MINI REVIEW
published: 03 December 2020
doi: 10.3389/fnut.2020.598913
Frontiers in Nutrition | www.frontiersin.org 1December 2020 | Volume 7 | Article 598913
Edited by:
Javier Raso,
University of Zaragoza, Spain
Reviewed by:
Giovanna Ferrari,
University of Salerno, Italy
Lilia Ahrné,
University of Copenhagen, Denmark
*Correspondence:
Dietrich Knorr
†These authors have contributed
equally to this work
‡Content of this paper is the thoughts
of the author and does not necessarily
represent the affiliated institution
Specialty section:
This article was submitted to
Nutrition and Food Science
Technology,
a section of the journal
Frontiers in Nutrition
Received: 25 August 2020
Accepted: 08 October 2020
Published: 03 December 2020
Citation:
Knorr D and Khoo C-SH (2020)
COVID-19 and Food: Challenges and
Research Needs.
Front. Nutr. 7:598913.
doi: 10.3389/fnut.2020.598913
COVID-19 and Food: Challenges and
Research Needs
Dietrich Knorr1*†and Chor-San H. Khoo 2†‡
1Technische Universität Berlin, Berlin, Germany, 2International Life Sciences Institute of North America, Washington, DC,
United States
The paper highlights several food and nutrition-related challenges encountered during
the COVID-19 pandemic, including food and water safety, supply chain disruptions, food
and water insecurity, consumer and food behavior, malnutrition and nutrient intakes, food
surveillance technology, as well as potential post-COVID-19 strategies. Its main objective
is to stimulate robust scientific discussions on existing research gaps and to develop
long-term “exit strategies” to prepare for future pandemics.
Keywords: food, nutrition and COVID-19, food and water safety, food and water security, COVID-19 and supply
chain, technology and pandemic
INTRODUCTION
At the turn of this century, there were speculations whether events of the “roaring 1920s” would
return a century later. What does return is another zoonotic pandemic, COVID-19, potentially
as destructive as the “Spanish Flu” pandemic of 1918–1919 that was caused by the H1N1 virus
with genes of avian origin. The 1918 flu affected one-third of the world’s population and claimed
over 50 million lives (1,2). The current COVID-19 pandemic, believed to begin in winter of 2019
in Wuhan, China, is traced to a novel corona virus (SARS-CoV-2) with animal origins. By May
6, 2020, cases of COVID-19 infections have spread to over 170 counties, with over 3.6 million
reported infected cases (3–6). By August 6, the global infected cases approached 20 million with
almost 713,000 deaths, and warning of impending second waves.
With the uncertainty of a vaccine in the foreseeable future, mitigation strategies have been
put in place that focus on social distancing, facial covering, frequent handwashing, stay at home
orders, working from homes, and testing taken on by public health priorities. These efforts lead
to drastic reduction in the workforce, travel, business, economy, food supplies, and overload the
healthcare system. There are also reports of changes in consumers’ food behaviors—purchase,
choices, preparation, and eating patterns.
As the COVID-19 pandemic continues, there is a need to question whether the current
food system is resilient to withstand a prolonged and pervasive global pandemic. The
twenty-first century food system is intrinsically complex and dynamic with many interrelated and
interdependent essential components working in tandem to ensure a resilient food supply. Any
disruption to one or more of these connections will affect the stability of the global food supply. Huff
et al. (7) illustrated the interrelated impact of a pandemic on multiple fronts—communication and
transportation systems, product and agricultural supplies—all of which lead to food and material
shortages. A review of the impact of the coronavirus on agriculture (8) suggests the pandemic affects
mainly on supply, demand, labor, food safety, and security.
OBJECTIVES
In this paper we highlight several challenges that the food and nutrition communities encounter
during the COVID-19 pandemic that limit definitive actions during and post pandemic. We hope
Knorr and Khoo Food Industry Influenced by COVID-19
that raising these broad issues will stimulate future dialogues
and robust scientific discussions on current research gaps, future
research needs among food and nutrition related communities
for developing a foundational framework for collaborative
solutions and partnership to build a resilient food and nutrition
system in readiness for future pandemic disruptions.
