Food Delivery Service During Social Distancing: Proactively Preventing or Potentially Spreading Coronavirus Disease–2019?

Social distancing and a shelter-in-place order are among the measures implemented to effectively prevent the spread of coronavirus disease–2019 (COVID-19).1 The shutdown of all nonessential services and restriction of restaurants to takeout service, in response to the social distancing measures, spark surge in food delivery service. Such a service has been touted as being a useful, convenient, and safe means to reduce the risk of exposure to infection sources of the novel coronavirus. Nevertheless, this distribution method may still pose a potential risk of spreading the disease. Very recently, we have reported that more than 60% of the infected cases occurring in a public hospital in Hanoi, the capital of Vietnam, are linked to food delivery of mildly ill or presymptomatic nonclinical staff working at the hospital cafeteria.2 This has raised a concern that food delivery has a great potential of contributing to the spread of the disease.3 While more and more people adhere to the shelter-in-place order, delivery workers are fulfilling customer orders. This has suddenly spurred them to the frontlines of the COVID-19 pandemic.4 The likelihood that delivery workers (1) have direct contact with novel coronavirus–infected customers without ever experiencing symptoms and (2) may subsequently act as a presymptomatic transmitter unwittingly passing the novel coronavirus to their healthy customers, coworkers, or families should be taken into consideration (Figure 1). Evidence has shown that presymptomatic or asymptomatic transmission is 1 of the major routes by which the novel coronavirus spreads.5 Furthermore, 1 study indicates that presymptomatic transmission accounts for 6.4% of 157 locally acquired cases of COVID-19 in Singapore.6