Engaging Local Health Departments to Identify Food Safety Best Practices During a Public Health Emergency

This article published in the Journal of Public Health Management and Practice highlights some of the difficulties maintaining routine retail food inspections during public health emergencies and lessons learned for prioritizing retail food regulatory practices during a significant public health event.

Local health departments (LHDs) throughout the United States have been greatly impacted by the coronavirus (COVID-19) pandemic. One area that had significant disruption of normal activities was food safety and retail food regulatory practices such as routine food inspections. Protecting food safety within retail food establishments is critical to promoting safe food consumption and preventing foodborne illness outbreaks. A food contamination event at a retail food establishment, more likely when food regulatory practices are reduced, has the potential to greatly impact public health. Reduced staffing along with shifting priorities that resulted from the pandemic posed a serious challenge for maintaining effective food safety practices and made it extremely difficult for LHDs to conduct routine food inspections. It became increasingly important to explore ways in which LHDs can overcome these challenges in the face of future public health emergencies.

At the National Association of County and City Health Officials (NACCHO), we had an opportunity to work with LHDs, represented by members of the Food Safety Workgroup, to explore factors of the COVID-19 pandemic that impacted food safety practices, and to develop guidance moving forward. We wanted to learn more about the challenges encountered at the local level and work to create strategies to overcome these challenges that could then be shared with peers across the U.S.

Our conversations with LHDs revealed five ways in which the COVID-19 pandemic primarily impacted food safety practices at the local level. These were: distrust of public health practitioners; inspectors facing threats and harassment; challenges with contact tracing and foodborne illness outbreaks; difficulty prioritizing routine food safety activities; and challenges with conducting virtual inspections. In collaboration with LHDs, NACCHO has identified recommendations for retail food regulatory programs to prepare for the next public health emergency. 

Moving Forward: What Is Needed to Ensure That Food Safety Programs Are Prepared for the Next Public Health Emergency?

Identified strategies for LHDs include the following:

  1. Fostering communication and positive relationships with food service establishments to work toward rebuilding trust between public health professionals and the communities being served. It is also important to improve relationships with underserved communities by creating an open dialogue and considering racial and other social factors in food safety messaging and decision making.
  2. Improving efforts to conduct effective virtual inspections by improving technology use, shifting from regulation to education, and reframing interactions between regulators and food service operators. In collaboration with the Food Safety Workgroup, NACCHO developed a factsheet with suggested strategies to conduct effective virtual inspections: Virtual Inspections of Food Service Establishments Through Risk-Based Inspections.
  3. Using food safety culture to characterize retail food establishments in order to prioritize regulatory and education efforts that will have the greatest impact on reducing foodborne illness during a public health emergency.
  4. Conducting a “hotwash” or an immediate evaluation of performance to identify successes and failures regarding retail food safety operations during the pandemic and developing and implementing support structures within the workplace to ensure the personal and professional safety of public health practitioners, especially staff performing food safety inspections.

Our work and the feedback we received from LHDs demonstrate that public health emergencies can have a serious impact on food safety practices and limit the ability to conduct effective inspections of retail food establishments. These recommendations provide a way to overcome the challenges and maintain food safety best practices amidst an emergency.

Interested in learning more? Read our issue brief here: Best Practices and Resources for EH Departments During a Public Health Emergency, or our article in the Journal of Public Health Management and Practice here: Engaging Local Health Departments to Identify Food Safety Best Practices During a Public Health Emergency.