CHALLENGES AND FUTURE NEEDS
Food and Water Safety
Viral Survivability
According to WHO, FAO, and the European Commission
(4,9) it is highly unlikely that SARS-CoV-2 virus can be
transmitted from food or food packaging. So far, the evidence
regarding person-to-person transmission of the illness remains
under investigation. Limited but emerging studies conducted
under laboratory conditions have reported the persistence of
SARS-CoV-2 and SARS-CoV-1 on various types of surfaces
(10,11). These studies implied that the survival of the virus
depends on the type and condition of the surfaces (paper, steel,
copper), humidity, initial virus concentration, environmental
temperature, and time. Due to different methods used to measure
virus presence (PCR, metagenomic), it remains challenging to
provide definitive actions. Recently, Anelich et al. review the
hazard-risk related to COVID-19 in foods and conclude that the
overall potential risk of acquiring COVID-19 from contaminated
food or packaging is low (12).
A similar situation exists for drinking water (9) regarding
virus persistence in drinking water. Though there is a possibility
of survival, so far, no SARS-CoV-2 virus has been detected in tap
water. This is also the basis for recommendations for proper hand
hygiene by all relevant governmental organizations.
Future Needs
1. Study to understand the factors and conditions that impact
the survivability of SARS-CoV-2 in food, drinking water, and
food surfaces.
2. More reliable and accurate data needed on SARS-CoV-2
persistence in different types of food products prepared under
different processing/preparation/storage techniques.
3. Develop a solid foundation of good hygiene practices and
implement effective food safety management systems along
the food chain.
4. Innovating and better understanding and advanced
technology platform for virus inactivation on food and
packaging materials, and to understand the principles of
mode of actions.
5. Advanced approaches for viral elimination in drinking
water supplies.
Supply Chain, Trade, and Delivery
Disruption
International and national food suppliers and customers are
severely impacted by national shutdowns and restrictions,
affecting jobs, economic growth, economy, growth, and mobility
(13,14). The restriction on guest workers to work on farms
and manufacturing plants have led to widespread disruption
in planting and harvesting of food, triggering unintended
consequences of unnecessary food losses and wastes. With
business shutdowns and unemployment increase, food insecurity
will increase the risk of poverty with the most vulnerable
individuals being likely hit the hardest (14–16).
Future Needs
1. Explore a model of radical change of existing supply chain
systems to one that will increase national self-sufficiency,
broaden supply chain, and incorporate rapid tracking and
tracing systems.
2. Explore a new and more targeted public educational initiative
that enhances public understanding of food value, food
processing and packaging approaches, and food safety during
a prolonged pandemic.
3. Explore paths to deliver fast, credible, and clear food
information, healthy food practices, and food waste reduction.
4. Studies to understand the impact of home deliveries on
nutritional quality and food safety of home-delivered foods
associated with true foodborne pathogens.
5. Explore packaging that is safe, resilient, sustainable, and cost
effective in prolonged and pervasive pandemics.
Food and Water Insecurity
The top three UN Sustainable Development Goals are no poverty,
zero hunger, and good health and well-being. All three of these
goals are most likely to be affected by the COVID-19 crisis
(16,17). The Global Report on Food Crises 2020 predicts that
“conflict/insecurity, weather extremes, desert locust, economic
shocks, and COVID-19 are expected to be key drivers of food
insecurity” (18). Naidoo and Fisher (19) argue that COVID-19
is exposing the fragility of all the 17 Sustainable Development
Goals, set by the United Nations and based on sustained
economic growth and globalization, with all of them now being
somehow threatened. A joint statement of FAO, IFAD, the World
Bank, and WFP (20) states: “the pandemic is already affecting the
entire food systems.” This stresses the urgent need to develop an
approach that integrates both the food system and the value chain
(21,22). This requires a radical change to current R&D practices,
to one that also must model in the challenges of our food systems,
including accessibility, availability, and affordability. The new
World Food Program (23) figures suggest that an additional 130
million lives and livelihoods will be at risk indicating that due
to the COVID-19 pandemic, acute hunger will almost double
by the end of 2020. The number of people displaced globally
is estimated at 71 million and 370 million children with no
access to school lunches due to national lockdowns (24). A
current USDA assessment reports that the number of people who
considered food as not secure is estimated at almost 20% of the
total population of the 76 low- and middle-income countries
examined (25). As the recommendation for COVID-19 and food
safety emphasizes the need for frequent handwashing with soap
and water, or the use of alcohol-based hand sanitizers (9,26,27),
these resources are not available or accessible to the low- income
and poor population, which are already hardest hit with disease
comorbidities. Thus, these guidelines become unachievable and
obsolete to these populations.
