Long Distance Transmission of SARS-CoV-2 from Contaminated Cold Chain Products to Humans - Qingdao City, Shandong Province, China, September 2020

Low-Temperature Adaptive Single-Atom Iron Nanozymes against Viruses in the Cold Chain

Outbreaks of viral infectious diseases, such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A virus (IAV), pose a great threat to human health. Viral spread is accelerated worldwide by the development of cold chain logistics; Therefore, an effective antiviral approach is required. In this study, it is aimed to develop a distinct antiviral strategy using nanozymes with low-temperature adaptability, suitable for cold chain logistics. Phosphorus (P) atoms are added to the remote counter position of Fe-N-C center to prepare FeN4P2-single-atom nanozymes (SAzymes), exhibiting lipid oxidase (OXD)-like activity at cold chain temperatures (-20, and 4 °C). This feature enables FeN4P2-SAzymes to disrupt multiple enveloped viruses (human, swine, and avian coronaviruses, and H1-H11 subtypes of IAV) by catalyzing lipid peroxidation of the viral lipid envelope. Under the simulated conditions of cold chain logistics, FeN4P2-SAzymes are successfully applied as antiviral coatings on outer packaging and personal protective equipment; Therefore, FeN4P2-SAzymes with low-temperature adaptability and broad-spectrum antiviral properties may serve as key materials for developing specific antiviral approaches to interrupt viral transmission through the cold chain.

A narrative review of alternative transmission routes of COVID 19: what we know so far

The Coronavirus disease 19 (COVID-19) pandemics, caused by severe acute respiratory syndrome coronaviruses, SARS-CoV-2, represent an unprecedented public health challenge. Beside person-to-person contagion via airborne droplets and aerosol, which is the main SARS-CoV-2's route of transmission, alternative modes, including transmission via fomites, food and food packaging, have been investigated for their potential impact on SARS-CoV-2 diffusion. In this context, several studies have demonstrated the persistence of SARS-CoV-2 RNA and, in some cases, of infectious particles on exposed fomites, food and water samples, confirming their possible role as sources of contamination and transmission. Indeed, fomite-to-human transmission has been demonstrated in a few cases where person-to-person transmission had been excluded. In addition, recent studies supported the possibility of acquiring COVID-19 through the fecal-oro route; the occurrence of COVID-19 gastrointestinal infections, in the absence of respiratory symptoms, also opens the intriguing possibility that these cases could be directly related to the ingestion of contaminated food and water. Overall, most of the studies considered these alternative routes of transmission of low epidemiological relevance; however, it should be considered that they could play an important role, or even be prevalent, in settings characterized by different environmental and socio-economic conditions. In this review, we discuss the most recent findings regarding SARS-CoV-2 alternative transmission routes, with the aim to disclose what is known about their impact on COVID-19 spread and to stimulate research in this field, which could potentially have a great impact, especially in low-resource contexts.

Cold-Chain-Food-Related COVID-19 Surveillance in Guangzhou between July 2020 and December 2022

OBJECTIVE

To monitor severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA contamination in samples linked to imported cold-chain food and assess the situation from the implementation of a centralized supervision warehouse system in Guangzhou, Guangdong Province, China.

METHODS

Swabs of workers and frozen-food-related samples were collected between July 2020 and December 2023 in Guangzhou, Guangdong Province. SARS-CoV-2 RNA was extracted and analyzed by a real-time quantitative polymerase chain reaction using the commercially available SARS-CoV-2 nucleic acid test kit. The risk level and food source were monitored simultaneously.

RESULTS

A total of 283 positive cold-chain events were found in Guangzhou since the first cold-chain-related event of the coronavirus disease 2019 pandemic was identified in July 2020. Most positive samples were a low-to-medium risk, and the cycle threshold value was >30. No live virus was detected, and no staff came into direct contact with a live virus. In total, 87.63% of positive events were identified through sampling and testing at the centralized food warehouse.

CONCLUSION

Cold-chain food has a relatively low risk of transmitting SARS-CoV-2. Centralized food storage can be used as an effective method to control this risk, and this measure can also be used for other food-related, contact-transmitted diseases.

