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People who tested positive for COVID-19 were twice as likely to have dined at a restaurant: CDC study

The study didn’t differentiate between the style of dining, which could have a bearing on risk of exposure.

People who tested positive for COVID-19 were roughly twice as likely to have dined at a restaurant than those who tested negative for the disease, a new study from the U.S. Centers for Disease Control and Prevention (CDC) suggests.

The study included data on 314 adults who took COVID-19 tests after experiencing symptoms in July — 154 “case-patients,” who tested positive; and 160 “control-patients,” who tested negative. Health care professionals conducted the tests at 11 facilities in 10 U.S. states: California, Colorado, Maryland, Massachusetts, Minnesota, North Carolina, Ohio, Tennessee, Utah and Washington.

Forty-two per cent of the case-patients reported having close contact with someone known to have COVID-19, compared to 14 per cent of the control-patients. The majority of this close contact (51 per cent) took place among family members.

Mask-wearing was comparable between the two groups: 71 per cent of the participants with COVID-19 wore a face covering in public, compared to 74 per cent of those who tested negative. Likewise, they engaged in activities which can result in a risk of community exposure. Researchers found similar rates in case- and control-patients when it came to shopping, going to a salon or gym, and attending in-home gatherings or religious services.

Where they deviated, the researchers said, was in dining out at restaurants (including indoor dining rooms, patios and other outdoor seating). Case-patients were roughly twice as likely to report dining out at some point within the two weeks prior to becoming ill than the control group.

“In addition to dining at a restaurant, case-patients were more likely to report going to a bar/coffee shop, but only when the analysis was restricted to participants without close contact with persons with known COVID-19 before illness onset,” the researchers noted, adding that cases of COVID-19 exposure in restaurants have been tied to air circulation. “Direction, ventilation and intensity of airflow might affect virus transmission, even if social distancing measures and mask use are implemented according to current guidance. Masks cannot be effectively worn while eating and drinking, whereas shopping and numerous other indoor activities do not preclude mask use.”

 “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 wrote.

Among the limitations of the study, the researchers wrote, was that they didn’t differentiate between the style of dining in their questions (e.g., indoor versus patio), which could have had a bearing on exposure. Additionally, the 11 health centres may not be representative of a larger group of people, they explained, and the participants were aware of their test results, which could have coloured their responses.

Despite the limitations, the researchers highlight that eating and drinking at restaurants and other foodservice establishments “might be important risk factors” associated with COVID-19 infection. “Efforts to reduce possible exposures where mask use and social distancing are difficult to maintain, such as when eating and drinking, should be considered to protect customers, employees and communities,” they wrote.

How to dine out safely has been top of mind for many since restaurants have started reopening across the country . Restaurants Canada estimates 10 per cent of restaurants have closed permanently due to COVID-19. By November, that number could increase to 60 per cent, according to the Canadian Chamber of Commerce. With the promise of patio dining receding as temperatures drop, the question is only becoming more pressing.

While there’s no evidence to suggest the spread of COVID-19 by handling or eating food, according to the CDC and the World Health Organization, there are steps you can take to reduce risk of contagion in a restaurant setting. Before you go, check the restaurant’s website for information on their COVID-19 safety protocols, and call to ask if all staff are wearing masks, the CDC suggests .

While you’re at a restaurant, practice good hand hygiene, wear a mask when you’re not eating, avoid high-touch areas such as self-serve touchscreens and shared serving utensils, and maintain a distance of at least two metres (six feet) from other people. “Try to assess the whole environment,” Jeffrey Farber, a professor of food microbiology at the University of Guelph, told the National Post in June . “Go into something where you’re going to feel safe and enjoy yourself.”

The lowest risk option, according to the CDC , is choosing a restaurant offering exclusively drive-through, delivery, takeout and curbside pickup. On-site dining — even outdoors at a distance — presents more risk.

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