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Posted by Dr. Sushrut Jangi August 6, 2013 12:51 PM
One rainy morning, I meet Ayr Muir at Cutty's, a breakfast-and-lunch outfit across from Clover's temporarily shuttered Harvard Street location. Even in that early hour, Ayr, the CEO of Clover Food Labs, asks for a few leaves of Swiss chard on top of his wheat bagel. "I wanted a real name," he says, when I ask him about his restaurant's namesake. "Something memorable, easy to say, that would evoke the things we are trying to do." He drinks from his tea and takes a bite of his bagel. "There's the luck element of the name, of course," he says.
Unfortunately, bad luck has come to Ayr in recent days: Clover Food Lab has been linked to dozens of cases of Salmonella in the Boston area this past month. Customers who fell ill ate one of two sandwiches: the chickpea fritter or the egg and eggplant. A cadre of epidemiologists from Massachusetts descended on Clover over the past few weeks to perform an exhaustive investigation of their food inventory, employees, and operations. "What can you tell me about the outbreak?" Ayr asked the state department when he first got a phone call from them three Fridays ago. Up until that moment, his restaurant had never been linked to food-borne illness. "Where could the Salmonella be coming from?" he wondered.
Food-borne illness is more common than we like to think. In the United States, nearly 50 million episodes occur yearly (on average, one of us will have food poisoning every three to four years). The most-wanted bacterium responsible for food-borne disease is Salmonella. But when we hear about a Salmonella outbreak, the story is usually touted as an exotic and rare event, a departure from the usual causes of food poisoning. It shouldn't be so. Salmonella is ubiquitous. After all, it's name has nothing to do with contaminated fish (the bacteria was named after the veterinary surgeon, Daniel Salmon); Salmonella-associated disease is almost a routine cause of food-borne illness from sources as varied as peanuts, mangoes, dry cereal, sprouts, papayas, and eggs. Such frequent cases often go undiagnosed and outbreaks aren't heavily advertised. The state investigates, a restaurant quietly turns off its lights, and after people have recovered, the doors open again.
But Clover has responded to this outbreak differently. "The day after that phone call from the state, I started to blog about it on our website, so that everyone, including our customers, would know what was happening."
Broadcasting the outbreak is an unusual move. The major federal agencies that regulate food safety including the FDA, the USDA, and the CDC historically have been tight-lipped when food outbreaks begin. And, as reported in the Columbia Journalism Review earlier this year, a fragmented food regulatory system has caused significant struggle for the media to report food outbreaks as they occur. For example, in 2009, the CDC began investigating a national Salmonella outbreak but headlines didn't hit newspapers until nearly three months later. The consequences? People get sick while outbreaks are still occuring; the media and the public, unfortunately, are often left in the dark.
A graduate of MIT with a degree in Material Science, Ayr thinks critically and scientifically about food, and he wants us, as a society, to start thinking thoughtfully about food as well - when it's good - and when something goes wrong. On his website, he advertises that Clover has "no back-of-house," meaning he wants the process of food preparation and distribution to be completely transparent.
So, just a day after he got a call from the state, Ayr notified the public. "We learned late Friday there is a Salmonella outbreak in Massachusetts," he wrote on his blog. "Some of the confirmed cases ate at Clover." Immediately, he described an action plan, the possible foods that might be responsible, and the changes he anticipated in the coming days. In perhaps the most intriguing experiment at Clover Food Lab thus far, Ayr is giving us a real-time window into an outbreak as it occurs, giving us updates on the last-known exposure and preliminary results of the state's tests ("so far, everything has come back negative.")
The gutsy response to the outbreak is a fulfillment of the promise that should exist between a food provider and the public, one that other restaurants would be wise to emulate. It's a move that brings us, the public, up close to the realities of food, both to its dangers and its benefits, rather than fostering the illusions that marketers try to sell us. Elizabeth Hohmann, a physician and an associate professor of medicine at Harvard Medical School who researches Salmonella, also advocates for the public to try to better understand what they are eating. "People want their food to be perfect, but it is not, and it won't ever be. Even with the best suppliers, handling, and elimination of cross-contamination, outbreaks will still occur, even in the best restaurants," Hohmann says. "Food," she reminds us, "is not in any way sterile! In our culture, there's a huge disconnect between our perception of food on a plate, and what food really is."
Ayr is hard at work trying to repair that disconnect between us and the food that we eat. "People have said to me, 'wait a minute, you take vegetables that came raw from a farm, and you carry those through your kitchen, to the restaurant, and then you make food?' And I say, yeah. Then they ask 'Have you ever been to any of those farms?' and I say, yeah, we've been to all of them."
Keeping outbreaks behind shuttered doors is not only a safety hazard but it prevents the public from thinking critically about food. "It's so hard to change that culture," Ayr says.
But I think Clover Food Lab is opening doors that have been traditionally locked. The restaurant's mostly organic, local, vegetarian food challenges the routine of processed foods and centralized distribution and asks us to put thought into what we eat outside of our homes and what we bring back to our kitchen counters. Perhaps Clover will have to do some work to regain our trust in the short-run. But we should be impressed with their response to this outbreak. "I expected a lot of negativity, so we braced ourselves," Ayr says, when he decided to go public. But that negativity never really came.
Most are already back onboard with Ayr's overall mission.
"Would you go back to Clover now that it's reopening?" I ask Hohmann.
She doesn't even hesitate. "Absolutely."
Recently, Ayr got an email from one of his customers.
I ate at your Brookline location, the woman wrote. I think I was one of the victims, since I had vomiting and diarrhea. But I'm okay. When are you planning on opening a location in Framingham?
Picture: Re-opening day at South Station, courtesy Lucia Jazayeri
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About the authorSushrut Jangi is an internist at Beth Israel Deaconess Medical Center and an editorial fellow at The New England Journal of Medicine. More »
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