{"id":9804,"date":"2020-09-13T12:50:36","date_gmt":"2020-09-13T16:50:36","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=9804"},"modified":"2020-09-13T13:09:49","modified_gmt":"2020-09-13T17:09:49","slug":"restaurants-are-hurting-but-dining-indoors-poses-real-covid-19-transmission-risk","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/restaurants-are-hurting-but-dining-indoors-poses-real-covid-19-transmission-risk\/2020\/09\/13\/","title":{"rendered":"Restaurants Are Hurting — But Dining Indoors Poses Real COVID-19 Risk"},"content":{"rendered":"

As we learn more about transmission of SARS-CoV-2, the news for restaurants goes from bad to worse.<\/p>\n

And while there’s a long list of sad things about this pandemic, the decimation of the restaurant business<\/a> for owners and the people who work there is right up there. The loss of the restaurant experience for us diners is pretty sad, too.<\/p>\n

Importantly, restaurant dining isn’t one of those hypothetical risks for COVID-19, such as surface contamination of groceries and delivered packages. It’s a real, well-documented concern with strong supporting evidence.<\/p>\n

In a CDC study<\/a> conducted at 11 healthcare facilities and just published last week, investigators queried 154 people with symptoms consistent with COVID-19 and positive tests, along with 160 control individuals testing negative. They asked about various activities in the two weeks prior to the onset of symptoms — eating out, shopping, going to an office, visiting a hair salon, taking public transportation, attending a religious service, and others.<\/p>\n

People with positive test results were more than twice as likely to have reported dining at a restaurant than were those who tested negative. No other activity conferred significant risk.<\/p>\n

It’s a small study, and the authors note several potential limitations, but they amplify the message that crowded settings, close contact, and lack of mask wearing indoors increase the risk of COVID-19.<\/p>\n

The vagaries of restaurant ventilation — so exquisitely detailed in this investigation of a restaurant outbreak in China<\/a> — add to the hazards of indoor dining.<\/p>\n

Here, one presymptomatic person infected nine other diners, all of whom sat under the the same air conditioning vent that recirculated \u201cold\u201d rather than fresh air.<\/p>\n

\"\"<\/a>

www.medrxiv.org\/content\/10.1101\/2020.04.16.20067728v1.full.pdf<\/p><\/div>\n

None of the 68 diners in other areas developed COVID-19, nor did any of the 8 waiters — likely because transient contact is much lower risk.<\/p>\n

Meanwhile, Harvard epidemiologist Professor Miguel Hernan compares epidemic curves in New York and Madrid in this fascinating thread<\/a>:<\/p>\n

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1\/
Look at the shape of these curves. <\/p>\n

New York and Madrid had similar epidemics until they spectacularly diverged.<\/p>\n

In March, both cities were caught by surprise and shut down because of #COVID19<\/a>.<\/p>\n

In September, the situation is under control in NY and alarming in Madrid.<\/p>\n

Why? pic.twitter.com\/VF0BCl0xyt<\/a><\/p>\n

— Miguel Hern\u00e1n (@_MiguelHernan) September 11, 2020<\/a><\/p><\/blockquote>\n