CDC reports that adults who test positive ‘twice as likely’ to have eaten at a restaurant

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Before we talk about this study, it’s important to note that this shows correlation, not causation. It seems somewhat damning to me, but it’s been a few decades since I took college courses that included statistics and I’m sure some of you will be able to understand and explain this better. However you may have heard that the CDC did a survey of 314 people who were about to be tested for COVID in 10 different states. About half of them tested positive. The main different between the two groups were that the people who tested positive were “twice as likely to have reported dining at a restaurant” and were also more likely to have gone out to a bar or coffee shop. Here’s People’s writeup on this.

A recent survey of adults who tested positive for COVID-19 found that they were “twice as likely” to have recently dined at a restaurant than those who tested negative, the Centers for Disease Control said in a new study.

The study… was based on a survey of 314 people who were tested for COVID-19 in July across 10 states: California, Colorado, Maryland, Massachusetts, Minnesota, North Carolina, Ohio, Tennessee, Utah and Washington. The participants all went to get tested because they were experiencing COVID-19 symptoms, but of that group, 154 tested positive while the other 160 tested negative.

The researchers asked each participant about their activities in the two weeks before they went to get tested, and both groups — those who tested positive and those who tested negative — reported going to church, the gym and stores. The main difference came in those who said they had recently dined at a restaurant, had drinks at a bar or gone to a coffee shop.

The group who tested positive “were approximately twice as likely to have reported dining at a restaurant than were those with negative SARS-CoV-2 [the virus that causes COVID-19] test results,” the study authors said. Additionally, those who tested positive for COVID-19 but did not know where they had been exposed to the virus were more likely to have gone to a bar or coffee shop.

The results are an indication that places where masks cannot be worn at all times, such as a restaurant where people need to take their masks off to eat or drink, may be a higher risk for infection, the study authors said.

“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,” they said.

The study, though, had limitations. The researchers did not ask the people who ate at restaurants if they dined indoors or outdoors — where respiratory droplets are more likely to quickly dissipate.

“Reports of exposures in restaurants have been linked to air circulation,” they said. “Direction, ventilation, and intensity of airflow might affect virus transmission, even if social distancing measures and mask use are implemented according to current guidance.”

[From People]

It’s possible that the people who are testing positive for coronavirus are the types who are taking more risks in general too, and that going to a restaurant or bar is just one facet of that. From the results of this survey and the CDC’s explanation itsounds like indoor air is especially hazardous though. Plus let’s be realistic, people are absolutely not wearing masks and social distancing. Over the weekend my son and I picked up takeout at a restaurant that does not have an outdoor seating area. We called it in ahead of time and it was ready when we got there. We both wore the KN95 masks while getting the food, I was genuinely scared in there. Every staff member was wearing a mask and they had large clear guards up around the cash register. Every person who came in the restaurant, I counted about 6 in three different groups in the five minutes we were there, was maskless. Everyone was over 55 too. I live in a rural area and people can be especially ignorant and entitled. I feel so bad for people who work in the restaurant and service industries. That sector has been hit especially hard and there are so many restaurants that won’t be able to recover.

I might eat somewhere with provisions like this:
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photos credit: Getty

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38 Responses to “CDC reports that adults who test positive ‘twice as likely’ to have eaten at a restaurant”

  1. ce says:

    Not surprised by this! I don’t understand what part of ‘airborne virus’ people don’t understand. I have only engaged in outdoor dining or takeout since March! Last weekend I was tempted to grab a seat inside because this restaurant happened to be off of the noisiest road ever, but I hunkered down and counted my blessings to even be at a restaurant at all. I went to the dentist a few days ago and that was the first time I’ve spent any time inside a ‘business’ without a mask, only did it because obviously everyone who works there was masked and they had all sorts of sanitizing and precautionary stuff. Urgg. Everyone just got bored and gave up on it. Super disappointing

    • Sojaschnitzel says:

      Exactly this. I occasionally do outdoor dining, because my country is rather disciplined when it comes to masks and distancing, but I really wouldn’t do anything indoors. It is seriously disspiriting and tiring to see (almost) everyone around me give up, normalise the risk and somewhat resume normal operations. I am soooo ready for that vaccine.

      • Anne Call says:

        Not interested in being served by someone wearing a mask and gloves. I get takeout from my favorite restaurants and will go back when vaccine is making us all safe.

