Are grocery stores and pharmacies vectors for the coronavirus?

There's so much to touch and grab at the grocery store – shopping carts, freezer door handles, cardboard boxes and plastic packaging.

Such surfaces are almost unavoidable for shoppers. But they also carry a certain amount of risk in the age of the COVID-19 pandemic, adding urgency to a troubling question: Have pharmacies and supermarkets become super-spreading virus vectors?

These businesses are among the few places left where people are allowed to gather, and they often get so many shoppers these days that their shelves are being picked clean.

Meanwhile, Trader Joe's is keeping shoppers up to date about store openings and closings after employees in New York, New Jersey and Maryland tested positive for COVID-19 or showed related symptoms. In northern California, a FoodMaxx store said it closed this week “for cleaning and sanitizing” after a worker tested positive for the disease and died, though the store said he hadn’t been in the store since March 6. 

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The recent death of a 49-year-old supermarket clerk in Italy has added to shoppers’ anxiety.

“The biggest concern about a grocery store is everyone wants to be there,” Virginia Tech epidemiologist Charlotte Baker told USA TODAY. “That means you’re closer in proximity than we’re recommending people be.”

A recent study in the New England Journal of Medicine suggests that people may acquire the virus through the air and after touching contaminated objects. The same study said the virus was detectable up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.  But epidemiologists say the risk of getting infected from such surfaces is relatively low, because the virus soon decays.

“Although the virus can remain on surfaces for a while, we still don't know how long they remain infectious to people,” said Caroline Buckee, associate professor of epidemiology at Harvard T.H. Chan School of Public Health.

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The bigger concern about such stores, experts say, is person-to-person transmission and being around so many people who might be carrying the virus. These stores and pharmacies have ramped up cleaning efforts and promoted social distancing between customers to minimize the risk of spreading the disease. But in practice, these efforts can vary widely between businesses, with some appearing to conduct business as usual, often because their customers aren’t taking their own precautions.

Shoppers line up at a grocery store in Ardsley, NY early Friday morning, March 20, 2020. The store is limiting shoppers and attempting to enforce social distancing.

"There’s still so much we don’t (know) about this virus, including whether people with no symptoms can spread infection," said an e-mail from Tom Frieden, former head of the Centers for Disease Control and Prevention and current head of the nonprofit Resolve to Save Lives. He says that as long as sick people stay home, and healthy people stay 6 feet away from others and wash their hands before touching their face, risk should be minimal.

The risk still can vary by chain and location. 

Different cleaning, distancing policies

On a recent Friday night, customers raided the shelves at a Grocery Outlet in San Diego, touching various surfaces, standing close to each other in line and reusing carts as normal without any apparent sanitization. By contrast, a security guard at a nearby Vons supermarket on Wednesday was regulating admission to the store by letting shoppers inside one at a time under a special maximum occupancy limit of 100.

The special measures didn’t go over well with some.

“This whole thing is ridiculous,” a woman muttered as she left the store after shopping.

Even in the best of times, grocery stores have been hives of invisible germs. A study in 2017 found that shopping carts at regular and budget food stores carry hundreds of times more colony-forming units of bacteria per square inch “than surfaces in your bathroom.” A shopping cart at a budget store had 270 times more colony-forming units than your average toilet handle, according to the study commissioned by, a supplier of reusable grocery bags.

With stocks running low at grocery stores throughout the nation to due to coronavirus concerns, an employee cleans bare shelves at the Stop & Shop supermarket in Tarrytown, N.Y. March 15, 2020.

But that was when things were normal, with no pandemic and no panic buying for toilet paper and bread. Now Walmart, Kroger, Albertsons, Whole Foods and Publix are among those planning to install plexiglass sneeze guards between cashiers and customers.

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In Pennsylvania, a grocery store had to discard an estimated $35,000 worth of products after a woman purposely coughed on fresh produce and other items this week in what was described as a “twisted prank,” according to the store’s Facebook page.  

Other extreme measures have been enacted amid reports of sick employees. In Oklahoma, an employee at a grocery store phoned into work on March 21 to say she had COVID-19. Since then, the store took measures to “fully disinfect the store,” according to letter posted on Facebook by Crest Foods president Bruce Harroz.

The same letter said the store was committed to staying open while continuing its increased cleaning and disinfecting program for “high-touch surfaces and high-traffic areas.” The letter prompted hundreds of comments on the company’s Facebook page, some expressing gratitude to store for its efforts and others expressing concern.

“I went yesterday to get groceries and the young man that bagged my groceries had a bottle of Pedialyte and 7 Up at the end of the register,” said a reply from a Facebook user.  “He was also excessively wiping his nose on his sleeve.”

The commenter didn’t say which store or chain. Crest Foods said in the letter that it continues to emphasize that employees should stay home when sick.

In a separate local news item this month, the same store chain told an Oklahoma television station this that it was looking to hire hundreds of new workers as demand grows for both groceries and jobs.

Coronavirus hazard pay?

Such work generally might merit hazard pay these days, said Debbie Berkowitz, a former federal regulator who now advocates for worker safety at the National Employment Law Project. 

Minnesota, Michigan and Vermont already have moved to classify grocery workers as emergency workers, much like health care workers, which would give them access to childcare services, according to the United Food and Commercial Workers union.

These workers never were highly paid to begin with and now find themselves on the front lines of the battle to keep the viral spread from spiking beyond the capacity of the U.S. healthcare system. They’re wearing gloves, sometimes masks and are armed with pumps of germ-killing gel near the cash register.

“Most of the time when there’s a workplace hazard, like a chemical that’s used in the workplace to clean something, most people see it as `That’s the worker’s (problem),’” Berkowitz said. “In this case, worker health and public health are the same because it’s all about protecting one another from one another and preventing the spread of this disease.”

She says the solutions “aren’t rocket science.” Experts say the same thing.

"Stores should ensure frequent, thorough cleaning of all surfaces, and make accommodations for employees, including frequent handwashing," Frieden wrote.

He noted that any place where people gather in close proximity has the potential to allow the spread of COVID-19. 

The difference for grocery stores and pharmacies is they're among the last businesses still open and attracting crowds.

Baker of Virginia Tech suggests bringing your own sanitizing wipes for those shopping carts. And while there’s no evidence of transmission by food, she also suggests washing food and wiping down packaging.

“Anywhere that has a risk of contact with an infectious person is risky, but we do still need to go to grocery stores, so again, it's best to be cautious,” said Buckee of Harvard.

She has an ominous prediction about where this virus is going:

Nearly everywhere, eventually.

“There might be pockets that remain unaffected if they are very remote,” she said. “But for the most part, I can’t imagine that there are any major cities where we’re not going to have some level of an epidemic.”

The effort now is to keep it from spreading so fast that it overloads hospitals and depletes medical supplies, leaving many without proper health care, including sick and injured people who aren’t infected with COVID-19. Grocery stores and pharmacies are a big part of the battle.

Infection "definitely is possible if someone is carrying or is symptomatic and goes into the grocery store and touches something,” Baker said. “If they’ve just coughed or sneezed and touches something, then definitely, it’s on that surface. And if you then you take your hands and put them on your face, you increase that chance of infection, but not necessarily more than you would have by being in the grocery store at all (by being around people). This is really where washing your hands or using hand sanitizer comes into play.”

Follow reporter Brent Schrotenboer @Schrotenboer. E-mail: