CDC finds link between COVID-19 cases and eating at restaurants, but experts say indoor dining can be done safely

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Two friends dine out in Farmingdale, N.Y. (Photo: Raychel Brightman/Newsday RM via Getty Images)
Two friends dine out in Farmingdale, N.Y. (Photo: Raychel Brightman/Newsday RM via Getty Images)

The Centers for Disease Control and Prevention released evidence this week suggesting that those who test positive for COVID-19 are more likely than those who test negative to have visited a restaurant or bar in the two weeks before — a finding that calls into question plans from New York City and Florida to reopen indoor dining.

The study, published in the CDC’s Morbidity and Mortality Weekly Report, was conducted on a random sampling of individuals who were tested for COVID-19 from July 1 to 29 at health care facilities in 11 states, including California, Colorado, Ohio and Tennessee. In all, it covered 154 individuals who tested positive for COVID-19 (after displaying symptoms) and 160 who tested negative.

Participants were asked to rate the frequency of their visits to places like offices, salons, gyms and bars on a five-point scale ranging from “never” to “more than once a day.” Additionally, they were asked to rate their adherence to guidelines issued at those places, including social distancing and mask-wearing, choosing such answers as “none” and “almost all.”

The researchers found no major differences between the people who tested negative for COVID-19 and those who tested positive when it came to visiting places like offices, salons or gyms. However, those who tested positive for the virus were twice as likely to have reported dining at a restaurant or bar in the two weeks before the onset of the illness. They were also less likely to report seeing all the patrons in the facility “adhering to recommendations such as wearing a mask or social distancing.”

The authors note that the finding has implications for states reopening. “Exposures and activities where mask use and social distancing are difficult to maintain, including going to places that offer on-site eating or drinking, might be important risk factors for acquiring COVID-19,” the report concludes. “As communities reopen, efforts to reduce possible exposures at locations that offer on-site eating and drinking options should be considered to protect customers, employees, and communities.”

Although the study did not differentiate between outdoor and indoor dining, experts have previously warned that the latter is riskier, due to things like poorer ventilation and less distancing. But Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, says that doesn’t mean the solution is to avoiding indoor dining altogether.

“You have to anticipate that you’re going to have some level of increase in cases and provide guidance to those restaurants and bars to be able to have to modify their operations in a way that decreases the transmission,” Adalja tells Yahoo Life. “The alternative is to not have indoor eating for a period of year, and I don’t think that’s the solution, either.”

Adalja says that many states, including Pennsylvania, have reopened indoor dining at 25 percent capacity and have not seen a rise in cases (the state plans to move to 50 percent occupancy next week). He says the key is enforcing safety measures, such as mask-wearing when not at the table, frequent hand-washing/sanitizing and requiring servers to wear masks or face shields or both. If these precautions are all in place, Adalja says, taking a mask off to eat or drink isn’t all that risky.

“When you’re sitting at the table eating, you’re usually there with people you already are mixing with, so face-covering policies are for when you’re not seated at your table,” says Adalja. “If the server is wearing a mask and a face shield, then there’s probably less benefit to wearing your mask at the table. [COVID-19] is not spread through fleeting contact, it’s significant exposure, 10 to 15 minutes. Severs are usually not there that long and they’re typically a few feet away.”

Joining the list of regions continuing to reopen, New York Gov. Andrew Cuomo announced this week that restaurants in NYC will be able to resume in-person dining at 25 percent capacity starting Sept. 30. Dr. William Schaffner, an infectious disease expert and professor of preventive medicine at Vanderbilt University, agrees with Adalja that it’s possible to take this step while mitigating risk.

But it’s decisions like that of Florida Gov. Ron DeSantis — who announced this week that bars will be allowed to reopen at 50 percent capacity — that concern him. “It’s particularly the bars that are the energizers, the accelerators of COVID spread because it’s people together closely without masks, for really long periods of time, indoors,” Schaffner tells Yahoo Life. “That’s different than the restaurant scene where it’s small parties that can be spread out and the person serving them is masked and they’re really only in close interaction with the people with whom they’re dining.”

He says the bar environment itself doesn’t lend itself well to social distancing. “The whole atmosphere is different. People go in, take off their masks, put them in their pockets — and they’re there for two hours and close to people,” says Schaffner. “They want that closeness, that geniality there, sipping and drinking all the time. So they never think to put the mask on.”

As for whether bars can reopen safely in the midst of a pandemic, Schaffner says, “We’ll see how it goes,” adding “You have to spread people out. Are they approaching this the way they’re approaching restaurants, or are they allowing more prolonged intense mingling? That’s where it gets dangerous.”

For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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