There is limited examination about COVID-19-related food handling concerns and practices that cause chemical or microbial contamination and illness, particularly among those with food insecurity. We investigated consumer food handling concerns and practices during the COVID-19 pandemic, and whether they differed by food insecurity status. An online survey was distributed among Chicago, Illinois residents between July 15-August 21, 2020 (N=437). Independent t-tests and Fisher’s Exact tests were used to identify differences in food handling concerns and practices between those with and without food insecurity (alpha=0.05). Survey items included questions about food handling practices that were considered safe or neutral (i.e., washing hands and produce with water, sanitizing food packaging) and unsafe (i.e., using cleaning agents to wash foods, leaving perishable foods outside) using 5-point Likert-style scales or categorical responses (i.e., yes, no). Participant responses fell between “slightly” and “somewhat” concerned about contracting COVID-19 from food and food packaging (mean ± SE: 2.7±0.1). While participants reported washing their hands before eating and preparing foods at least “most of the time” (mean ± SE: 4.4 ± 0.0 and 4.5 ± 0.0, respectively), only one-third engaged in unsafe practices. The majority of participants (68%) indicated that they altered food handling practices due to the COVID-19 pandemic and received information about food safety from social media (61%).  When investigating differences in concerns and practices by food insecurity status, food insecure participants were more concerned about COVID-19 foodborne transmission for all food items (ps<0.0001) and more frequently performed unsafe based food handling practices than those with food security (ps<0.0001). Results from this study suggest more investigation is needed to understand barriers to safe food handling knowledge and practices, particularly among those with food insecurity.

Objectives Concerns about COVID-19 transmission have led to greater engagement in unsafe food handling practices (i.e., practices that can cause illness due to chemical or microbial contamination of food). Despite public awareness that certain medical conditions exacerbate COVID-19 illness severity, little is known about whether these patients have unique concerns and/or engage in unsafe practices to prevent COVID-19 infection. We compared the concerns and practices between adults with and without underlying medical conditions associated with greater COVID-19 severity. Methods An online survey was distributed among urban residents between July-August 2020 to inquire about food handling concerns and practices. Participants were included in the “higher-risk” group if they had ≥1 medical condition known to aggravate COVID-19 severity. Participants without any of these underlying medical conditions were included in the comparison group. Food handling concerns were rated on a 5-point scale (1 = never, 5 = always) and practices were determined using “yes/no” responses. Between-group differences in food handling beliefs and practices were analyzed with independent t-tests and Fisher's exact tests. Results Participants (n = 437) had a mean age of 34.2 ± 0.5 years. The higher-risk group (n = 132) was more concerned about foodborne transmission of COVID-19, regardless of food vehicle, than the comparison group (all ps < 0.0001). The higher-risk group also washed produce with cleaning agents (e.g., soap, hydrogen peroxide) more frequently [3.1 ± 1.6 vs. 2.5 ± 1.7; P = 0.001]. Relative to the comparison group, the higher-risk group left perishable food items outside for >1 hour (P < 0.0001) and washed raw meats with water and/or cleaning agents more often (P = 0.0001), while washing their hands before food preparation less often (P = 0.02). Conclusions Those at higher risk of greater COVID-19 severity were more concerned with foodborne COVID-19 transmission and more frequently engaged in unsafe food handling practices than those without underlying conditions. Effective methods are needed to correct misinformation surrounding COVID-19 foodborne transmission, especially among those with underlying medical conditions. Funding Sources This study was supported by a National Cancer Institute training grant.