Frontiers in Nutrition | www.frontiersin.org 2December 2020 | Volume 7 | Article 598913
Knorr and Khoo Food Industry Influenced by COVID-19
Future Needs
1. Stress the importance of protective hygiene and protection
measures for humans.
2. Improvement in current efforts to increase in the availability
and accessibility of safe food and water to poor populations,
and to prevent fraud and misbranding.
3. Develop interdisciplinary food systems and value chain
integration approaches.
4. Increase efforts to explore new ways for food and water
recovery and generation.
Consumer Food Behavior
COVID-19 is changing where, how, and what consumers eat.
There is report of more online shopping, fewer grocery trips, but
more food purchased per trip, and more snacks and ready-to-eat
meals. In a survey study of 1,000 adults in the United States on
their food behavior and practices during COVID-19 (5), 80% of
the respondents indicated they were somewhat confident that the
food they were buying was safe; 50% of the respondents indicated
that they had reduced in-person shopping, 40% indicated that
they bought more packaged foods, and 47% indicated that they
were eating more home cooked meals. In the US household,
food spending increased due to stockpiling during the COVID-
19 pandemic as reported by Baker et al. (28). A silver lining
has emerged amidst the recent pandemic. There is a growing
appreciation for food value, food safety, and healthy food intakes,
as well as an awareness of the need to reduce household
food wastes.
Future Needs
1. Understanding the changes in consumers’ food in an
environment in response to mitigation efforts.
2. Understanding overall impact of pandemic-related
circumstances on consumer food and nutrient intakes,
and dietary patterns.
3. Study the impact of increased home food delivery on
households and individual nutritional and health status
(fitness, weight, blood pressure, risk factors) during a
pandemic, etc.).
4. Food safety habits and hygiene practices regarding consumers,
and food processing, handling, and preparation.
5. Understanding dynamics and psychology of food choices and
intakes during and post pandemics and effects on long-term
food behavior.
6. Study of the impact of COVID-19 on consumer food home
preparation and food waste reduction.
Diet and Nutrition
Recent data suggest that in humans, SARRS-CoV-2 affects the
respiratory systems as well as other organs (29) indicating the
high complexity of the human immune system to protect against
invading pathogens or foreign material. Though nutrients such
as copper, folate, iron, selenium, zinc, vitamins A, B6, B12, C,
and D play critical roles in supporting the immune system, it is
not likely that the viral infection can be modified acutely by a
specific nutrient or food intervention. At different phases of the
infection or disease progression, different and multiple nutrients
or food may be involved. Currently, there is no food or nutrition
intervention known to stop COVID-19. However, a healthy and
diverse diet and nutrition can support and modulate immune
responses to viral infections (29). The interaction between gut
microbial diversity and COVID-19 especially in elderly has been
indicated (30), and the importance of oral microbiota and good
oral hygiene has also been stressed (31). A well functioning
immune system is critical to a robust response to any pathogenic
infections (32). Current dietary guidelines to follow a healthy
diet has been recommended to be the best support to the
immune system including possibly delaying immunosenescence
or providing robust response to pathogenic infection (32,33).
Future Needs
1. There is a need to understand the link between nutritional
status and COVID-19, and the impact of nutritional health in
recoveries in different population groups.
2. Research to address the potential impact of nutritional status
on morbidity and mortality from SARS-CoV-2.
3. Close the gap in knowledge in the modulating role food and
nutrients play in COVID-19.
4. Develop current healthy guidelines and eating pattern
recommendations applicable for pragmatic adherence during
a pandemic, e.g., management of COVID-19.
5. Explore adaptation of traditional care pathways to allow
temporary mechanisms for pragmatic and safe decision
making for public on behavioral changes in nutrition to embed
nutritional care into COVID-19 health care practice.
