Coronavirus

Has Restaurants' Role in Spreading COVID-19 Been Exaggerated?

The evidence is limited and mixed, but data from New York, Minnesota, and California suggest that restaurants there account for a small share of infections.

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When he blocked enforcement of state and local bans on indoor and outdoor dining in San Diego County last week, Superior Court Judge Joel Wohlfeil cited a lack of evidence that restaurants following COVID-19 safeguards, such as occupancy limits and physical distancing, posed a significant public health risk. Politicians and public health officials tend to assume that dining out is an important source of coronavirus transmission. But while the evidence is limited and mixed, data from New York, Minnesota, and California suggest that restaurants' role in the epidemic has been exaggerated in at least some parts of the country.

New York Gov. Andrew Cuomo, who allowed indoor dining in New York City to resume at the end of September, shut it down again last week. Yet the statewide contact tracing data that Cuomo released on December 11 indicate that restaurants account for a very small share of COVID-19 infections. According to Cuomo's numbers, which are based on 46,000 cases since September, just 1.4 percent of infections were traced to "restaurants and bars." That finding is similar to data from Minnesota, where Gov. Tim Walz banned indoor and outdoor dining at a time when 1.7 percent of COVID-19 cases were associated with restaurants.

The percentages reported for retailers, gyms, and "hair & personal care" in New York were even tinier: 0.6 percent, 0.14 percent, and 0.06 percent, respectively. But all of these sources paled in comparison with "household/social gatherings," which accounted for 74 percent of the cases.

Cuomo's numbers did not indicate what share of the cases associated with restaurants and other businesses involved customers rather than employees. But data from Los Angeles County—the most populous local jurisdiction in the country, with 10 million residents—shed some light on that question. The Los Angeles County Department of Public Health reports 500 COVID-19 clusters involving three or more laboratory-confirmed cases in nonresidential settings. About 40 of those (8 percent) involved restaurants, with the number of cases ranging from three to 12. But all of the cases involved employees rather than diners.

In late October, by contrast, Los Angeles County Public Health Director Barbara Ferrer said "we've…seen somewhere between 10 and 15 percent of our cases being connected to a dining experience." A month later, the ABC station in Los Angeles reported, based on county data, that "restaurants have been linked to less than 4% of coronavirus outbreaks in non-residential settings."

The difference between "cases" and "outbreaks" may explain some of that gap. But during a press briefing on November 23, Ferrer conceded that estimating the contribution of particular infection sources is an iffy proposition. "I wish we could answer this question," she said. "I think people would feel better if we could say with certainty where people got infected, but we just can't."

California Gov. Gavin Newsom banned indoor dining in Los Angeles County at the beginning of July. Last month the county imposed a ban on outdoor dining that was blocked earlier this month by Superior Court Judge James Chalfant, who said it was "not grounded in science, evidence, or logic." But by then, Los Angeles County was subject to a state ban on outdoor dining that kicks in when a region's available ICU capacity drops below 15 percent.

California Health and Human Services Secretary Mark Ghaly has admitted that the ban was not based on evidence that outdoor dining was playing a significant role in spreading COVID-19. Ghaly said the policy is "not a comment on the relative safety of outdoor dining" but is instead aimed at discouraging Californians from leaving home.

Judge Wohlfeil did not merely question the ban on outdoor dining. He said neither San Diego County nor state officials had presented any evidence that indoor dining, when operated in compliance with occupancy limits and other COVID-19 safeguards, was contributing to the local spread of the disease either.

The San Diego County Health and Human Services Agency reports that "bars and restaurants" accounted for 9.2 percent of "potential community exposure settings" mentioned by people who tested positive for COVID-19 in interviews conducted from June 5 to December 12. But the agency does not break out restaurants as a separate category, and it adds this caveat: "Potential community exposure settings are defined as indoor or outdoor locations in which cases came within 6 feet of anyone who was not a household member for at least 15 minutes during the 2-14 days prior to symptom onset, even if the case wore a mask or facial covering. Potential exposure settings are places case-patients visited during their exposure period, not confirmed sources of infection. Persons may have visited more than one location."

Most people (54 percent) did not mention any potential exposure settings, while less than 5 percent mentioned "group gatherings." The latter result is surprising, given that New York found "household/social gatherings" accounted for three-quarters of cases. Although people might be reluctant to admit getting together with members of other households, it is not clear why they would be especially reluctant in San Diego County. Maybe New York's contact tracers are simply better at eliciting that information.

The evidence implicating restaurant dining in the spread of COVID-19 is largely indirect. A study of 10 states that the Centers for Disease Control and Prevention published in September, for example, found that people who tested positive for COVID-19 in July were more than twice as likely as control subjects who had tested negative to report visiting a restaurant in the two weeks prior to symptom onset. "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 researchers concluded.

