping the number of possible exposures, both to yourself and others.

    If you decide you have to go, buy enough for a week or two. Make a list so that you remember every item you’ll need to get by.

    Delivery better than in-person shopping

    You might consider finding out if delivery service is available. Many food stores (and even restaurants) are urging customers to buy online and arranging delivery or, at least, curb pick-up (avoid direct hand-offs). The highest viral load in the environment is indoors, so the fewer stores you enter, the better.

    Let’s say that you can’t get food delivered or curbside pickup. In that case, ask when the slowest times are. Less customer traffic means less exposure. Don’t forget to wipe down your doorknob and steering wheel with disinfectant as you leave and on returning.

    If you’re going inside, it’s best for one person to do the shopping. Leave the kids at home if at all possible. Children are innately curious: They will touch all sorts of stuff and, invariably, stick their finger in their nose or otherwise touch their face. A lot.

    Perhaps most importantly, do not head out to the store if you’re sick, or if you’re the caretaker for someone who is obviously ill with COVID-19. Ask a family member or friend to go instead and leave the groceries outside your door.

    DURING YOUR SHOPPING TRIP

    You’ve decided you have to go shopping for food today. If that’s the case, wash your hands with soap and water before your go and use hand sanitizer often during and after your visit. If there are sanitizing wipes available, take advantage of them and wipe your cart handle. If not, consider bringing your own.

    For many people, food shopping is a sensory experience. Is this peach nice and firm or soft and juicy? How about that one? You tell yourself that the best way to tell is to pick it up and feel. This is a habit you’ll have to break to lower your chances of getting infected. Pick up just what you’re going to consume and use hand-sanitizer before and after making your selection.

    1) Don’t bring your kids! 2) Don’t handle fruit you’re not buying!
    3) wear gloves!

    After some hesitation, the CDC finally recommended wearing face masks or coverings when out in public. This is more for other people’s protection but everyone benefits. For grocery store trips, disposable gloves may not be a bad idea as well.

    As with any public setting, you should maintain a distance of at least 6 feet from others.  If aisles have been converted to one-way thoroughfares, don’t go against “traffic”. Be focused on getting the stuff you need and heading out as soon as possible.

    Some may decide on frozen foods rather than fresh. There is no evidence at present, however, that frozen vegetables are safer than fresh produce. In fact, freezing is the methods labs use to preserve viruses.

    You should consider asking the cashier and anyone bagging your groceries to use hand sanitizer before handling your food. You won’t be the most popular customer at the store, but that’s one or two less people that have handled your food. Pay with a credit or debit card (or touchless system) to avoid the handoff of cash and receiving change. If you have to sign use your own pen as a stylus.

    AFTER YOUR SHOPPING TRIP

    Wash your hands as soon as you get home and after putting food away. At present, the CDC and other health officials don’t recommend wiping down food packaging with a disinfectant; they believe that transmission is mostly person-to-person and not object-to-person. The risk of package contamination is very low (but not zero!). I believe that it wouldn’t hurt to, at least, wipe down non-porous containers like glass, plastic, or cans with disinfectant wipes. SARS-CoV2 can live on some of these surfaces for three days.

    What about cardboard boxes? The data suggests that SARS-CoV2 doesn’t live more than 24 hours on cardboard packaging, so consider waiting a day or so to use that item.  Many packaged items are cardboard outside and packed in plastic inside. If you have to use them sooner than 24 hours, you can remove the box, throw it away, and use the original plastic or Tupperware-style containers.

    Some recommend spraying boxes with disinfectants. The CDC says that the likelihood of getting infected from a contaminated cardboard box is “very low”.

    Some folks believe that leaving groceries in the garage for three days is a good strategy. This, however, may represent a food safety problem: As weather gets warmer, especially down here in South Florida, the garage is unlikely to be at the right temperature to prevent the growth of bacteria. Also, you (hopefully) have more pests in your garage than in the rest of your house.

    Instead, pick a spot where bagged groceries are placed when you come in and another where you place disinfected or otherwise clean items. Give the unpacking spot an extra-good cleaning with a disinfectant wipe.

    Rinse all produce with water

    All produce should be rinsed with water. This is a good idea whether there’s a pandemic or not. Germs, dirt, and pesticides may reside on the skin of a fruit or vegetable. A good rinsing with water will flush them off and down the drain. Don’t use soap or chemical disinfectants, though; they can cause GI upset or worse.

    If you have reusable grocery bags, wash them after your trip to the store. Cloth bags should go in the laundry. Reusable plastic should be washed with soap or other disinfectant.

    Joe Alton MD

    Dr. Joe Alton

    Learn more about pandemic preparedness in “Alton’s Pandemic Preparedness Guide: Dealing with Emerging and Current Viral Threats”, now available on Amazon and at store.doomandbloom.net

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