6. Initiate long-term studies on relationships between human
diets and immune system related to SARS viral effects
7. Increase efforts to improve knowledge relating protective
effects of human microbiota.
Food Surveillance and Technologies
As COVID-19 affects many fronts simultaneously, food
surveillance measures of the pandemic impact needs to be
monitored from multiple different perspectives to afford a
wholistic overview. Jaykus and Hoelzer (34) proposed that
food surveillance measures should include consumer-eating
habits, healthcare- seeking behavior, healthcare delivery changes
(telemedicine), healthcare delivery capacity, public health
laboratory testing, and epidemiological capacities. The use of
technologies to expedite and implement mitigation strategies
is central to assess mitigation success, weakness, and impact
in a pandemic. Recently, Tonby (35) reported six technologies
that have helped several Asian governments and businesses to
shape the region’s early response to COVID-19 safeguarding
disruptions in health and livelihood. These technologies, which
could be used as general guidance worldwide, enable rapid
track–trace–test quarantine cycles, monitor and manage surges
in health care delivery capacity, enable rapid dissemination of
pandemic information to the public, digitalizing products and
services, enabling remote working and learning (35).
Future Needs
1. Identification of critical factors to provide wholistic models for
future food surveillance in a pandemic.
Frontiers in Nutrition | www.frontiersin.org 3December 2020 | Volume 7 | Article 598913
Knorr and Khoo Food Industry Influenced by COVID-19
2. Identification of effective technologies that can provide
effective public information strategies.
Exit Strategy
From 1347 to 1351, the Black Death killed between 30 and
60% of all Europeans. Recent work on this past pandemic
revealed that social and economic inequalities already then
shaped its course (36). More recently, food economists
have been warning the global “just-in time” food delivery
chains were inherently at risk of failing (37) as the current
disruption within the food chain demonstrates. Assessing exit
strategies across Europe using mobility data, Ruktannonchai
et al. (38) warned against ending stringent national and
successful interventions prematurely and found that appropriate
coordination across the continent could aid in eliminating
COVID-19 transmission. In addition, the importance and need
for behavioral changes has been stressed (38,39). According to
a McKinsey & Company report (35), technology can make a
difference on how business and society respond to risks of a
global pandemic.
Future Needs
1. Development of tools for rapid and transparent
information and for effective surveillance of
the public.
2. Provision of clear food safety and hygiene requirements for
every step along the food chain.
3. Establishment of strict and global traceability tools for food
and food constituents.
4. Creation of food safety and hygiene regulations for all food-
handling personnel.
5. Initiation of local/regional storage facilities for food staples
and drinking water.
6. Increasing local/regional self-sufficiency for food and
water supplies.
7. Designing alternative concepts to current “just in time” for
availability practices.
8. Assurance of continuous feeding programs for poor
populations during school closures and lockdown with
nutritious food.
9. Provision of local/regional recommendations for shelf stable
food storage.
CONCLUSION
We urge the nutrition and food-related scientific communities
to develop ideas, concepts, position papers, research, and
educational activities on how to address challenges arising
from COVID-19 pandemic, and solutions for recovery from
the current crisis. In addition, we encourage the scientific
communities to anticipate needed food and nutrition priorities
for future pandemics, and to build a more resilient food system
that better integrate critical factors such as the food supply chain,
nutritional security, healthy food accessibility, education, and
communication on food safety and preparation in the event
of long quarantines. Ensuring confidence in the food supply
through enhanced public education of food value, processing
techniques, and food safety are critical elements. Developing
long-term “exit strategies” and goals are necessary to prepare
for future pandemics. Lawton (40) warned that “amid the
pandemic, a second epidemic of preliminary, unverified and
misinterpreted research has broken out.” The race to publish
underscores the importance of having an advisory body to
protect and maintain data, and scientific quality, integrity, and
transparency. Subsequently, there is a need to form a global food,
nutrition, and related science advisory body to prepare and advise
for future pandemics as also suggested by Loeb and Gil (41).
Recommendations by the advising scientific body will need also
to be shared and adopted by decision makers to enable successful
and sustained implementations of programs.
AUTHOR CONTRIBUTIONS
All authors listed have made a substantial, direct and intellectual
contribution to the work, and approved it for publication.
