Eating out may come with a higher risk of catching COVID-19 than riding public transportation or getting a haircut at a salon, a study suggests. The findings, from the US Centres for Disease Control and Prevention (CDC), highlight the risk of activities in which people can't always wear a mask and practice social distancing, such as eating and drinking while at a restaurant.
For the study, the researchers analysed information from 314 adults who were tested for COVID-19 at one of 11 health care facilities across the US. All of the participants had experienced some symptoms that led them to be tested. About half of the participants had received a positive test, while the other half received a negative test.
Participants were interviewed about activities they engaged in during the 14 days before their symptoms started, including going to a store, gym, office, salon, bar or coffee shop; attending religious services, using public transportation or dining at restaurants.
Overall, people who tested positive for COVID-19 were twice as likely to report dining at a restaurant in the 14 days prior to becoming sick than people who tested negative. And when the researchers excluded people who had a known contact with COVID-19, they found that those who tested positive were nearly three times more likely to report dining at a restaurant, and nearly four times more likely to report going to a bar or coffee shop, than those who tested negative.
No other activities from the survey were linked with an increased risk of COVID-19. The authors note that one limitation of their study is that it did not distinguish between indoor and outdoor dining.
"Exposures and activities where mask use and social distancing are difficult to maintain, including going to locations that offer on-site eating and drinking, might be important risk factors for SARS-CoV-2 infection," the authors concluded.
The CDC does recommend ways to reduce the risk of contracting COVID-19 while dining at restaurants, including wearing a mask as much as possible when not eating and maintaining a 6-foot (1.8 meters) distance from people you don't live with; sitting outside when possible, and calling ahead to ask whether all staff at the restaurant are wearing masks at work.
What is already known about the topic? Community and close contact exposures contribute to the spread of COVID-19.
What is added by this report? Findings from a case-control investigation of symptomatic outpatients from 11 U.S. health care facilities found that close contact with persons with known COVID-19 or going to locations that offer on-site eating and drinking options were associated with COVID-19 positivity. Adults with positive SARS-CoV-2 test results were approximately twice as likely to have reported dining at a restaurant than were those with negative SARS-CoV-2 test results.
What are the implications for public health practice? Eating and drinking on-site at locations that offer such options might be important risk factors associated with SARS-CoV-2 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.
Kiva A Fisher; Mark W Tenforde; Leora R Feldstein; Christopher J Lindsell; Nathan I Shapiro; D Clark Files; Kevin W Gibbs; Heidi L Erickson; Matthew E Prekker; Jay S Steingrub; Matthew C Exline; Daniel J Henning; Jennifer G Wilson; Samuel M Brown; Ithan D Peltan; Todd W Rice; David N Hager; Adit A Ginde; H Keipp Talbot; Jonathan D Casey; Carlos G Grijalva; Brendan Flannery; Manish M Patel; Wesley H Self; IVY Network Investigators; CDC COVID-19 Response Team
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US CDC abstract