      • Hayy says:

        We moved last yr & conserved $$ by cutting out dining & shopping. After a move were were psyched to NOT accumulate more “stuff”, and eating at home is cheaper w more control on additives, taste & health preferences. We’re the uber healthy weirdos who did great during the pando, I guess

  2. Mandy Purr says:

    I’m super happy to live in a state with a strict mandate on wearing masks inside businesses. I’ve been side-eyed a couple of times when I’ve been adamant about only doing outdoor dining or takeout but I stand by it. Poor ventilation seems to be a major factor in contracting the virus, it makes complete sense because, science. I wish people could be more considerate.

    • Seraphina says:

      I agree with your comment about poor ventilation. My parents watch news from other countries and one news source stated that homes need to be ventilated as much as possible – open those windows and get air to run through the home.

      And this will be a major cause of concern for many as they are slowly brought back to work. Older buildings without good ventilating systems and cube world are a hot bed for this virus.

      • Tiffany :) says:

        With the smoke from fires creating unhealthy air quality, we can’t open our windows in Los Angeles.

        As if a pandemic by itself weren’t horrible enough.

        In the coming months I worry for the states who face extreme winter weather conditions, and how it will force people inside.

  3. Sankay says:

    I’ve been frequenting, supporting, local restaurants since early July without issue. I look to ensure they are following the guidelines and have stopped going to those places that didn’t. Personally, as someone living alone I could not remain isolated – I was literally going out of my mind. I’m actually hoping I get minimal exposure to the virus over time. I have not been sick. There’s no way we can all remain isolated for 2 years waiting for a vaccine. We must remember that people are still working, and not all have the option to work at home. I deplore those who won’t do the bare minimum of wearing a mask and distance themselves but isolation is not good either.

  4. Case says:

    Yeah, I mean of course people can go wherever is open if they feel it’s safe, but I personally would not feel comfortable dining out inside or outside. I see a lot of people going out to eat with friends, which…I don’t know. Having your mask off at such close proximity around someone you don’t live with seems risky, and is even riskier when you consider the many mask-less diners around you.

  5. MrsRobinson says:

    As a Californian, I’d love to be able to go outside, much less eat outside. It’s been smoky for almost a month.

    • Amber says:

      I’m a Californian with asthma. It’s now literally true that the only safe place for me is inside my own home. The smoke is finally clearing a little bit where I am as of today and yesterday. It’s been difficult to have *yet another* thing taken away with not being able to go outside because the air quality is unhealthy or even hazardous. I hope where you are clears up soon too.

    • JanetDR says:

      Hoping to hear better news for the West coast soon. It’s so alarming and so many lives impacted.

  6. Heylee says:

    If you had asked me the average level of anxiety I have on a day to day basis I would probably say 3 or 4. I don’t have panic attacks but I can on occasion really spin myself out if I’m stressed already.

    I mention this because my anxiety is currently keeping me from doing things like eat outside at a restaurant. My husband has been trying to convince me to relax the safety precautions I’ve insisted upon, but i try to explain that if I think something is not really safe, I just can’t do it because my anxiety during and afterward will be so uncomfortable. I wonder how many people eat at a restaurant right now and feel zero anxiety? Unicorn people to a brain like mine.

    • Case says:

      @Heylee, I know plenty of people who aren’t comfortable dining out at all, myself included, so don’t feel bad about it! I know it’s easy to look on social media and feel like everyone else is just “back to normal,” but that’s not the whole story. It took me until probably June or July before I even felt comfortable getting takeout, and that’s only because I read a lot about exactly why it is safe to do and how to properly disinfect containers. I think now is a really important time to have confidence in your boundaries and stick to them — anxiety is actually a good thing to listen to during a pandemic, lol.

      I truly can’t even begin to fathom the mindset of people who are so unconcerned about Covid. Maybe I’m over the top in the other direction, maybe I COULD do more, but the risk is too great in my eyes.

    • Maxime duCamp says:

      I tried outdooor dining for the first time last weekend and it was better than I expected but it’s not something that I plan on doing regularly. It also helped that I went at an odd time–mid-afternoon, after the lunch rush but too early for dinner–and that the restaurant had great protocols in place. The tables were spread out and it’s a small place so there weren’t more than 10 tables total. There was a hostess who explained the process and directed you to an open table; she also helped people who were having technical issues ordering via the website. Most tables had just couples and even a few solo diners like myself. There was one table with a multi-generational family that had 8 people. You had no contact with the wait staff. The table had a QR code to scan from which you were directed to their online menu and ordering website. You ordered and paid online. Staff delivered orders to two small tables that had been established as order drop-off stations and announced the name of the person who had ordered. All staff was wearing masks as was everyone outside the cordoned off outside seating area; most people within the cordoned off seating area kept their masks on until their food arrived. But this was one small place that had a good system going and not how all places operate. I took a calculated risk because I live alone in a small studio apartment and don’t get outside as often as I should; I live in an area where people are generally very good about wearing masks all the time when out in a public space, even if it is outdoors; and in a month or two it will be too cold to eat outside anyway. I’ve been very cautious during the entire pandemic and haven’t met up with any friends or family since mid-March, I felt it was one small, relatively safe thing that I could do on a nice day to restore a small bit of normalcy to my life before I go completely feral but I totally understand that others might make a different risk vs. benefit analysis.

      • Pusspants says:

        Wow! That’s the most impressive contact-less restaurant system I’ve learned about. I don’t blame you for wanting to get out to do something normal since you live in a studio alone. I’ve avoided restaurants, other than take out, but I can also eat on my side deck & live with another person (my husband). Your approach makes sense to me (i.e., doing a few things carefully so you can have some social engagement). Thank you for being careful & I hope you are able to continue to find safe ways to socially engage during the pandemic!

    • Amber says:

      You are not being unreasonable. This is a very reasonable fear to have. Dining out, to me, is not worth dying for. I’d rather take limited risks for things that are deeply meaningful to me like spending time (outside, six feet apart) with a friend, or visiting a national park and being in nature (with a mask, on a less-populated trail). We all have our own boundaries and thresholds for what level of risk we are willing to accept.

      • jbones says:

        This is what I love about this site; so many like minded people all together. It’s an Individualistic, laissez faire, sh*tshow out there and I take comfort in the comments here.

  7. Kate says:

    When I was recently interviewing nanny candidates for my kid (keeping him home from preschool this year) I was texting with one woman who seemed great on paper. She mentioned she was out with her family at some diner because “it’s the only place without a wait lately” and I was like …oh.

  8. GrnieWnie says:

    Social scientist here. The study ostensibly wasn’t designed to isolate causation, so the best it can do is show correlation. But there is an obvious causal logic: people who are in public spaces, particularly indoors and without masks, are more likely to contract the virus (as the authors observe). This is due to the nature of the virus itself, which we have some concrete knowledge about. In order to show causation, a study has to demonstrate the causal logic and eliminate other possible causes.

    Sometimes too much is made of causation vs correlation. It matters much in research, where certainty is prized. But for real life, the distinction matters a lot less. The causal logic (the “why” and “how” part) here is basic, given what we know about the virus, and the study suggests exactly the outcome we might expect. Though we can’t speak with certainty, the takeaway–that eating in restaurants increases your chances of contracting the virus–is common sense. In other words, the research simply further supports what we already generally know.

  9. Sarah says:

    I think the correlation point is very important, as mentioned in the story people eating out may also be more prone to other risky behaviour. We know this is airborne and can hang around in the air, if you are spending time around others and without masks your chances of becoming inflected are going to be higher.

    I’m not a particularly anxious person and our city here in the UK is doing really well at keeping infection levels low (watch this space as all the students arrive in the coming weeks – I am NOT happy that people from all over the country will be coming here) and a couple of friends have suggested eating out but I keep seeing servers in restaurants without masks, leaning over tables and generally doing their job. Just nope. I can’t do that.

  10. lucy2 says:

    I’ve only done outdoor dining, and only at 2 places – both where everyone was wearing a mask when not seated, and where the tables were very far apart and in open area (not a tent with the sides down as others here seem to think is ok!). My state just opened up 25% capacity indoor dining, and I have no desire to do it. I will continue to get take out to support local places, and outdoor dining where there are proper precautions, but that’s it.

  11. Smalltown Girl says:

    Masks are required by law here. It is the new norm. You can take your mask off at the table if you eat indoors, but have to wear it the moment you get up.

  12. JanetDR says:

    A co-worker and both took a leave for Fall once we learned that we were doing a hybrid plan (Speech pathologists in a special ed preschool). We were messaging about perhaps trying to see each other, but after discussing options, realized that it wasn’t worth it. I’ve done just a few socially distanced, masked visits and it is an adjustment to not eat or drink together! I would rather Zoom for sure.