ACKNOWLEDGMENTS
The authors are grateful to Lucia Anelich for her valuable
contributions to the manuscript.
REFERENCES
1. Cyranoski D. Profile of a killer. Nature. (2020) 581:22–26.
doi: 10.1038/d41586-020-01315-7
2. Taubenberger JK, Morens DM. 1918 Influenza: the mother of all
pandemics. Emerg Infect Dis. (2006) 12:15–22. doi: 10.3201/eid1209.
05-0979
3. WHO. COVID-19 and Food Safety: Guidance for Food Businesses: Interim
Guidance. Rome: WHO (2020).
4. EU. COVID-19 and Food Safety: Questions and Answers. Brussels: EU. (2020).
5. IFIC. COVID-19: May 2020: A Second Look at COVID-19’s Impact on Food
Purchasing, Eating Behaviors, and Perceptions of Food Safety. Washington, DC:
IFIC. (2020).
6. Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry
RF. The proximal origin of SARS-CoV-2. Nat Med. (2020)
26:450–2. doi: 10.1038/s41591-020-0820-9
7. Huff AG, Beyeler WE, Kelley NS, McNitt JA. How resilient is the
United States’ food system to pandemics? J Environ Stud Sci. (2015) 5:337–
4. doi: 10.1007/s13412-015-0275-3
8. Jambor A, Czine P, Balogh P. The impact of the coronavirus on
agriculture: first evidence based on global newspapers. Sustainability. (2020)
12:1–10. doi: 10.3390/su12114535
9. WHO. Water, Sanitation, Hygiene, and Waste Management for SARS-CoV- 2,
the Virus That Causes COVID-19. Rome: WHO. (2020).
10. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on
inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect.
(2020) 104:246–51. doi: 10.1016/j.jhin.2020.01.022
11. van Doremalen N, Bushmaker T, Morris DH. Aerosol and surface
stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med.
(2020). doi: 10.1101/2020.03.09.20033217
12. Anelich LE, Lues R, Farber JM, Parreira R. VSARS-CoV-2 and risk to food
safety. Front Nutr. 8:580551. doi: 10.3389/fnut.2020.580551
Frontiers in Nutrition | www.frontiersin.org 4December 2020 | Volume 7 | Article 598913
Knorr and Khoo Food Industry Influenced by COVID-19
13. Rizou M, Galanakis IM, Aldawoud TMS, Galanakis CM. Safety of foods, food
supply chain and environment within the COVID-19 pandemic. Trends Food
Sci Technol. (2020) 102:293–9. doi: 10.1016/j.tifs.2020.06.008
14. Laborde D, Martin W, Swinnen J, Vos R. COVID-19 risks to
global food security. Science. (2020) 369:500–2. doi: 10.1126/science.
abc4765
15. Hobbs JE. Food supply chains during the COVID-19 pandemic. Can J Agric
Econ. (2020) 68:171–6. doi: 10.1111/cjag.12237
16. Lau LS, Samari G, Moresky RT, Casey SE, Kachur SP, Roberts LF, et al.
COVID-19 in humanitarian settings and lessons learned from past epidemics.
Nat Med. (2020) 26:640–2. doi: 10.1038/s41591-020-0851-2
17. Poppick L. The Effects of COVID-19 Will Ripple through Food Systems. (2020).
Available online at: https://www.scientificamerican.com/article/the-effects-
of-covid-19-will346ripple-through-food-systems/
18. FSIN. Global Report on Food Crises.Joint Analysis for Better Decisions. Rome:
Food Security Information Platform. (2020).
19. Naidoo R, Fisher B. Reset sustainable development goals for a
pandemic world. Nature. (2020) 583:198–201. doi: 10.1038/d41586-020-
01999-x
20. FAO/IFAD/World Bank/WFP. Joint Statement on COVID-19 Impacts on Food
Security and Nutrition. FAO, IFAD, World Bank, WFP (2020).
21. Khoo CS, Knorr D. Grand challenges in nutrition and food
science technology. Front Nutr. (2014) 1:4. doi: 10.3389/fnut.2014.
