 |
| Restaurant Noma. Photo Credit: Huffington Post |
Last
Friday morning, Extra Bladet, a Danish Tabloid, broke the story last Friday
morning: “Noma: 63 hit by Roskildesyge (Norovirus in Danish).” Norovirus, a
highly virulent and contagious virus, causing nausea, vomiting and diarrhea, or
gastroenteritis, sickened 63 out of 435 guests over a two-day period in
February according to reports by The Danish Veterinary and Food Administration.
For
the world’s top restaurant, this was not just a case of Noma catching the flu.
The story went viral. Food websites, such as Eater and Grub Street, lapped up
the story as soon as it was reported in Danish papers, and soon, all other
established media sources, including National Public Radio, AP, UPI, Huffington
Post, ABC News and the LA Times followed suit.
While
the Twittersphere was burning through its schadenfreude quota, the actual scientific
details about the illness were buried under a pile of snark. Norovirus has been
at epidemic levels, causing almost 21 million illnesses each year in the US
alone. According to the CDC, there is really no specific treatment and
prevention, that is, proper hand and food hygiene, is often the best cure.
The
problem is that norovirus is one tough bug. According to a paper in the Journal
of Infectious Diseases[1],
“Noroviruses are perhaps the perfect human pathogens… highly contagious, rapidly and
prolifically shed, constantly evolving, evoking limited immunity, and only
moderately virulent, allowing most of those infected to fully recover, thereby
maintaining a large susceptible pool of hosts.” In other words, it’s a public
health nightmare. Carriers often don’t know they have it or continue to carry
it after they recover, thus passing it on to unsuspecting victims. It can survive at a wide range of temperatures, from below
freezing up to 140F, and can survive for nearly two weeks on many surfaces. And it doesn’t need a high viral load
to do its job: less than 20 viral particles are enough to cause illness. And it just needs one carrier to infect an
entire community or institution.
Considering
the prevalence, incidence and virulence of norovirus, it seems almost
unbelievable that Noma didn’t have a previous outbreak of norovirus or have
more patrons puking their guts out. What happened at Noma
could have happened anywhere and everywhere, as it did in London in 2009 when
240 diners contracted the virus at the three-Michelin-starred restaurant, The
Fat Duck and a Chipotle outlet near Kent State University in Ohio in 2008.
But
then the question is why didn’t Noma have an outbreak earlier or have more
guests holding their stomachs? Hygiene is one factor. While the Danish
authorities cited hygiene problems, specifically a “lukewarm” hand washing
faucet, chefs and waitstaff are given strict instructions to wash hands
thoroughly with hot water and soap on a regular basis. Although norovirus has
been known to withstand even a dishwasher, frequent hand washing often cuts
transmission rates. But one policy that Noma has is critically important: paid
sick days. The CDC has found that 89% of norovirus outbreaks occur in places
were food is prepared and handled on a regular basis: schools, nursing homes,
cruise ships and restaurants. As it
takes only one infected person to cause an outbreak, keeping quarantine on ill
or possibly infected workers is paramount. Noma has a strict illness policy in
which any ill worker, from the office to the cleaning staff, is sent
immediately home at the slightest sign of illness and is told to stay home for
48 hours after symptoms subside. And they are paid for those days.
Compare
this to the United States. According to the CDC, in 2011, 12% of restaurant
workers reported signs of norovirus. The CDC also reports that 50% of norovirus
infections can be traced back to food service workers. [2] According to the Institute
for Women’s Policy Research,[3] 78% of hotel and food
service workers do not have paid sick leave. Another food service workers
advocacy group, ROC (Restaurant Opportunities Center) United estimates 90% of
food service workers lack paid sick leave. Due to the low wages and the job
instability of food service work, many of America’s cooks, busboys, and servers
can neither afford to stay home due to lost wages nor firing, only encouraging
ill workers to come to work and infect their co-workers and patrons. Add the
lack of health insurance to the absence of sick days, and you have a recipe for
an ongoing epidemic.
But
where is the will to change public health and labor policies to prevent such
epidemics from happening? Small business owners complain that health insurance
and paid sick days are too costly for them. Yet the cost of NOT giving workers
sick days is much greater. According to the Integrated Benefits Institute, $227
billion are wasted due to lost productivity from illness.[4] In an economy that is
barely recovering from a recession, these are dollars that cannot afford to be
squandered. According to Cornell University economist Sean Nicholson, for every
dollar spent on employee health care, employers can save three dollars in
costs.
While
Noma tries to repair its unfairly damaged reputation, millions of other food
service workers at no-name restaurants are just trying to work through another
sick day. Too bad that they don’t have Eater or Grub Street gleefully sneering
at their misfortune. It might be the only way that their plight and that of
millions of others working without sick days will finally be able to serve you
and the public better.
[2]Widdowson M-A,
Sulka A, Bulens SN, et al. Norovirus
and foodborne disease, United States, 1991–2000. Emerg. Infect. Dis.
2005;11:95-102
[3] Vicky
Lovell, Institute for Women’s Policy Research, Women and Paid Sick Days: Crucial for
Family Well-Being, 2007.
