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Dining Out and the COVID-19 Risk

Adults with confirmed COVID-19 were twice as likely as control participants to report having dined out at a restaurant in the 14 days prior to symptom onset.

The spread of the novel coronavirus (COVID-19) in communities can be linked to close contact with persons known to have the illness as well as visiting locations that offer on-site eating and drinking options, such as restaurants or bars and/or coffee shops, according to Morbidity and Mortality Weekly.

Investigators from the U.S. Centers for Disease Control and Prevention (CDC) examine the number of exposures reported by 154 case patients and compared that to the number of exposures reported by 160 control participants in order to assess community and close contact exposures associated with the spread of COVID-19. The case patients were symptomatic adults with COVID-19 confirmed by PCR testing, while the control participants were adults from the same 11 outpatient facilities who tested negative for COVID-19 between July 1-29, 2020.

The study authors added that close contact with someone with known COVID-19 was more commonly reported among case patients than among control participants (42% vs. 14%, respectively). Half of the close contacts were with family members. Additionally, case patients were more likely to report having dined at a restaurant—including at any area designated by the restaurant, including indoor, patio and outside seating – in the 2 weeks preceding their illness onset compared to control participants.

When the study authors specifically looked at participants without known close contact with a COVID-19 patient, case patients were also more likely to report dining at a restaurant and going to a bar and/or coffee shop than control participants.

Among 107 participants who reported dining at a restaurant and 21 who reported going to a bar or coffee shop, case patients were less likely to report observing almost all patrons at the location adhering to recommendations such as mask-wearing or social distancing, the study authors noted.

“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 study authors wrote. “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.”

These findings were based on CDC personnel administering structured interviews by telephone with the participants. The investigators also collected demographic characteristics, information about underlying medication conditions, symptoms, self-rated physical and mental health, close contact with a person with known COVID-19, workplace exposures, behaviors about participants’ mask-wearing, and community activities in the 2 weeks before symptom onset. Questions about community exposure included gatherings, shopping, dining at restaurants, going to the office, a salon, gym, bar or coffee shop, or church/religious gathering, and using the public transportation system.

Regarding masks, the investigators found that in the 14 days prior to COVID-19 symptom onset, 71% of the case patients and 74% of the control patients reported “always” using cloth face coverings or other mask types while in public.

The study authors said acknowledged reports of COVID-19 exposures being linked to air circulation, and added that direction, ventilation, and airflow intensity could all possibly affect virus transmission. This could be true, they said, even while social distancing measures are in place and masks are being worn according to recommendations. They said that masks cannot be worn effectively while eating and drinking, though they can be worn effectively during shopping and other indoor activities.

“Implementing safe practices to reduce exposures to SARS-CoV-2 during on-site eating and drinking should be considered to protect customers, employees, and communities and slow the spread of COVID-19,” the study authors concluded.