00004
22. Knorr D, Watzke H. Food processing at a crossroad. Front Nutr. (2019)
6:85. doi: 10.3389/fnut.2019.00085
23. WFP. COVID-19 will double number of people facing food crises unless swift
action is taken. World Food Prog. (2020) 3–5.
24. Schuette M, Asendorpf B. Schlecht verteilt. Die Zeit. (2020) 18:32.
25. Felix B, Christensen C, Beckman J, Ajewole K. International Food Security
Assement 2020-30 of the Economic Research Service of the USDA. Washington,
DC (2020).
26. Food Standard Agency. Guidance for Consumers on Coronavirus and Food.
London: Food Standard Agency (2020).
27. Food Standard Agency. Guidance for Food Businesses on Coronavirus
(COVID-19). London: Food Standard Agency (2020).
28. Baker SR, Farrokhnia RA, Meyer S, Pagel M, Yannelis C. How does household
spending respond to an epidemic? Consumption during the (2020). COVID-
19 Pandemic. Rev. Asset Pricing Stud. (2020) 10:834–62. doi: 10.3386/
w26949
29. Zaim S, Chong J, Sankaranarayanan V, Harky A. COVID-
19 multiorgan response. Curr Probl Cardiol. (2020) 21:1–
9. doi: 10.1016/j.cpcardiol.2020.100618
30. Dhar D, Mohanty A. Gut microbiota and covid-19-
possible link and implications. Virus Res. (2020) 285:198018.
doi: 10.1016/j.virusres.2020.198018
31. Patel J, Sampson V. The role of oral bacteria in COVID-19. Lancet Microbe.
(2020) 1:e105. doi: 10.1016/S2666-5247(20)30057-4
32. Calder P, Carr A, Gombart A, Eggersdorfer M. Optimal nutritional
status for a well-functioning immune system is an important factor to
protect against viral infections. Nutrients. (2020) 12:1181. doi: 10.3390/nu12
041181
33. Allen K. Links between Coronavirus, Nutrition and the Immune System.
London: World Cancer Research Fund, International (2020).
34. Jaykus L, Hoelzer A. COVID-19: Keeping Our Food Safe During the
Pandemic. New York, NY: Academy of Sciences (2020).
35. Tonby O. How technology is safeguarding health and livelihoods in Asia.
New York, NY: McKinsey Publication. (2020).
36. Wade L. An unequal blow. Science. (2020) 368:700–3.
doi: 10.1126/science.368.6492.700
37. Anonym. Food in a time of COVID-19. Nat Plants. (2020)
6:429. doi: 10.1038/s41477-020-0682-7
38. Ruktanonchai NW, Floyd JR, Lai S, Ruktanonchai CW, Sadilek
A, Rente-Lourenco P, et al. Assessing the impact of coordinated
COVID-19 exit strategies across Europe. Science. (2020)
369:eabc5096. doi: 10.1101/2020.06.16.20132688
39. Lambert H, Gupte J, Fletcher H, Hammond L, Lowe N, Pelling M, et al.
COVID-19 as a global challenge: towards an inclusive and sustainable future.
Lancet Planet Heal. (2020) 4:e312–4. doi: 10.1016/S2542-5196(20)30168-6
40. Lawton G. Science in crisis. New Scientist. (2020) 246:12–
4. doi: 10.1016/S0262-4079(20)30879-4
41. Loeb A, Gil D. Let’ s Create an Elite Scientific Body to Advise on Global
Catastrophes. (2020). Available online at: https://blogs.scientificamerican.
com/observations/lets-create-an-elite398scientific-body-to-advise-on-
global-catastrophes/
Conflict of Interest: The authors declare that the research was conducted in the
absence of any commercial or financial relationships that could be construed as a
potential conflict of interest.
Copyright © 2020 Knorr and Khoo. This is an open-access article distributed
under the terms of the Creative Commons Attribution License (CC BY). The use,
distribution or reproduction in other forums is permitted, provided the original
author(s) and the copyright owner(s) are credited and that the original publication
in this journal is cited, in accordance with accepted academic practice. No use,
distribution or reproduction is permitted which does not comply with these terms.
Frontiers in Nutrition | www.frontiersin.org 5December 2020 | Volume 7 | Article 598913
