Is It Safe to Eat at Restaurants Yet?

Dining out right now will come with certain risks. Here’s what you can do to keep yourself and others around you safe.

America is in the early stages of reopening. After weeks of stay-at-home orders, more than 30 states have allowed nonessential businesses to reopen. This means that thousands of restaurants, after pivoting to takeout or closing altogether, are now legally permitted to open their dining rooms to customers.

Broadly, restaurants are being encouraged — or ordered — to reduce capacity and space out tables, but the exact rules vary from state to state. In Texas, for example, restaurants are limited to 50 percent capacity indoors (with unlimited capacity outdoors), while in South Carolina, social-distancing measures are recommended but not enforced. With no universal guidance, restaurants are left to design their own protocols for creating safe spaces for their employees and customers. The reopenings don’t necessarily reflect a successful beating back of the virus, either. In some states, reopenings have moved forward even as the number of cases rises. So the question remains: Even if you can go to a restaurant, should you?

Without a vaccine, there is risk. No one knows how long it will take to create a working vaccine, and although there arepromising trialsin progress, thehead of the World Health Organization’s health emergencies program believesa viable vaccine is so far off that the novel coronavirus may just become a consistent part of our futures. And so right now, the decision of whether or not to dine out is personal. It’s dependent on the prevalence of the disease in your region as well as individual risk. (Are you at increased risk of becoming seriously ill if you contract COVID-19? Are you living with someone who is?) It also depends on the restaurant’s design and safety protocols, and while there is no absolutely risk-free way to eat out right now, according to experts, there are scenarios that are safer than others. Whether you’re in a state that has “reopened” or are merely fantasizing about the day you’ll sit in a dining room again, the answers to these questions can help you weigh the risks and make an informed decision about when to return to a restaurant and how to behave once you get there.

If your state has reopened dine-in service, does that mean it’s safe to go back to eating in restaurants?

With so much unknown about the coronavirus, coupled with its continued community spread and testing that still isn’t robust enough to effectively identify and isolate everyone who may be infected, it’s premature to declare reopened businesses and lifted restrictions on public life to be 100 percent safe. “I am an eating enthusiast who loves going out to eat with my friends and family, and as much as I’m eager for restaurants to reopen … we just don’t know enough about transmission to really estimate the risk of infection,” says Angela Rasmussen, a virologist and associate research scientist at Columbia University.

The question remains: Even if you can go to a restaurant, should you?

But truthfully, there’s no such thing as “safe” — if by “safe” we mean “absolutely zero risk” — in environments with other people until there’s a vaccine (which may take a very long time) or until everyone has contracted the virus and developed antibodies that confer sustained immunity. Given that “zero-risk safe” isn’t possible, and that health concerns have to be balanced with economic concerns (unless, say, the federal government were to offer more direct help to the populace, perhaps in the form of monthly $2,000 stimulus checks), the question becomes: How do we mitigate risks during this incremental process known as reopening/recovery?

It’s important to remember the basics of how SARS-CoV-2 can spread: through large viral droplets, through contaminated inanimate objects known as fomites, and, as some studies suggest, through airborne particles, according to Joseph Allen, assistant professor of exposure assessment science at Harvard University and co-author of the book Healthy Buildings: How Indoor Spaces Drive Performance and Productivity. Given these potential modes of transmission, there are a number of factors to consider when it comes to dining out again, like: indoors or outdoors? Mask on or off? Cash or credit?

These are all questions that restaurant owners are thinking about right now as many prepare to reopen, but it’s a good idea to ask those businesses what their concrete plans are to prevent virus transmission, says infectious disease epidemiologist and infection prevention researcher Saskia Popescu. And then there are the basic guidelines that everyone should consider: getting updates from your local health department to know whether your area is seeing decreasing cases; continuing to practice good infection-control habits like hand hygiene; and opting for takeout or delivery if you’re high-risk or live with someone who is, per Popescu.

Above all, remember that risk is shared: It’s not just you at risk of infection here, but your loved ones, other people’s loved ones, and an entire community. “I hope that, as a country, we will continue to think about our neighbors, our community members, and those of us who are at higher risk,” saysMichael Knight, assistant professor of medicine and the patient safety officer at the George Washington University. “As a good neighbor and a good citizen, what role can you take to get some sense of normalcy and to improve our economic conditions, but to also decrease the risk?” That may mean still limiting nonessential trips even if restrictions in your state are lifting — or, at the very least, taking note of the following suggestions to mitigate risk as much as possible.

Are you safer in a bigger restaurant with socially distanced tables than a smaller restaurant with the same protocols?

As people return to dining rooms, social distancing will be essential for restaurants of every size.

A bigger, well-ventilated restaurant with strict limits on the number of people working and the number of people it serves will be safest. “A larger restaurant that can spread out people better and still have fewer staff and have fewer clients will be preferable to all trying to pack in,” says Robyn Gershon, professor of epidemiology at the NYU School of Global Public Health.

A report from architects Charles Hemminger and Seth Boor shows what socially distanced tables could look like for restaurants in San Francisco. Changing restaurant layouts to accommodate social distancing will require them to reduce the number of people they serve, and for restaurants that get by on very thin margins under normal circumstances, reducing capacity in this way might not be sustainable financially. Arranging tables six feet apart may be more possible for restaurants with bigger spaces for both logistical and financial reasons, but the number of people in a space increases risk, and by that calculation, a smaller restaurant with socially distanced tables would be safer than a larger restaurant trying to serve as many people as possible under the new rules. “The more people, the higher the risk that someone there is infected,” explains Knight. “The No. 1 risk is interacting with someone else who is infected.”