Stability of SARS-CoV-2 and persistence of viral nucleic acids on common foods and widely used packaging material surfaces

SARS-CoV-2 is still spreading globally. Studies have reported the stability of SARS-CoV-2 in aerosols and on surfaces under different conditions. However, studies on the stability of SARS-CoV-2 and viral nucleic acids on common food and packaging material surfaces are insufficient. The study evaluated the stability of SARS-CoV-2 using TCID₅₀ assays and the persistence of SARS-CoV-2 nucleic acids using droplet digital polymerase chain reaction on various food and packaging material surfaces. Viral nucleic acids were stable on food and material surfaces under different conditions. The viability of SARS-CoV-2 varied among different surfaces. SARS-CoV-2 was inactivated on most food and packaging material surfaces within 1 day at room temperature but was more stable at lower temperatures. Viruses survived for at least 1 week on pork and plastic at 4°C, while no viable viruses were detected on hairtail, orange, or carton after 3 days. There were viable viruses and a slight titer decrease after 8 weeks on pork and plastic, but titers decreased rapidly on hairtail and carton at -20°C. These results highlight the need for targeted preventive and disinfection measures based on different types of foods, packaging materials, and environmental conditions, particularly in the cold-chain food trade, to combat the ongoing pandemic.

Comprehensive analysis of clinical indications and viral strain variants among patients infected with SARS-CoV-2 in Inner Mongolia, China

Since the first appearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, the virus is still evolving and mutating until now. In this study, we collected 6 throat swabs from patients who diagnosed with COVID-19 in Inner Mongolia, China, to understand the entry of multiple SARS-CoV-2 variants into Inner Mongolia and analyze the relationships between variants and clinical features observed in infected patients. In addition, we performed a combined analysis of clinical parameters associated with SARS-CoV-2 variants of interest, pedigree analysis, and detection of single-nucleotide polymorphisms. Our results showed that the clinical symptoms were generally mild although some patients demonstrated some degree of liver function abnormalities, and the SARS-CoV-2 strain was related to the Delta variant (B.1.617.2), AY.122 lineage. The epidemiological investigations and clinical manifestations confirmed that the variant exhibits strong transmission, a high viral load, and moderate clinical symptoms. SARS-CoV-2 has undergone extensive mutations in various hosts and countries. Timely monitoring of virus mutation can help to monitor the spread of infection and characterize the diversity of genomic variants, thus limiting future waves of SARS-CoV-2 infection.

Application of Stress and Anxiety to Viral Epidemics-6 to Measure the Anxiety Response of Cold Chain Practitioners During the COVID-19 Post-Pandemic Era in China

OBJECTIVE

This study explored the psychometric properties of the Chinese version of the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) scale for cold chain practitioners exposed to moderate-to-high risk of infection.

METHODS

A total of 233 cold chain practitioners participated in an anonymous online survey, conducted from October to November 2021. The questionnaire comprised participant demographic characteristics, the Chinese version of SAVE-6, the Generalized Anxiety Disorders-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) scales.

RESULTS

Based on the results of the parallel analysis, the single-structure model of the Chinese version of SAVE-6 was adopted. The scale showed satisfactory internal consistency (Cronbach's alpha=0.930) and good convergent validity based on Spearman's correlation coefficient with the GAD-7 (rho=0.616, p<0.001) and PHQ-9 (rho=0.540, p<0.001) scale scores. The optimal cutoff score for Chinese Stress and Anxiety to Viral Epidemics-9 Items was identified as ≥12 (area under the curve=0.797, Sensitivity=0.76, Specificity=0.66) for cold chain practitioners.

CONCLUSION

The Chinese version of the SAVE-6 scale has good psychometric properties and can be applied as a reliable and valid rating scale to assess the anxiety response of cold chain practitioners in the post-pandemic era.

Stability of SARS-CoV-2 in cold-chain transportation environments and the efficacy of disinfection measures

Background

Low temperature is conducive to the survival of COVID-19. Some studies suggest that cold-chain environment may prolong the survival of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and increase the risk of transmission. However, the effect of cold-chain environmental factors and packaging materials on SARS-CoV-2 stability remains unclear.

