How Safe Is It To Eat Takeout?

Don Schaffner had Thai takeout for dinner a few nights ago, just as he did occasionally in the weeks and months before the current COVID-19 pandemic.

That's worth knowing. Schaffner is a distinguished professor at Rutgers University in New Jersey whose expertise includes quantitative microbial risk assessment, predictive food microbiology, hand-washing and cross-contamination.

"I know people are worried, but from what we know currently about the virus, it's safe to eat food prepared at restaurants so long as you take the proper precautions — in particular hand-washing," says Schaffner.

As the coronavirus spreads in the U.S. and Americans heed directives to stay home, takeout and delivery of prepared food is picking up. Yet in these fearful times, many of us are wondering if eating takeout is a good idea. (Plus shouldn't we be cooking all those groceries we stocked up on?)

Luckily for lazy cooks, eating food prepared in restaurants appears to be a safe choice. Current guidance from the Food and Drug Administration states that "there is no evidence to suggest that food produced in the United States can transmit COVID-19."

Infectious disease and food safety experts we spoke to say they base their determination that takeout food is safe on decades of research on other coronaviruses, which were first identified in humans in the 1960s.

"While COVID-19 is new to us, coronaviruses are not, and with all the studies done on these viruses, there has never been any information to implicate food-borne transmission," says Dr. William Schaffner, a professor of medicine in the department of infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tenn.

The coronavirus that causes COVID-19 is primarily spread via droplets expelled through coughing or sneezing, says William Schaffner. If you're standing too close (within about 6 feet) to an infected person when the person coughs or sneezes, or even possibly when the person speaks or exhales, viral droplets could make their way to your nasal passages and mucous membranes. Or if you touch a surface with droplets on it and then touch your eyes, nose or mouth, that could also lead to infection.

All this means that transmission via food is incredibly unlikely, say both professors Schaffner — unless you actually inhaled your food. "Even in the so unlikely scenario of virus through a sneeze or cough coming into contact with, say, a salad, that would enter the body through the throat," William Schaffner says.

William Schaffner explains that the virus is primarily risky to us when it attaches to surfaces in our respiratory track, not when we accidentally eat it. "The virus seems to be latching onto cells in the upper reaches of the nose, a place food doesn't enter," he explains. "Virus that found its way into your gastrointestinal tract would be killed by the acid in your stomach."

Several infectious disease experts whom NPR spoke to concurred that research hasn't turned up any evidence of COVID-19 spreading through food.

"There are no published reports of linkage to food [of the novel coronavirus]," says Dr. Rachel Bender Ignacio, an associate professor of allergy and infectious diseases at the University of Washington School of Medicine. In February, the World Health Organization said the same thing, though it noted that food safety authorities are keeping an eye on the issue.

While all the experts we spoke to were in agreement that restaurant food is safe to order during the COVID-19 outbreak, if you are immunocompromised or just feeling extra wary, you may want to consider ordering cooked food only rather than uncooked items such as sandwiches. Cooking at high-enough temperatures kills viruses, says Elizabeth Mills, a registered dietitian at the Villanova University College of Nursing, in Villanova, Pa.

"There's much we don't know about the survivability of the virus on surfaces, including food," she says. "But what we do know is that the coronavirus is a strand of RNA surrounded by a protein shell. Protein is denatured, or loses its biologic function, when exposed to cooking."

But like other experts we spoke to, Mills says that since there is no evidence that food is a carrier of the coronavirus, there is currently no reason to avoid any foods, including salads. "At the same time, there is a ton of evidence that eating a varied diet that includes fruits and vegetables supports good health, including a healthy immune system," Mills says.

It's also worth noting that safe food-handling rules, required of any establishment that serves food, would also be protective against spreading the coronavirus, says Don Schaffner. These include wearing gloves, workers staying home when sick, frequent hand-washing and disinfecting of surfaces in the kitchen.

And no food establishment can operate unless there's at least one person on the premises who is trained in food safety, says Don Schaffner. The rules that govern safe food preparation during the outbreak are long-standing ones that food service directors already know, he says.

The FDA has produced guidance on food safety and COVID-19. The only significant change from standing guidance before the pandemic is the recommendation from the FDA to maintain a 6-foot distance between food workers when possible, to reduce the risk of transmission among them.

"Commercial kitchens are required to follow FDA and USDA food safety rules, including the maintenance of clean and sanitized facilities and food contact surfaces," says Olga Padilla-Zakour, director of the Cornell Food Venture Center at Cornell University. These include washing hands for 20 seconds with soap before handling food.

While food hasn't been shown to be a transmission entry point for the coronavirus, surfaces can be. A research letter study published in The New England Journal of Medicine in March found that the coronavirus was detectable for up to four hours on copper, up to 24 hours on cardboard and up to three days on plastic and stainless steel.

So rather than worrying about the food itself, Padilla-Zakour recommends that you keep surface sanitization and social distancing in mind when you order takeout. She recommends the following steps:

• Take a few minutes to create a safe food environment when the food arrives by cleaning any surfaces it will touch.
• Pay (and tip) in advance to minimize person-to-person interaction with the driver or restaurant takeout clerk.
• Let the driver leave the food at the doorstep. Wait until the driver is at least 6 feet away before picking up the food.
• Remove the food from the takeout bags or containers, and dispose of or recycle them appropriately.
• After disposing of packaging, wash your hands for 20 seconds with soap and water.
• Wipe counters and other surfaces where you unpacked the food.

Across the U.S., thousands of restaurants have closed or cut staff, and the National Restaurant Association says early estimates indicate that 5 million to 7 million restaurant workers may lose their jobs due to COVID-19, and many already have. If you decide to order takeout, doing so can help support struggling local businesses and the people they employ.

Keep in mind that while you are limiting your risk by having the food delivered or by having someone meet you at the restaurant door for pickup, someone else is potentially increasing their risk in those transactions, says Arthur Caplan, director of the Division of Medical Ethics at New York University's Langone Medical Center.

So help protect those workers as much as you can by picking up your food at curbside, if a restaurant has that option, or waiting for the delivery person to drop off your food and then leave before you open the door, Caplan says. He even suggests doing a bundled order with your neighbors — but each one adding their own tip — which can mean fewer trips for a driver but more money for the day. Make sure you practice social distancing when you collect the food, though.

Copyright 2020 NPR. To see more, visit https://www.npr.org.