Recommendations to Prevent COVID-19 Transmission at Food Fairs and Markets

What this guideline says

GMJ summary

This Pan American Health Organization (PAHO) handbook provides comprehensive recommendations to prevent SARS-CoV-2 transmission in food fairs and markets across Latin America while maintaining food security. The document addresses a critical tension: these markets are essential for food access—especially for vulnerable populations—yet present significant infection risk due to crowding and aerosol generation.

The guidance is structured around four stakeholder groups: national and local authorities (responsible for coordination, situation assessment, training and risk communication); market operators (managing physical space, operations, hygiene and capacity); workers (personal hygiene, customer care, symptom monitoring); and visitors (physical distancing, mask use, organized shopping). Key measures include relocating markets to large outdoor spaces like stadiums, maintaining at least 1.5 m physical distancing, implementing one-way pedestrian flow, controlling capacity, providing hand-washing stations, and ensuring social protection for informal workers who might otherwise attend work while ill.

The document emphasizes that food markets are vital economic and social infrastructure—in Chile alone, 1,114 registered fairs operate 113,112 stalls serving over 2 million weekly shoppers—and that their safe operation requires intersectoral coordination, adequate resourcing, enforcement of protocols, and protection of the predominantly informal workforce.

Key points

For clinicians — doses and thresholds as stated in the guideline

1. Maintain physical distance of at least 1.5 m between people inside markets and fairs at all times
2. Relocate markets to large outdoor spaces (stadiums, sports fields) to allow better distancing and ventilation; avoid enclosed spaces that promote aerosol generation
3. Implement one-way pedestrian flow with separate entrance and exit points; restrict vehicle access and adjust operating hours to prevent crowding
4. Establish hand hygiene stations with soap and water at entrances; require correct mask use covering nose and mouth throughout visits
5. Workers with respiratory symptoms or COVID-19-compatible illness must not attend work and should seek medical testing immediately
6. Prevent customers from directly handling products; use prepackaged items and avoid direct contact during transactions
7. Form intersectoral emergency committees at national and local levels including health, agriculture, social development, and market stakeholders
8. Provide social protection for informal and self-employed market workers to prevent attendance while ill or as contacts of confirmed cases

Recommendations for national and local authorities

Table extracted from the guideline

Source: Pan American Health Organization, Recommendations to Prevent COVID-19 Transmission at Food Fairs and Markets. Reproduced in summary form.

From the guideline

Verbatim

“Food markets and fairs present a major risk of SARS-CoV-2 infection and there is considerable evidence of highly infectious lethal outbreaks in the countries studied.”

Editor’s perspective

Why this matters for Georgia and the region

Applicability

Georgia and the South Caucasus

Questions this guideline answers

Quick answers

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