Methods

This study aimed to reveal cold-chain environmental factors that preserve the stability of SARS-CoV-2 and further explore effective disinfection measures for SARS-CoV-2 in the cold-chain environment. The decay rate of SARS-CoV-2 pseudovirus in the cold-chain environment, on various types of packaging material surfaces, i.e., polyethylene plastic, stainless steel, Teflon and cardboard, and in frozen seawater was investigated. The influence of visible light (wavelength 450 nm-780 nm) and airflow on the stability of SARS-CoV-2 pseudovirus at -18°C was subsequently assessed.

Results

Experimental data show that SARS-CoV-2 pseudovirus decayed more rapidly on porous cardboard surfaces than on nonporous surfaces, including polyethylene (PE) plastic, stainless steel, and Teflon. Compared with that at 25°C, the decay rate of SARS-CoV-2 pseudovirus was significantly lower at low temperatures. Seawater preserved viral stability both at -18°C and with repeated freeze-thaw cycles compared with that in deionized water. Visible light from light-emitting diode (LED) illumination and airflow at -18°C reduced SARS-CoV-2 pseudovirus stability.

Conclusion

Our studies indicate that temperature and seawater in the cold chain are risk factors for SARS-CoV-2 transmission, and LED visible light irradiation and increased airflow may be used as disinfection measures for SARS-CoV-2 in the cold-chain environment.

Needs, Challenges and Countermeasures of SARS-CoV-2 Surveillance in Cold-Chain Foods and Packaging to Prevent Possible COVID-19 Resurgence: A Perspective from Advanced Detections

The pandemic caused by SARS-CoV-2 has a huge impact on the global economy. SARS-CoV-2 could possibly and potentially be transmitted to humans through cold-chain foods and packaging (namely good-to-human), although it mainly depends on a human-to-human route. It is imperative to develop countermeasures to cope with the spread of viruses and fulfil effective surveillance of cold-chain foods and packaging. This review outlined SARS-CoV-2-related cold-chain food incidents and current methods for detecting SARS-CoV-2. Then the needs, challenges and practicable countermeasures for SARS-CoV-2 detection, specifically for cold-chain foods and packaging, were underlined. In fact, currently established detection methods for SARS-CoV-2 are mostly used for humans; thus, these may not be ideally applied to cold-chain foods directly. Therefore, it creates a need to develop novel methods and low-cost, automatic, mini-sized devices specifically for cold-chain foods and packaging. The review intended to draw people's attention to the possible spread of SARS-CoV-2 with cold-chain foods and proposed perspectives for futuristic cold-chain foods monitoring during the pandemic.

Quantitative determination of the electron beam radiation dose for SARS-CoV-2 inactivation to decontaminate frozen food packaging

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from cold-chain foods to frontline workers poses a serious public health threat during the current global pandemic. There is an urgent need to design concise approaches for effective virus inactivation under different physicochemical conditions to reduce the risk of contagion through viral contaminated surfaces of cold-chain foods. By employing a time course of electron beam exposure to a high titer of SARS-CoV-2 at cold-chain temperatures, a radiation dose of 2 ​kGy was demonstrated to reduce the viral titer from 10^4.5 to 0 median tissue culture infectious dose (TCID₅₀)/mL. Next, using human coronavirus OC43 (HCoV-OC43) as a suitable SARS-CoV-2 surrogate, 3 ​kGy of high-energy electron radiation was defined as the inactivation dose for a titer reduction of more than 4 log units on tested packaging materials. Furthermore, quantitative reverse transcription PCR (RT-qPCR) was used to test three viral genes, namely, E, N, and ORF1ab. There was a strong correlation between TCID₅₀ and RT-qPCR for SARS-CoV-2 detection. However, RT-qPCR could not differentiate between the infectivity of the radiation-inactivated and nonirradiated control viruses. As the defined radiation dose for effective viral inactivation fell far below the upper safe dose limit for food processing, our results provide a basis for designing radiation-based approaches for the decontamination of SARS-CoV-2 in frozen food products. We further demonstrate that cell-based virus assays are essential to evaluate the SARS-CoV-2 inactivation efficiency for the decontaminating strategies.