However, if a small restaurant doesn’t have the space to properly space out tables or safely manage the flow of people, that would cancel out some of the benefit of its small capacity. Restaurants need to ensure “there’s enough space to move so that people aren’t on top of each other,” says Allen. Dining room tables spaced six feet apart is just the first consideration; diners also need to remain socially distanced in waiting areas, bathroom lines, and in multi-stall restrooms. Plus, without proper ventilation, this space becomes immediately unsafe.

Should you be worried about the number of people at your table? How many is too many?

Although the CDC’s phase 1 reopening guidelines suggest limiting gatherings to groups of no more than 10 people, some experts caution that dining out in groups that size is still risky. “As things open up, we still need to be safe,” says Popescu. “If those are people you’re living with, that’s fine, but if you’re going out to meet eight friends, I worry about the increased risk for that many people.”

Consistently, studies have shown that the virus spreads most easily among groups of people in enclosed spaces. Super-spreader events, in which one infected person passes the virus to multiple people, occur when people from different households come together for an activity indoors, whether it’s a religious service or a birthday party. Similarly, a large group dinner that gathers people from different households in a restaurant dining room could put everyone at risk.

“You’re going out to meet eight friends, I worry about the increased risk for that many people.”

Diners can’t socially distance while sitting at the same restaurant table, and they can’t wear masks while eating, so there’s a clear risk of transmitting the virus. Gershon agrees that limiting group dining to people who live together lowers risk. “It would make sense to go out with people that you’ve been in quarantine with and not introduce ourselves to other people that we haven’t been in close contact with over these past several weeks.” So while there’s no ideal dining party size, if you must look beyond your own household, fewer people at your own table is safer.

How much does a restaurant’s ventilation system/airflow really play into things? Should that influence where you sit to limit risk of coronavirus transmission?

We know that the virus spreads when people are in close contact, and according to the CDC, respiratory droplets that are produced when a sick person coughs or sneezes are the most common mechanism for transmission. These droplets don’t travel more than six feet from the sick person, which is why social-distancing rules use the six-feet marker.

However, there is also evidence that the virus can spread through small droplets produced during normal activity, like talking or laughing, and while larger droplets fall to the ground, according to a new study published in the Proceedings of the National Academy of Sciences and covered by the New York Times, these small droplets can remain suspended in the air for up to 14 minutes. Additionally, research shows that the virus is aerosolized, meaning it’s contained in even smaller droplets called aerosols that can travel through air. And in April, Chinese researchers released the results of a study that showed how air currents from a Guangzhou restaurant’s ventilation system carried aerosols to restaurant patrons more than six feet away from an infected diner. The study seemed to suggest that diners should be wary of ventilation systems — and that there might be “safe” places to sit in restaurants. But it’s not so simple.

According to Rasmussen, although the study indicates ventilation and airflow can play a role in virus transmission by transporting aerosols, there are too many unknowns to take meaningful action. “The dynamics of droplet transmission are still very much an open question,” she says.

Ultimately, though, ventilation works to mitigate the spread of the virus. Ventilation systems, if constructed properly — meaning that they’re delivering fresh outdoor air and recirculating air through a high-efficiency filter — help clean the air. “We’ve known about these factors for a long time in terms of how they can exacerbate a problem in a building or work to help mitigate disease,” says Allen. “It’s not so much that an air conditioner or any other system is inherently good or bad, it’s how it’s being operated and how the air is being delivered.”

While it’s possible for the virus to be carried in small droplets through the air, airflow can also disrupt aerosol transmission. According to Kevin Van Den Wymelenberg, director of Energy Studies in Buildings Laboratory at the University of Oregon, increasing airflow in a room, whether it’s through a ventilation system or opening windows to create a cross breeze, is one of three built-environment considerations that may reduce transmission. There’s also evidence to suggest that humidity supports immune function, prevents viral particles from being deposed deep into the respiratory tract, and has been shown to deactivate viruses. And while more data is needed, some preliminary research shows that sunlight can deactivate the virus in the same way it does for bacteria.

Still, it’s too soon to declare a sunny table outside the path of an air vent the safest seat in a restaurant dining room; according to Rasmussen, it’s hard to extrapolate specific recommendations without more studies. And as long as there is a person in a restaurant with the virus, there’s no way for it to be 100 percent safe. “If there’s one viral shedder in that space,” says Van Den Wymelenberg, “there’s risk.”

Is outdoor or patio seating safer, taking into consideration airflow and exposure to passersby?

The natural ventilation of the outdoors makes it safer than enclosed spaces, and states like Louisiana and Connecticut are allowing outdoor dining before moving to open restaurant dining rooms. “There’s no way to know how much safer, but anywhere you’ve got more dilution, it’s going to reduce the risk of airborne or aerosol transmission,” says Van Den Wymelenberg.

As with indoor seating, it’s vital that diners take social distancing into account when eating outside, whether it’s on a restaurant’s patio or in a park. “Being outdoors is not sufficient itself,” explains Allen. “We still have to take these other precautions … including maintaining physical distancing, managing the flow of people in and out of the space, managing the waiting area, managing the bathrooms. It really has to be this holistic strategy.”

While it’s feasible to keep six feet of distance between diners seated outside, it may not be reasonable to expect the same distance from passersby in cities where restaurants share sidewalks with pedestrians. But although this technically puts diners in contact with more people, potentially increasing risk, the likelihood of contracting the virus from a passerby who comes within six feet isn’t high. Popescu notes that face-to-face interactions for a prolonged period of time (around 10 minutes) are more concerning, and several reports on community spread compiled and posted on Twitter by Muge Cevik, an infectious diseases and virology clinician and researcher at the University of St. Andrews, show that “close and prolonged” contact, not brief interactions, is the overall driver of the epidemic.

Credit: Eater

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