The study found "no significant differences" between cases and controls with regard to several other possible risk factors, including shopping, spending time in an office, visiting a salon, going to a gym, visiting a bar or coffeeshop, attending church, using public transportation, and gathering with others in a home, whether the number of people was fewer or greater than 10. So if this study implicates restaurants, it also seems to absolve those other settings, which many politicians believe are risky enough to justify government restrictions. The finding regarding social gatherings is especially puzzling in light of New York's data.

PLoS One study published in October looked at interstate differences in case numbers and trends during the early stages of the epidemic last spring. The researchers found that "early social distancing restrictions, particularly on restaurant operations, [were] correlated with increased doubling times"—i.e., how long it took for the number of confirmed cases to double. Leaving aside the difficulty of disentangling causation from correlation, this study is not directly relevant to the question currently facing policy makers: whether allowing restaurants to operate with "social distancing restrictions" and other safeguards poses an intolerable risk.

Similarly, a Stanford University model based on mobility data projects how infections tied to particular business categories "would increase if we returned this category to pre-pandemic levels of mobility without taking additional precautions like increased mask-wearing or occupancy caps." According to the model, "reopening full-service restaurants has the largest predicted impact on infections, due to the large number of restaurants as well as their high visit densities and long dwell times." Fitness centers are the second most significant contributor to disease spread in this model.

Again, these projections counterfactually assume that restaurants and other businesses will operate as they did prior to the pandemic. They also focus on public "points of interest," meaning they exclude the private gatherings that New York found accounted for the vast majority of infections. The fact that restaurants and gyms following COVID-19 precautions accounted for a very small or negligible share of cases traced in New York suggests that such businesses can operate without contributing much to the spread of COVID-19.

Restaurants may be a more significant source of virus transmission in other jurisdictions. In Houston, where restaurants have been allowed to operate indoors at 75 percent of capacity since mid-September (compared to 25 percent in New York City prior to last week's ban), 8.7 percent of people who tested positive for COVID-19 have reported restaurants as a potential source of exposure in interviews conducted since June 1.

During her presentation in October, Ferrer claimed that in Louisiana, "25 percent of cases had their origins in bars and restaurants." That figure, which was reported in August, excludes outbreaks in "congregate settings" such as nursing homes and prisons, which together account for a large share of infections. Leaving out those sources, according to the latest data from Louisiana, restaurants have accounted for 7 percent of cases.

Ferrer also claimed that "in Maryland, 12 percent of cases were traced back to restaurants." The actual finding, which Gov. Larry Hogan reported in late July based on "recent interviews conducted with COVID-19 patients," was that 12 percent of them were employed by restaurants. Hogan also said 23 percent of the COVID-positive people who were interviewed reported eating in restaurants, which does not necessarily mean that is where they were infected. By comparison, 54 percent of the interviewees said they worked outside their homes, and 39 percent said they had visited stores—both of which Hogan likewise described as "higher-risk locations."

California HealthLine notes that contact tracing varies widely across the country and is woefully inadequate in many places, which makes it hard to get a handle on the role that restaurants (or other sources) are playing in virus transmission. State and local restrictions on restaurants also vary widely, which compounds the difficulty. In the absence of better data, politicians continue to issue edicts that wreck businesses without any confidence that it will do much good.

[This post has been updated with data from Minnesota.]

NEXT: Study: Prison COVID-19 Spread Led to Hundreds of Thousands of Community Infections

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      1. It’s weak soup broth with shitty veggies floating in it and mystery meat.

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  2. As good a time as any:

    The 12 Days of Reason, 2020 Edition

    12 Trump Derangements
    11 Peaceful Protests
    10 Cities Burning
    9 Months of Lockdowns
    8 Fauci Flip-Flops*
    *Statistics compiled by Ron Bailey, margin of error +/- 136,000%
    7 Voting Conspiracies
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    2 Fast Tracked Vaccines
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    1. Beautiful.

      And a Brain for Boehm

    2. love this.

    3. well done!

    4. And don’t forget immigration…

    5. Excellent!

  3. I reject the premise that spreading covid is even a problem.

    1. reality is wrong!!!!!

    2. That’s an interesting thought. In other words; It’s gonna spread and there is close to nothing we can do about it so take appropriate personal precautions and get on with our lives? It is tough to know how much of a difference all of these precautions have made. No way to effectively test the alternatives.

      1. Look at the Dakotas/Nebraska/Wisconsin area. All curves look the same, vastly different rules.

        Lockdowns aren’t the difference between overwhelmed hospitals and a manageable hospital load, so we should lift all lockdowns.