Viral Cultures for Assessing Fomite Transmission of SARS-CoV-2: a Systematic Review and Meta-Analysis

Background

The role of fomites in the transmission of SARS-CoV-2 is unclear.

Aim

To assess whether SARS-CoV-2 can be transmitted through fomites, using evidence from viral culture studies.

Methods

Searches were conducted in the World Health Organization COVID-19 Database, PubMed, LitCovid, medRxiv, and Google Scholar to December 31^st, 2021. Studies that investigated fomite transmission and performed viral culture to assess the cytopathic effect (CPE) of positive fomite samples and confirmation of SARS-CoV-2 as the cause of the CPE were included. The risk of bias using a checklist modified from the modified Quality Assessment of Diagnostic Accuracy Studies – 2 (QUADAS-2) criteria was assessed.

Findings

Twenty-three studies were included. The overall risk of bias was moderate. Five studies demonstrated replication-competent virus from fomite cultures and three used genome sequencing to match fomite samples with human clinical specimens. The mean cycle threshold (C_T) of samples with positive viral culture was significantly lower compared with cultured samples that returned negative results (standardized mean difference: –1.45; 95% confidence interval (CI): –2.00 to –0.90; I² = 0%; P < 0.00001). The likelihood of isolating replication-competent virus was significantly greater when C_T was <30 (relative risk: 3.10; 95% CI: 1.32 to 7.31; I² = 71%; P = 0.01). Infectious specimens were mostly detected within seven days of symptom onset. One study showed possible transmission of SARS-CoV-2 from fomites to humans.

Conclusion

The evidence from published studies suggests that replication-competent SARS-CoV-2 is present on fomites. Replication-competent SARS-CoV-2 is significantly more likely when the PCR C_T for clinical specimens and fomite samples is <30. Further studies should investigate the duration of infectiousness of SARS-CoV-2 and the frequency of transmission from fomites.

Optimization of COVID-19 prevention and control measures during the Beijing 2022 Winter Olympics: a model-based study

Background

The continuous mutation of severe acute respiratory syndrome coronavirus 2 has made the coronavirus disease 2019 (COVID-19) pandemic complicated to predict and posed a severe challenge to the Beijing 2022 Winter Olympics and Winter Paralympics held in February and March 2022.

Methods

During the preparations for the Beijing 2022 Winter Olympics, we established a dynamic model with pulse detection and isolation effect to evaluate the effect of epidemic prevention and control measures such as entry policies, contact reduction, nucleic acid testing, tracking, isolation, and health monitoring in a closed-loop management environment, by simulating the transmission dynamics in assumed scenarios. We also compared the importance of each parameter in the combination of intervention measures through sensitivity analysis.

Results

At the assumed baseline levels, the peak of the epidemic reached on the 57th day. During the simulation period (100 days), 13,382 people infected COVID-19. The mean and peak values of hospitalized cases were 2650 and 6746, respectively. The simulation and sensitivity analysis showed that: (1) the most important measures to stop COVID-19 transmission during the event were daily nucleic acid testing, reducing contact among people, and daily health monitoring, with cumulative infections at 0.04%, 0.14%, and 14.92% of baseline levels, respectively (2) strictly implementing the entry policy and reducing the number of cases entering the closed-loop system could delay the peak of the epidemic by 9 days and provide time for medical resources to be mobilized; (3) the risk of environmental transmission was low.

Conclusions

Comprehensive measures under certain scenarios such as reducing contact, nucleic acid testing, health monitoring, and timely tracking and isolation could effectively prevent virus transmission. Our research results provided an important reference for formulating prevention and control measures during the Winter Olympics, and no epidemic spread in the closed-loop during the games indirectly proved the rationality of our research results.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s40249-022-01019-2.

Epidemiological and clinical characteristics of the largest COVID-19 outbreak along the China-Myanmar border in Ruili City, Yunnan Province, China

Background

Imported COVID-19 patients posed great challenges to border areas' COVID-19 control. However, research was scarce to reveal epidemiological characteristics of COVID-19 in border areas. This study aimed to explore the detailed transmission chains, and reveal epidemiological and clinical characteristics of the largest COVID-19 outbreak caused by Delta variant of concern (VOC) occurred in the China-Myanmar border area.

