Vermont Department of Health's Elisabeth Wirsing on Minimizing Coronavirus Risk at Restaurants - Seven Days

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• Luke Awtry
• Bartender Morgan McAvoy mixing drinks at Burlington’s Shanty on the Shore in June

In normal times, Vermont Department of Health inspectors pay surprise visits to restaurants to make sure raw meats are safely chilled, mice haven't nested in the dry goods and employees wash their hands regularly. But in 2020, the team at the state's Food and Lodging Program has had to expand its surveillance from mice to masks.

Inspectors of food businesses traditionally focus on reducing cases of foodborne gastrointestinal illness. Now they are also involved in helping minimize the spread of a highly contagious global pandemic, which has required a radically new approach to doing their work.

From mid-March to mid-June, the only visits that Vermont inspectors made were virtual ones to license food businesses that were new or changing ownership. In lieu of their usual unannounced, on-site evaluations of ongoing compliance, they made more than 1,000 phone calls to help food businesses navigate the regularly updated requirements specified in Gov. Phil Scott's "Be Smart, Stay Safe" executive order.

As seated dining has gradually ramped up in Vermont, however, so has inspection activity — and public concern about the safety of eating out.

According to Food and Lodging Program chief Elisabeth Wirsing, in July the program received 57 complaints from the public about executive order compliance — almost double the June number. About 70 percent of those complaints involved employee face coverings.

Not surprisingly, the issue is also front and center for restaurants. Working through the "middle of the summer with a face covering over a hot grill has been probably the major challenge we've been hearing from businesses," Wirsing said.

Wirsing spoke with Seven Days about the risks of dining out, whether gloves help and why surprise inspections remain on hold for now.

SEVEN DAYS: What does the health department understand to be the risk of transmission of COVID-19 through food and beverage?

ELISABETH WIRSING: Currently, there has not been evidence to show that COVID-19 is spread through food or food packaging. We still believe that, unlike foodborne, gastrointestinal viruses that can often make people sick from contaminated food, COVID-19 is a virus that causes respiratory illness, and it's thought mainly to spread from person to person.

It may be possible that a person could get COVID-19 by touching a surface or an object that has the virus on it, and then touching their own mouth, nose or possibly their eye. But this is still not thought to be the main way that the virus spreads.

SD: How about the risk of transmission of COVID-19 from dining at a restaurant?

EW: The risk would be similar to other indoor environments. Respiratory droplets [are] released when an infected person talks, coughs or sneezes, and not everyone infected with the virus may have symptoms. So you could become infected if you have indoor contact with those aerosols from an infected person for an extended period of time.

The same general precautions to help prevent the virus from spreading [anywhere] apply also in restaurants. Most important is employees wearing cloth face coverings. Also that customers wear face coverings when they're not eating, and reduced capacity so that social distancing of tables can really occur. And everyone washing their hands and staying home if they're sick.

SD: Are these more important for indoor dining?

EW: Indoor, certainly, is where especially the precautions are important, but precautions apply in both settings because there are people in both settings.

SD: In addition to the general precautions you mentioned, what are some notable restaurant-specific requirements?

EW: Implementing a reservation system to help manage the flow of customers and also keeping that list of [customer] contacts, though that doesn't apply to all service settings, like food trucks or counter service. [Also] elimination of shared food service, like buffets, and other self-serve, like utensils and shared condiments.

Bar seating and drink or food production areas must remain closed to patrons to reduce prolonged contact between patrons and bartenders and to prevent close contact between patrons. Standing is not allowed while you're inside. There really needs to be a seated, controlled environment.

SD: Who are the requirements designed to protect?

EW: The goal is protection for everyone: employees, delivery folks or services that may come in, the public — anyone really who interacts in the space.

SD: Must a restaurant close if an employee tests positive for COVID-19 or has been exposed to someone who tests positive?

EW: We haven't had a situation that I'm aware of where it's been required to really shut down immediately. Businesses certainly, out of caution, can take whatever steps they feel may be necessary or appropriate.

In the few instances I'm aware of when an employee tested positive, the immediate action is, that employee needs to go home. The contact-tracing team will follow up with the employee and evaluate the close contacts that worked with that employee during the infectious period. There's a very detailed process of gathering information to determine the risk and the action steps.

SD: What happens if a customer tests positive within a week after dining at a restaurant?

EW: The customer, similarly, would be contacted by the contact-tracing team. Part of their process is [asking] where they have been in the last 14 days. If a restaurant is identified during what is determined to be the patient's infectious period, the contact tracers will contact the restaurant and review what protocols [were] in place to mitigate transmission of COVID.

[State] guidance requires that operators maintain an easily accessible log of customers and their contact information for 30 days in case contact tracing is required. In the absence of logs, [the state] may require a public announcement of possible exposure if a case is identified.

SD: Should every restaurant employee wear a face covering?

EW: Employees must wear face coverings over their nose and mouth when in the presence of others.

SD: I was at a restaurant where I could see in the kitchen that the cook was not wearing a face covering, but he appeared to be working alone. He put the prepared takeout on a table. And then the cashier, who was wearing a face mask, would get it when he had stepped away. Was that OK?

EW: It may be a very rare instance that there's one employee working completely alone, but what we find is there's usually some interaction between employees. Our preference is that everybody wears a face covering, which you've probably heard the health department say all day long.

SD: Can people eating out realistically keep their faces covered?

EW: It's a challenge, but if you're not eating or drinking, the ask is to wear your face covering.

SD: Are there new rules about restaurant employees using gloves?

EW: [Regular] food safety regulations require frequent handwashing, and bare-hand contact is prohibited from ready-to-eat foods. There have not been any additional COVID requirements for gloves in food service establishments.

The public often see gloves as a good idea or an additional precaution, [but] gloves can be used improperly. Wearing gloves does not make you invincible if you're still touching everything.

SD: It is tough to social distance in many restaurant kitchens. How are you providing guidance on this issue?

EW: [We] emphasize social distancing and wearing cloth face coverings together to help reduce the risk of transmission between people. We've been having a lot of conversations with businesses about thinking creatively about options for adjusting their food preparation spaces and reducing or moving staff.

SD: What's going on with regular restaurant inspections?

EW: During the emergency, we did stop in-person, on-site routine inspections, the unannounced inspections. We're conducting what we're calling food safety check-ins by phone to review COVID requirements and food safety risk factors in a nonregulatory, open discussion format.

We also have been following up on complaints received from the public. In mid-June, we did resume some scheduled in-person inspections for priority areas, mainly licensing complaints. We are currently trying to finish planning for more routine inspection work. It's going to look a little different; even the routine inspections will be scheduled.

SD: Oh, so not the usual surprise inspections?

EW: It may not be practical for unannounced inspections, and it also may just not be appropriate. We want to make sure that the person in charge is available to talk through what's going on. We also call ahead of time to schedule and review what precautions the business has been taking, and also what precautions we are taking. For the interim, that is the approach that a lot of states are taking.

SD: What kind of enforcement can your inspectors provide on COVID-related guidelines?

EW: Our role has been education and outreach, and that has been working. We find businesses want to do the right thing and protect public health and their employees. If there is a situation where there is noncompliance or refusal to comply, that information can be shared through a process working with law enforcement and the Attorney General's Office.

SD: What can people do if they have a concern about a restaurant's compliance?

EW: The public can call or email the Food and Lodging Program. I recommend people also, if they feel comfortable, mention something while they're on-site to a person in charge. Sometimes the establishment is not aware, or they can respond and address the issue.

This interview has been edited and condensed for clarity and length.

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