        1. “Lockdowns aren’t the difference between overwhelmed hospitals and a manageable hospital load, so we should lift all lockdowns.”

          Uh-oh. Someone needs to be shadow banned or at least carry a warning.

  4. everything’s role in spreading covid-19 has been exaggerated.

    1. Almost everything – I’d say China’s role has been understated, if anything.

      1. Stu Varney’s side chick told me this morning China’s covid-recovery has been spectacular

      2. So has the role of WHO.

  5. Yes!

  6. We cannot have any super spreader events involving joy. The only ones allowed involve struggle sessions, protests and voting. The two minute hate will continue until morale improves.

    1. Well, there are those that get joy from rioting, looting, burning and assaulting.

  7. i think it is appropriate to talk about reduced capacity to increase distancing…… something many restaurants are doing even when not mandated…. but none of these restaurants are operating business as usual. they are increasing outdoor dining, they are increasing distance between tables or adding barriers, they are implementing masks when not seated policies….. crowded bars and nightclubs might be hard to defend in the current situation, but that is not what we are talking about here….. we are talking about restaurants that are trying to be as responsible as possible. i don’t think the government should be shutting them down. (especially not the outdoor dining parts.)

    the government’s role should be limited to keeping people aware of the current situation. they should offer suggestions, not edicts. we can’t have life as normal, but that needs to be a reality we make happen as a society, and not one forced on us.

    1. We could, oh, I don’t know, think rationally

      Shopping and eating out are among the last places I’d expect to ever catch a respiratory bug

      In such places you have brief, fleeting contact with people not in your party, furthermore, its long been customary to not invade people’s personal space in such places.

      I suppose you could be unlucky enough that someone in those places sneezes or coughs in your face, but the only people who’ve ever done that to me are my kids.

  8. Given how bad contact tracing is in the US, how would we know if it came from restaurants? It is easy to tell when it comes from a household setting: “did anyone in your have COVID19?”

    Try that for a restaurant – even answering “what restaurants were you in during the last 10 days” may be difficult. Now, “what restaurants were you in during the last 10 days where a server or patron had COVID19” – good luck.

    On the other hand, countries with good contact tracing do find significant spread in restaurants. Furthermore, it is basic respiratory infection epidemiology to expect significant spread in restaurants – unless special measures are taken: appropriate ventilation, and distancing. Masking of patrons can’t be done – they can’t eat and drink with masks on.

    So it is just wishful thinking to take the *measured* spread in US restaurants and treat it as being as accurate as measured spread in situations much better measure measurements – households and health care visits.

    1. On the other hand, countries with good contact tracing do find significant spread in restaurants.

      No, they don’t.

      1. The big super spreaders are Costco, Walmart, Target, et al. These places are PACKED with people almost exclusively wearing cloth masks. The CDC recommends health care workers not use cloth masks as “there is no evidence they are effective.”

  9. Golly. Just can’t figure out who to believe on this. A bunch of people with extensive training as epidemiologists and public health, medical workers trying to keep their local emergency systems from collapsing or a bunch of sophomoric young men for whom this whole problem is one big pain in the ass and for whom a crybaby strain of Libertarianism gives license to substitute their own convenient reality.
    Hey, but maybe none of them know anyone who’s actually gotten sick. So they assume its all bullshit. Maybe I should consider that I, personally have never had, nor has anyone I’ve actually known well, had their civil liberties infringed by some illegitimate government, never been actually over-taxed, never spent a day in jail. I guess all such claimed problems are bullshit too.

    1. I believe the “sophomoric young men” more than I believe politicians, media, and the medical establishment who have exaggerated the death toll (a gunshot victim is hardly a “coronavirus” victim) and lied about masks, asymptomatic transmission, and the effectiveness of lockdowns.

    2. I believe the actual data in real life. It’s easy to find.

      Why don’t you do it?

    3. You remember the epidemiologists telling us the sky was falling and millions would die? Should we continue to trust those folks? Or, maybe we should support and encourage freedom.

      1. have you been living under a rock for he last 9 months? the “millions dead” was if nothing changed…… are you trying to tell me nothing changed for the last 9 months? we didn’t get better treatments? we didn’t do anything as a society to slow the spread? so everything is exactly the same as it was a year ago? we have 300K dead in the US with everything that has changed this year….. what do you think that number would be if we were to let the virus run rampant the way you fucktards want?

    4. “Golly. Just can’t figure out who to believe on this…”

      Here, try believing in this:
      Fuck off and die, slaver.

    5. Oh look, another neo-yuppie sack of shit who gets to work from home while millions have lost their jobs due to coronapanic and shitty restrictions that haven’t done a bit of good.

      1. how does asking you to wear a fucking mask eliminate your ability to work?

        1. Every tried to do fine work in an isolation suit while your goggles are fogging up?

    6. You sound pretty shrewd.

      Would you like to play poker?

  10. Now do all lockdown rules.

    South Dakota looks exactly like the states that locked down. They had no problems with hospital capacity.

    Open it all. If you’re scared stay home.

    1. They had no problems with hospital capacity.

      In the Black Hills, we are just at full adult ICU capacity now (though there are a number of pediatric ICU beds available which could probably be converted quickly). And there was always spare capacity over in Sioux Falls so we could transfer patients if needed. But we are also continuing a downward progression of positive tests since a peak in the 2nd week of November.

      Despite what the media would have you believe, there was no Sturgis spike. There was no Thanksgiving spike. Governor Noem has let us figure out the right approach at a local level through this whole thing.

  11. Come on Sullum, we all know the real villain here. It’s Donald Trump. How can you call yourself a journalist without finding a way to blame Trump for this problem AND every other problem?

  12. The shut down orders ignore the reality of human behavior. Despite admonitions not to socialize, humans are social animals and will find ways to do so. Removing public places like restaurants and bars results in people meeting up at friends’ houses. Restaurants & bars have invested untold millions of dollars to become hygienic and safe places with the addition of ventilation, sanitizing procedures, enough room for distancing both inside and out, along with commercial grade disinfection equipment. This is not the case in homes which are smaller, have harder to sanitize surfaces and no staff to maintain germ free conditions. So I would argue that you are better off meeting people outside of your immediate home environment in these obviously safer locations. The “scientists” have it wrong because they have not factored in normal human behavior. And if you’re going to argue that people must stay in their homes, good luck with that. The only way that can be enforced would be with martial law.

  13. SleepyJoe will solve this problem on day one.

  14. “…But by then, Los Angeles County was subject to a state ban on outdoor dining that kicks in when a region’s available ICU capacity drops below 15 percent…”

    So it’s only unconstitutional until they find a work-around?

  15. I am impressed. We have here one of the rare exceptions to Betteridge’s Law.

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  17. It’s clear to me that banning outdoor dining is dumb.

    Indoor risk is higher, depending on ventilation and how closely people sit together.

    https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article

  18. http://lbpost.com/news/county-covid-icu-capacity

    Outdoor dining has been banned for three weeks.

    Indoor dining has been banned for six months.

    It is pretty fucking obvious that these bans accomplished jack shit!

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  19. the entire scamdemic hoax is exaggerated

  20. If everything that is thought to be a significant spreader of the virus only contributes 1% of the spreading, where is all of the spread actually coming from?

    I’m the first to say that lockdowns are bad policy, but if we judge each arena of society by only its confirmed case spread, we’re only going to be accounting for a small fraction of total spread. As much as I hate to say it, restaurants et al are probably spreading significantly more than what is being officially confirmed.

    1. Most of the covid transmission have occurred when people have gotten together indoors for more than 15 minutes with family members and friends.

      But since even totalitarian Democrats won’t ban families and friends from getting together (and won’t mandate masks or social distancing in people’s homes), they blame restaurants, bars, gyms, other so-called non essential businesses and Trump rallies for spreading the virus.

  21. https://www.6sqft.com/74-of-new-yorks-covid-spread-is-coming-from-at-home-gatherings/

    The slide is from one of Cuomo’s press conferences.

    Travel/Vacation 1.06%
    Retail 0.61%
    Religious activities 0.69%
    Restaurants and bars 1.43%
    Healthcare delivery 7.81%

    Going to get your COVID test may expose you more to COVID than going to a restaurant.

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  23. Gee Jacob, you think?

  24. Sullum thinks that actual evidence and genuine public health concerns should be motivating these Democrat governors.

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  25. Scott Atlas, who is more libertarian than Reason editors and writers, had an excellent op/ed on the disastrous lockdowns today at
    https://www.wsj.com/articles/a-pandemic-of-misinformation-11608570640

  26. The reality is that COVID-19 spreads rapidly at home and then back into the general populace.

    Our intervention measures are applied to the low risk settings (outdoors, stores, restaurants, …) when in reality we should be apply them to high risk areas: that is, social distancing at home and promptly isolating the sick in quarantine centers.

    Of course, we can’t do this in practice. But let’s be realistic about what is going on: Effectively we are saying that seat belts save lives so please wear them while sitting on the couch while watching television and don’t bother about the car.

  27. Has anything’s role in spreading COVID 19 not been exaggerated?

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