Union Square Hospitality CEO Danny Meyer talks about the postponement of indoor dining in New York City, taking a business approach to reopening restaurants and feeding the hungry.
Public health experts and government officials say they are concerned that bars and restaurants are playing a role in increasing the number of Covid-19 cases in parts of the U.S.
These spaces pose particular challenges for transmission control due to both human behavior and the way in which the coronavirus spreads more efficiently, indoors through close and prolonged unprotected contact. Potentially risky behavior includes speaking out loud, not wearing masks and drinking alcohol, which can make people less aware of the risk, the scientists said.
To limit transmission, public health experts recommend that people stay 6 feet away, wear masks, practice good hand hygiene, and avoid touching their faces.
Bartender with mask and gloves and customer at an outdoor bar table (iStock)
“It’s much harder to do those four things in a bar or restaurant than in a workplace,” said Lisa Lee, an infectious disease epidemiologist and associate vice president for Virginia Tech. At work and in the office, it may be easier to distance yourself socially , monitor who is present and wear masks continuously, plus people don’t normally drink, he said. “In general, office work will be much less risky than a type of bar situation.”
At least 138 new cases of Covid-19 were recently traced to a bar in East Lansing, Mich., According to Ingham County Health Officer Linda Vail. According to case investigations and contact tracing, health officials found that as of July 1, 119 of those cases were people who contracted the virus while at the bar. The other 19 were secondary infections: people infected by someone who contracted the disease at the bar.
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The owners of the bar told Ms. Vail that they were operating at 45% of their capacity, but the video on social media showed that many customers lined up outside clustered together, without masks. Ms. Vail said her office received complaints of overcrowding and inconsistent use of masks by internal staff; Many customers did not wear masks inside, according to some complaints.
Some state and local governments are withdrawing plans to reopen and renewing restrictions on bars, restaurants, movie theaters, zoos and museums after seeing a record number of daily coronavirus infections. Colorado Governor Jared Polis ordered bars and nightclubs to stop the service in person. Texas Governor Greg Abbott said the state’s coronavirus crisis was fueled in part by people who congregated in bars. He closed bars and limited the restaurant’s capacity to 50%. In California, where cases are also on the rise, Governor Gavin Newsom on Wednesday ordered restaurants to close to eat indoors and closed bars in much of the state.
Deep Sushi restaurant employees Jordan Arrowood, left, clean the top bar as Carrie Souza enters an order at the sushi restaurant. (AP Photo / Tony Gutiérrez)
In New York City, restaurants are open for dinner, but can only serve customers outdoors, where the risk of transmission is less. The air flow dilutes the amount of virus that prowls.
“We have to think of this in terms of relative risk. There are no absolutes, “said Thomas Russo, professor and head of infectious diseases at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo.
There is a general hierarchical order to risk going out to dinner, he said. The safest route is simply to get food through a drive-in or take away. Then comes dinner al fresco, with caveats: Tables must be separated, and the farther the better. Less safe is dining in a restaurant.
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This echoes the recommendations of the Centers for Disease Control and Prevention, which indicate that driving, delivery, extraction and collection on the sidewalk carried the least risk of transmission because they limited the number and duration of interactions between potentially infected people. Meals on site, indoors and outdoors, posed the greatest risk if capacity was not reduced and tables were not spaced at least 6 feet apart.
Experts say eating indoors is particularly dangerous in places where ventilation and air filtration are poor because viral particles can accumulate in the air. In January, an infected restaurant that still had no symptoms transmitted the virus to five other people while eating at a restaurant in Guangzhou, China. Some investigators looking at the case noted that ventilation was poor. They hypothesized that the aerosolized virus from the patient’s breath or speech accumulated in the air over time, while the strong air flow from an air conditioning unit helped recirculate the particles.
People sit outside the Suprema restaurant in the West Village as New York City moves into Phase 2 of the reopening. (Photo by Noam Galai / Getty Images)
According to experts, even the safest outdoor eating option has risks. Viral particles dissipate further outdoors, reducing the risk of coming in contact with enough viruses to become infected. At the population level, being outdoors reduces the risk of a super-spreading event. But on an individual level, experts say, if someone is outside and sitting or standing next to an infectious person, there is not as much dilution. The probability of inhaling what they exhale is high, especially if they do not wear masks and talk and share food for a long period of time.
“That creates the greatest risk of transmission,” said Rachael Jones, an occupational health and safety expert at the University of Utah.
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In crowded urban settings like New York City, tables can sit together on a sidewalk, exposing people to diners outside of their own party. “It is difficult to maintain separation,” said Dr. Jones. “You can’t wear a mask while you eat.”
Bars are “logarithmically worse” than restaurants, Dr. Russo said. People in bars tend to group together, he said, and are more likely to move. That means that a person who has the virus can transmit it to many more than if the person were sitting at a table eating a meal.
Another thing to keep in mind, infectious disease experts said: When people drink, they relax, and sometimes their tolerance for risk is higher. Even if they start with good intentions, wearing masks and social distancing, they are likely to become more lax about those things as the drinks progress. People in bars are also more likely to scream, spraying respiratory drops into the air, experts said.
Guests dine at a restaurant in Phoenix. (AP Photo / Matt York, file)
Transmission among younger people, who tend to experience a milder form of Covid-19, is on the rise, in states like Florida.
“I think it is important for us to make younger people understand that it is imperative that they take this seriously,” said Charlie Latham, mayor of Jacksonville Beach, Florida. He said the city saw no appreciable increase in cases when restaurants reopened to 25% of capacity and then expanded to 50%, but experienced one when bars reopened. As of June 26, Florida bars cannot sell alcohol for on-site consumption.
New York City has delayed the start of meals indoors, citing concerns about the spread of the coronavirus across the country. On Monday, Mayor Bill de Blasio cited the East Lansing situation, as well as case groups in Texas and Florida that could be linked to bars and restaurants, as a matter of concern. “We can’t go ahead with indoor dining in New York City right now,” Mr. de Blasio said later in the week.
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The National Restaurant Association has issued reopening guidelines based on CDC recommendations, encouraging the use of facial covers for employees, socially distanced seating, mobile payments, and limits on the number of employees in break rooms. Temperature controls for staff are at the discretion of management.
“We ask all of our customers to help us keep our employees and their diners safe by following all existing guidelines,” said a spokesperson.
While there are ways to make food safer, there will always be some level of risk around other people, said Benjamin Chapman, a professor and food safety specialist at North Carolina State University who has worked with state officials and industry to develop a best practices training program for restaurants wishing to reopen.
A woman wears a face mask while selling drinks at a bar along the boardwalk in Asbury Park, NJ, on May 24, 2020. (KENA BETANCUR / AFP via Getty Images)
He and other experts say restaurants should limit the number of customers, move seats outdoors if possible, separate customers, and require staff and guests to wear face covers. Restaurants should also impose distance and wearing masks on people waiting in line, they say.
Servers should minimize interactions with clients, said Dr. Chapman. That could mean using mobile orders and having customers pick up food from a counter, he said.
In Honolulu, Joey and Yana Cabell reopened their seaside restaurant for dinner in early June. Employees wear masks and gloves. Fewer staff frequent the tables to reduce interactions. Most of the dining room is well ventilated by natural air flowing through open floor-to-ceiling doors, Cabell said. Owners have installed cab partitions and extended seats. They are encouraging customers to make reservations to reduce overcrowding and have instituted mandatory temperature controls for employees.
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“We want people to feel as comfortable as possible in these strange times,” said Cabell, 56, a Covid-19 survivor. “There are still many unknowns.”
Tracking contacts will play a role in dictating the pace of reopening of restaurants, bars and other companies, epidemiologists and infectious disease experts said. As states reopen, it is critical to monitor the number of new infections and hospitalizations and to reevaluate which companies can remain open and which should be reduced, they said.
“The more we reopen, every increase, every thing you do, the risk increases,” said Lisa Winston, vice chief of inpatient medical services and epidemiologist at Zuckerberg San Francisco General Hospital, who works closely with the local health department. . “As with most things, it is a balance.”
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