Methods

During the outbreak from July to September, 2021 in Ruili City, Yunnan Province, China, epidemiological investigation data and clinical-related data pertaining to confirmed COVID-19 patients were collected. Patients' contact history data and viral gene sequencing were used for inference of transmission chains. Sociodemographic and epidemiological characteristics, cycle threshold (Ct) value, and antibodies level were compared between patients who were vaccinated against COVID-19 or not.

Results

A total of 117 COVID-19 patients were confirmed during the outbreak, among which 86 (73.5%) were breakthrough infections. These patients evenly split between Chinese and Myanmar people (50.4% vs. 49.6%). Most of these patients were mild (45.3%) or moderate (48.7%) infections with no death reported. Multi-source of infection led to 16 transmission chains with a maximum of 45 patients in one chain. Patients vaccinated against COVID-19 before infection had relatively higher antibodies (IgM and IgG) levels and more rapid response to infection than non-vaccinated patients (p < 0.05).

Conclusion

Land border areas have greater risks of imported COVID-19 and more complicated epidemics. It should be cautious in formulating entry and exit requirements for border areas. The immune effect of COVID-19 vaccines and related mechanism should be further explored.

Genomic Surveillance for SARS-CoV-2 Variants of Concern from Imported COVID-19 Cases - the Mainland of China, 2021

Introduction

After the epidemic in Wuhan City was brought under control in 2020, local outbreaks of coronavirus disease 2019 (COVID-19) in the mainland of China were mainly due to imported COVID-19 cases. The ongoing evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has continued to generate new variants. Some have been designated as variants of concern (VOCs) by the World Health Organization (WHO). To better assess the role of imported SARS-CoV-2 surveillance and the prevalence of VOCs in 2021, the genomic surveillance data of SARS-CoV-2 from imported COVID-19 cases of 2021 in the mainland of China were analyzed.

Methods

The analyses included the number of sequence submissions, time of sequence deposition, and time of detection of the VOCs in order to determine the timeliness and sensitivity of the surveillance. The proportions of VOCs were analyzed and compared with data from the Global Initiative of Sharing All Influenza Data (GISAID).

Results

A total of 3,355 sequences of imported cases were submitted from 29 provincial-level administrative divisions, with differences in the number of sequence submissions and median time of sequence deposition. A total of 2,388 sequences with more than 90% genomic coverage were used for lineage analysis. The epidemic trend from Alpha to Delta to Omicron in imported cases was consistent with that in the GISAID. In addition, VOCs from imported cases were usually identified after WHO designation and before causing local outbreaks.

Conclusions

The global distribution of SARS-CoV-2 VOCs changed rapidly in 2021. Robust genomic surveillance of the imported SARS-CoV-2 in the mainland of China is of great significance.

Comparison of Surface Persistence of SARS-CoV-2 Alpha and Delta Variants on Stainless Steel at 4°C and 24°C

Most studies on surface persistence of SARS-CoV-2 have been conducted at temperatures between 20°C and 30°C. There is limited data on the survival of SARS-CoV-2 at low temperatures. In this study, the stability of SARS-CoV-2 Alpha and Delta variants on stainless steel was investigated at two temperatures (4°C and 24°C). The results show that both variants decayed more rapidly at 24°C compared with 4°C. At 24°C, Alpha and Delta variants showed reductions of 0.33 log₁₀ and 1.02 log₁₀, respectively, within the first 2.5 h. However, at 4°C, Alpha variant showed a reduction of 0.16 log₁₀ within the first 2.5 h while no reduction was observed with Delta variant. After remaining in situ for 24 h at 24°C, log₁₀ reductions of 2.66 (Alpha) and 3.11 (Delta) were observed. No viable Alpha and Delta variant was recovered after 48 h and 72 h, respectively. After 24 h in a refrigerated environment (4°C) log₁₀ reductions of 1.16 (Alpha) and 0.95 (Delta) were observed. Under these experimental conditions, both viruses survived on stainless steel for at least 1 week. No viable Alpha and Delta variant was recovered after 10 days. These findings support the potential for increased fomite transmission of SARS-CoV-2 during winter months in colder regions worldwide and in some industrial sectors. IMPORTANCE Human transmission is believed to occur primarily through direct transfer of infectious droplets or aerosols. However, fomite transmission through contact with contaminated surfaces may also play an important role. This study provides novel evidence comparing the stability of Alpha and Delta variants on stainless steel surfaces at 4°C and 24°C. At 4°C both variants were found to be still detectable for up to 7 days. At 24°C Delta variant could be recovered over 2 days compared with Alpha variant which could not be recovered after 2 days. This has implications for fomite transmission interventions for people living and working in cold environments.

