It is time to acknowledge coronavirus transmission via frozen and chilled foods: Undeniable evidence from China and lessons for the world.

Since the broke out of the novel coronavirus disease at the end of 2019, nearly 650 million people have been infected around the globe, and >6.6 million have died from this disease. The first wave of infections in mainland China had been effectively controlled within a short period, with no domestic cases of infection for 56 consecutive days from April 16, 2020. Nonetheless, the re-emergence of several outbreaks in multiple Chinese cities posed a new challenge for public health authorities after new cases of infections were found in Xinfadi Market in Beijing on June 11, 2020. In the following series of re-emergent outbreaks, findings from epidemiological investigations suggested that more than twenty re-emergent outbreaks were caused by fomite transmission, predominantly via imported frozen and chilled foods contaminated by the SARS-CoV-2 virus. Seven of the eleven incidents involving frozen and chilled foods were identified by screening individuals with occupational exposure to imported cold-chain foods and associated individuals. Evidence showed that low temperatures and poor ventilation typically maintained through cold-chain logistics create amenable environments for the survival of SARS-CoV-2, making transnational cold chain logistics a congenial vehicle to spread the virus through global transport of consumer goods. To address this gap, here we present a scrutiny of the findings from epidemiological investigations in recent re-emergent outbreaks in China caused by fomite transmission via imported foods and goods. A national regime of traceable cold-chain foods and reinforced customs inspection protocols were established by public health authorities in mainland China as emergency responses to recurring outbreaks from fomite transmission via imported goods. We urge that more attention needs to be given to this specific route of pathogenic transmission to ensure biosecurity and to increase the preparedness for epidemic or pandemic scenarios by the global food industry and logistics carriers.