  13. Veronica S. says:

    Not surprised. I ate out once since the rules relaxed here because we wanted to support a local restaurant, and it was definitely nerve wracking enough that it wound up being the first and last time. It just doesn’t feel right making waitresses handle so much that touches your mouth.

  14. Hmppyy says:

    I also wonder if this has something to do surf restaurant workers touching food. I ordered a sandwich to go at Starbucks yesterday and just felt a bit queezy seeing that non of the employees were wearing gloves and they were directly touching my food. Seems like just one sick employee could infect a lot of people

    • Case says:

      Technically you’re not supposed to be able to catch COVID by ingesting it. Someone sick could cough on your salad and you still shouldn’t get it.

      • ME says:

        Explain to me how this works. Say you touch something, the virus gets on your hands, and then you touch your mouth, you could infect yourself. But somehow food entering your mouth that is infected with Covid won’t make you sick?

      • Case says:

        @ME I know it’s weird, but everything I’ve read from experts says it must get into your respiratory system to properly infect you and make you sick, and that since it is not a food borne illness, you can’t get it from consuming, say, droplets that are left on your pizza. Of course they’re still researching, but there’s been no indication that is a way the virus spreads. Even your example of getting the virus on your hands and then touching your face has proven to be a very uncommon way of getting the full-on virus now that they’ve done more research.

    • Amber says:

      Depending on what state you’re in that could be a health code violation. I worked as a waitress in a bar and I had to get my food handlers’ certificate and in California you *have* to wear nitrile gloves (a new pair for each sandwich!) every time you prepare anything like a sandwich, or basically any time you touch anything that’s not going to then be cooked. So if I were cutting strawberries to make jam, I didn’t have to wear gloves because they were going to simmer at medium-high heat for a while and effectively be sterilized (I typically wore gloves anyway). But making a salad, slicing cheese or meat or tomatoes, toasting bread for sandwiches, mashing avocados for avocado toast…all of that goes straight into somebody’s mouth after you prepare it and isn’t cooked. I used to go through dozens of pairs of gloves during each shift. It could be that they are experiencing supply chain shortages as nitrile gloves are also used in hospitals. It does seem like COVID19 is not likely to be transmitted from eating food but other diseases can be.

    • Nic says:

      I know at our Starbucks the dont use gloves but they use a pair of tongs to open the bag your food item goes in and then to pick up the food item as well. Maybe they did that? I’ve been weird about people handling my food since before the pandemic so I pay attention to things like that.

      • CROWHOOD says:

        The guidance on gloves for Starbucks is to utilize tongs in place e of gloves and wash hands constantly. Their fear is that with gloves, people won’t change them enough and you do not wash your hands with gloves on.

  15. manda says:

    To me, this study seems really small, but maybe it’s enough for statistic significance. I barely got a B- in stats so I know I don’t know.

    My husband and I recently ate outside at a restaurant, and there were literally no other people there, but it felt weird taking off the mask. We only did it because we needed to eat, we were in an area with a much wider array of restaurants than near our house, and the place was dead. I keep thinking that there are no restaurants near me that are that good or have that great of an atmosphere that I am willing to eat inside rather than get take out. It just doesn’t make sense.

  16. Amando says:

    I haven’t been to a sit down restaurant since February. It’s not worth it. Just get take out folks.

  17. mimi says:

    Two other things about the study:
    - The subjects were between the ages of 18 and 40
    - The number of people dining together from different households was not addressed
    These are important additional factors to the “indoor vs outdoor” differential that just 2 weeks ago was being sanctioned by the CDC.

  18. Liz version 700 says:

    The problem with indoor areas is they haven’t fully addressed the ventilation issues. You can be sitting 20 feet away but if someone sneezes in front of the ac… and this doesn’t surprise me at all. My husband and I are doing delivery only until the US gets someone who cares about people dying in charge. I miss restaurants like crazy, meeting friends, seeing somewhere besides my house. But I don’t think certain indoor spaces are safe. I am also not going anywhere near a gym.

  19. Lolagirl says:

    My partner and I own a restaurant on an island in WA state and have made the really brutal decision to only offer takeout for the duration of this. If you can imagine, people have very strong opinions about what we’re doing. There is something to be said however, for the kind of people traveling and dining right now… generally they do not feel like this is an issue to begin with, so it’s been a little murky to navigate. I keep seeing news of gatherings, even outside, increasing the spread. As there’s no way to feel we can keep our small staff safe while offering in person dining, takeaway it is.

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