Home quarantine or centralized quarantine? A mathematical modelling study on the COVID-19 epidemic in Guangzhou in 2021

Several outbreaks of COVID-19 caused by imported cases have occurred in China following the successful control of the outbreak in early 2020. In order to avoid recurrences of such local outbreaks, it is important to devise an efficient control and prevention strategy. In this paper, we developed a stochastic discrete model of the COVID-19 epidemic in Guangzhou in 2021 to compare the effectiveness of centralized quarantine and compulsory home quarantine measures. The model was calibrated by using the daily reported cases and newly centralized quarantined cases. The estimated results showed that the home quarantine measure increased the accuracy of contact tracing. The estimated basic reproduction number was lower than that in 2020, even with a much more transmissible variant, demonstrating the effectiveness of the vaccines and normalized control interventions. Sensitivity analysis indicated that a sufficiently implemented contact tracing and centralized quarantine strategy in the initial stage would contain the epidemic faster with less infections even with a weakly implemented compulsory home quarantine measure. However, if the accuracy of the contact tracing was insufficient, then early implementation of the compulsory home quarantine with strict contact tracing, screening and testing interventions on the key individuals would shorten the epidemic duration and reduce the total number of infected cases. Particularly, 94 infections would have been avoided if the home quarantine measure had been implemented 3 days earlier and an extra 190 infections would have arisen if the home quarantine measure was implemented 3 days later. The study suggested that more attention should be paid to the precise control strategy during the initial stage of the epidemic, otherwise the key group-based control measure should be implemented strictly.

Surveillance of SARS-CoV-2 Contamination in Frozen Food-Related Samples - China, July 2020 - July 2021

Introduction

Current evidence shows that coronavirus disease 2019 (COVID-19) is neither a food safety issue nor a foodborne disease. However, the outbreaks of this disease in workers of meat- or poultry-processing plants and food markets have been reported in many countries. Systematic reports on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contamination in food-related samples worldwide are lacking so far. This study aimed to survey and monitor SARS-CoV-2 contamination in samples of foods or their packaging, storage environment, and employees, as well as explore the possible potential for virus transmission via frozen foods.

Methods

Swabs of frozen food-related samples were collected between July 2020 and July 2021 in 31 provincial-level administrative divisions (PLADs) and Xinjiang Construction Corps in China. The SARS-CoV-2 RNAs were extracted and analyzed by real-time quantitative polymerase chain reaction using the commercially available SARS-CoV-2 nucleic acid test kit.

Results

More than 55.83 million samples were analyzed, and 1,455 (0.26 per 10,000) were found to be positive for SARS-CoV-2 nucleic acid. Among the virus-positive samples, 96.41% (1,398/1,450) and 3.59% (52/1,450) were food/food packaging materials and environment, respectively. As for 1,398 SARS-CoV-2-positive food and food packaging materials, 99.50%, (1,391/1,398) were imported and 7 were domestic. The outer packaging of food was frequently contaminated by the virus 78.75% ( 1,101/1,398).

Conclusions

Our study supported speculation that cold-chain foods might act as the SARS-CoV-2 carrier, and food handlers/operators were at high risk of exposure to the virus. It is necessary to carry out a comprehensive mass testing for SARS-CoV-2 nuclei acid, along with contact tracing and symptom screening in cold-chain food handlers and processors so as to identify high proportions of asymptomatic or pre-symptomatic infections. Meanwhile, research and development of effective self-protection equipment available at a temperature below -18 ℃ is urgent.

