Right now, indoor dining comes with a risk that it's important to understand.
Hal Bergman/Getty ImagesLike everything else in life, eating out at restaurants takes on a whole new meaning in 2020. When it comes to COVID-19 risk, we know that activities that put you in close proximity to other people while not wearing masks, especially indoors, significantly increases risk of transmitting or contracting the virus. One setting where this is particularly true is at restaurants, yet many people are still choosing to dine indoors and outdoors during the pandemic.
The US Centers for Disease Control and Prevention released a report in September that found that adults who tested positive for COVID-19 were two times more likely to have eaten out at a restaurant in the two weeks before they got sick. The report did not ask participants to report whether they dined indoors or outdoors at a restaurant, but the CDC and other health authorities say that any dining setting where people are in close contact with each other without masks presents risks.
To gain more insight on the specific risks dining out presents, I spoke with Dr. Anne Liu, an infectious disease specialist at Stanford Health Care. Below she shares how to mitigate those risks, especially heading into the colder months, and what you need to know about dining in compared to grabbing takeout.
The risks of dining at restaurants
"Eating indoors in a restaurant is a higher risk activity," Dr. Liu says. "Several risk factors are coming together with indoor dining: being indoors, prolonged conversations and frequent mask removal. Until someone invents a mask that you can eat in, while still capturing respiratory droplets, that risk remains."
The major risk factors for dining at restaurants are the fact that you're indoors, close to other people and unable to wear a mask. Even if you're dining with people you live with, you will also likely come into contact with others outside your household during the dining experience.
"Sharing contact with objects including food is probably a lesser risk but may also compound the situation," Dr. Liu says.
Dr. Liu also adds that the link between dining out and COVID-19 transmission could be connected to other factors, like if people who eat out right now are less risk-averse in general than those who do not. "Specific spreading events have been linked to indoor dining, so viral transmission with indoor dining is likely contributing to cases, to some degree. In addition, people who dine indoors at restaurants may also be less risk-averse in their behavior beyond restaurants, compared to people who are avoiding indoor restaurant dining entirely right now," Dr. Liu says.
Wear a mask while talking, and only unmask whenever you're eating and drinking.
Getty ImagesHow to make dining out safer
Given that Dr. Liu says dining out is a high-risk activity during the pandemic, opting for takeout poses a much lower risk. But if you do decide to dine indoors, here's what Dr. Liu says you should look for to reduce risk. Also keep in mind that, according to Dr. Liu, "each intervention reduces risk to different degrees, but none are perfect. When it comes to indoor dining, multiple interventions need to be used together."
Wear masks whenever you're not eating and check for a mask policy
Ideally, the restaurant has a mask policy where staff are required to wear masks, and guests should wear masks until food arrives and they are eating or drinking. "A mask policy that maximizes the proportion of time everyone in the restaurant spends masked will add to safety incrementally," Dr. Liu says.
Mask up during conversations. Mask down only when actively eating and drinking.
Tables should be spaced at least 6 feet apart
"[Social] distancing is also worthwhile, but should absolutely not be relied upon as the sole safeguard when indoors," Dr. Liu says. Some restaurants are installing plastic or plexiglass barriers between tables to help prevent the virus spreading, which can be helpful, but she says the best practice is to ensure multiple safety measures are implemented at once, i.e., masks, distancing and barriers between tables.
"We have yet to see data on the effect of plastic barriers, but mechanistically I don't have great confidence that these can be a sole safeguard under any circumstance," Dr. Liu says. "Plastic barriers might be a nice bonus, but they cannot be considered a mainstay."
Go at off-peak hours
Many restaurants are required to stick to low capacity for the number of guests allowed in at a time, but not all places are implementing this. As a rule, try to dine at off-peak hours when it's less likely to be crowded.
Dine with people that live with you or are in your 'quarantine' pod
Eating out at a restaurant requires you to be in close proximity to others you are dining with, so you should carefully choose which people you eat with. "Consider who your dining companions are, who their contacts have been, and how you can't tell if people are infected by how they look and how they feel," Dr. Liu says.
If you're dining with someone who engages in more high-risk activities, then you are also at risk. The safest option is to dine with people who live in your household or who are in a "quarantine pod" with you, so everyone is on the same page when it comes to safety.
Getting takeout is a safer alternative to dining indoors.
Hal Bergman/Getty ImagesFinal thoughts
If you're on the fence about dining out, know that it's a personal decision based on your own risk factors (do you have preexisting medical conditions or live with high-risk people?) and it also depends on what's happening in your community. Communities with high rates for the virus are riskier settings for dining out than those with lower rates.
"That's a risk-benefit calculation that every person needs to be making individually, within the boundaries of local public health guidelines. Most of my high-risk patients have avoided dining out entirely," Dr. Liu says. "People just need to remember that indoor situations in which people from different households come together, without consistent masking, can bring out how contagious this virus is, especially in communities where infection rates are up."
Finally, restaurants and restaurant staff are facing a lot of stress and risk by continuing to serve customers and keep their business open. If you can, try to tip generously. "This situation might be stressful for the restaurant staff. Attending to multiple safety protocols constantly while maintaining a welcoming environment is a challenge. Plus, not every patron might be considerate and understanding of new policies designed to maximize safety," Dr. Liu says.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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