What is so risky indoor food during COVID-19

One of the reasons that banning indoor dining is a politically and morally difficult choice is the restaurant industry and its workers already facing financial ruin after months of significantly less business.

But on the question of COVID-19 safety, the science is clear: going out to eat is associated with an increased risk of coronovirus transmission.

“People talk a lot about superspreader incidents, but so are superspreader destinations – the types of places that are particularly at-risk and lead to particularly high rates of infection,” David Grusky recently One of the researchers behind a Stanford University study modeled coronovirus spread to indoor locations. “One of those places is a full-service restaurant.”

Before states took the long road toward reopening their economies, epidemiologists warned that the virus was most likely to spread rapidly indoors. Many listed indoor meals among potential high-risk activities that should only be resumed with extreme caution.

Since spring, Grusky and others said, emerging science has only reinforced the early apprehensions of pathologists. Mathematical modeling, cellphone data, physics, and epidemiology have been studied to confirm food outages during the epidemic.

But even for hospitalization and reopening authorities and countrywide throughout Massachusetts, restaurant dining halls remain, and often controversially, open in many places.

Restaurant owners and the associations they represent have fiercely defended the safety of their businesses, emphasizing care and cost in complying with restrictions, including Massachusetts, at least 6 feet away Laying tables, seating or reducing parties of only six people, limited patron meal 90 minutes, and 9:30 pm

And some owners and patrons alike have pointed to data they think they have on hand: the state’s contact tracing report.

Contact trailers in Massachusetts have connected 84 COVID-19 groups to restaurants, a small fraction of the state’s 23,888 known case groups.

But scientists urged to interpret that data carefully. Of The identified groups, nearly all – as of Thursday’s report of 22,487 – are classified as “domestic prevalence”, meaning that two or more people living together are infected.

But this information “doesn’t really help us”, said Samuel Scarpino, a northeast university epidemiologist. We know that people who live together are likely to spread the disease to each other, he explained, but the first household member to be infected had to get COVID-19 elsewhere, whether at work, Work is going on, or out and about the community.

“What we need to do is figure out how to stop [COVID-19] From going to homes, ”said Scarpino.

He said, “It is very little information that we have so little information [from contact tracing] Regarding the locations of late transmission in the pandemic, “said Mark Lipsch, a professor of epidemiology at Harvard TH Chan School of Public Health. Lipsitch said the limits of tracing are a national and even international problem, Which is not exclusive to Massachusetts.

But with state contact tracing data providing little evidence of how and where the coronovirus spreads, both Scarpino and Lipcich felt confident in saying that restaurants and especially indoor dining are risky.

Lipswitch stressed that a variety of research helps to identify the most likely sources of COVID-19 spread: modeling that uses real-world data to estimate how many people differ Will be infected under reopening scenarios; Case-controlled studies compare the behavior of COVID positive people to those who are not infected; And basic physical and epidemiological facts about how the virus itself is transmitted.

All of those types of research clearly point to restaurants as a particularly high-risk activity, Lipsch said. And the evidence is increasing.

In September, the Centers for Disease Control released a case-control study asking symptomatic people seeking COVID-19 tests to list the types of locations they had two weeks before testing.

Researchers found that those who tested positive were more than twice as likely to report eating at a restaurant, whether indoors or outdoors, than those who ended up testing negatively. No other setting showed a strong association with positive cases such as restaurants, a finding researchers attributed to the fact that eating and drinking required people to remove their masks, while most other activities did not. Occur.

In November, a group of Korean researchers looked closely at how the transmission passed from one person to another in restaurants. Dr. of Jombuk National University Medical School. The study, led by Joo-hyung Lee, found that a restaurant outbreak had spread in five minutes, with a spread between Two patrons sitting more than 20 feet away. A third person was also infected.

None of the three patrons in the confirmed cases interacted directly, but the researchers drew the flow of air into the restaurant and found that the ventilation system likely drops directly from table to table.

Add to that Stanford model, published in November. Grusky and his fellow researchers used cellphone data to describe how 98 million people moved from 10 major cities in the US. He said that the data along with the reported daily case counts for models from each city for how people visited in certain types of settings predicted coronovirus.

The model found that two mobility factors – how densely populated a given setting is and how long visitors stay – are closely associated with increased risk of COVID-19 transmission. It also predicts that the city’s decision to open one type of setting — especially in full-service restaurants — increases the number of cases compared to any other setting studied by researchers.

High-density and long-stay are the “structural features” of restaurants, Grusky said, adding that it helps explain how the model compares to other high-risk settings, including fitness centers, cafes and snack bars and hotels and motels. The reason why more cases are under.

Model, case study, and ventilation diagrams aside, Lipcich stated that the reason for the indoor dining spread is COVID-19 is simple – and specific to coronoviruses rather than restaurants.

“Open, especially open, mouth, talking loudly, and proximity and poor ventilation are all contributing to coronovirus transmission. It’s all really clear,” he said.

The risk factor for this particular epidemic map on indoor food is slightly more than purely coincidental – a profoundly unfortunate one for an industry struggling to stay afloat.

“There is nothing mysterious about the restaurant,” Lipsch said. “Whether it’s a restaurant, or a gym, or a house of worship, or a room you visit with your best friends and Yodel.” . . It is just that some activities spread the virus more effectively. “

Dasia Moore can be reached at [email protected] Follow him on twitter @daijmoore.

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