COVID-19 Outbreaks Linked to Imported Frozen Food in China: Status and Challege

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA contamination was reported on China’s imported frozen foods and packaging materials. However, there was no evidence of this disease initiated by environment-to-human transmission until the outbreak of coronavirus disease 2019 (COVID-19) in Beijing in June 2020. This article aimed to analyze and summarize COVID-19 outbreaks related to cold-chain foods to provide a scientific basis for tracing the epidemiological trajectory of the pandemic, providing risk assessments, and mitigation policies. Overall, 37 COVID-19 outbreaks and 5,741 infected cases were reported within the study period. It was found that 7 outbreaks and 689 cases were linked to imported frozen foods. The first index case among the 7 outbreaks was exposed to SARS-CoV-2-contaminated outer packaging of frozen food, triggering the subsequent community transmission. This study supported the speculation that cold-chain foods act as a pathway for SARS-CoV-2 and might present a risk for virus transmission between countries and regions. Handlers and processors exposed to the imported frozen foods should be effectively self-protected, daily monitored for clinical manifestations of COVID-19, and tested for SARS-CoV-2 nucleic acid at regular intervals.

The Safety of Cold-Chain Food in Post-COVID-19 Pandemic: Precaution and Quarantine

Since the outbreak of coronavirus disease-19 (COVID-19), cold-chain food contamination caused by the pathogenic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has attracted huge concern. Cold-chain foods provide a congenial environment for SARS-CoV-2 survival, which presents a potential risk for public health. Strengthening the SARS-CoV-2 supervision of cold-chain foods has become the top priority in many countries. Methodologically, the potential safety risks and precaution measures of SARS-CoV-2 contamination on cold-chain food are analyzed. To ensure the safety of cold-chain foods, the advances in SARS-CoV-2 detection strategies are summarized based on technical principles and target biomarkers. In particular, the techniques suitable for SARS-CoV-2 detection in a cold-chain environment are discussed. Although many quarantine techniques are available, the field-based quarantine technique on cold-chain food with characteristics of real-time, sensitive, specific, portable, and large-scale application is urgently needed.

SARS-CoV-2 cold-chain transmission: Characteristics, risks and strategies

Low temperature and certain humidity are conducive to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) for long‐time survival and long‐distance spread during logistics and trades. Contaminated cold‐chain or frozen products and outer packaging act as the carrier of SARS‐CoV‐2, that infects the high‐risk population who works in the ports, cold storage or seafood market. Since the coronavirus disease 2019 (COVID‐19) pandemic worldwide, multiple localized outbreaks caused by SARS‐CoV‐2 contaminated imported cold‐chain products have been reported in China, which brought challenges to COVID‐19 prevention and control. Here, we review the evidences of SARS‐CoV‐2 cold‐chain transmission from six confirmed cold‐chain related COVID‐19 outbreaks in China, especially in terms of SARS‐CoV‐2 whole‐genome sequencing and virus isolation. In addition, we summarize the characteristics and mode of SARS‐CoV‐2 cold‐chain transmission from both six COVID‐19 outbreaks in China and the outbreaks suspected cold‐chain transmission in other countries. Finally, we analyze the underlying risks of SARS‐CoV‐2 cold‐chain transmission and propose the preventive countermeasures.

SARS‐CoV‐2 contaminated cold‐chain products can infect high‐risk populations and subsequently cause community transmission

Specific locations, such as seafood market stalls, can amplify outbreaks

Cold‐chain fomites accelerate global spread of SARS‐CoV‐2 and cause “silent transmission”

Rational sampling, comprehensive disinfection, protection of high‐risk groups and pollution classification are the main strategies

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.

Strengthening Community Defenses to Prevent and Control the Spread of COVID-19 in China

In light of the severity of coronavirus disease (COVID-19) around the world, it is an arduous task for China to prevent COVID-19 from being imported from abroad and proliferating domestically. The community is the first and most effective line of defense and can effectively cut off the channels of spread of the epidemic. In order to reduce risks of COVID-19 transmission in the community, it is necessary to sort out the loopholes in risk and management, as well as investigate previous epidemic transmission events in the community.