This is the worst thing you can do during COVID-19

In anticipation of a seasonal COVID-19 surge, medical experts have begun drafting risk assessments for commercial markets.

While some state officials have decided against shutdown easing amid rising cases, others have opted to permit indoor dining in accordance with public health guidelines.

But are they enough? Well, that depends on the status of your region and the frequency with which you come into contact with disproportionately affected populations.

There are a lot of variables to consider, but if we’re strictly talking about reducing coronavirus cases, social distancing is the most effective countermeasure introduced thus far.

“With masks off, we have to rely on the other precautions, especially social (or physical) distancing, good hand hygiene, and respiratory etiquette. Distancing almost always means reduced occupancy to allow sufficient room between tables,” epidemiologist, Dr. Stephen Morse at Columbia University explained in a recent release. “There have been cases of SARS-CoV-2/COVID-19 caught in restaurants, including Sweden and the UK, although it’s not always possible to say how carefully precautions were observed, and the much riskier bar or pub areas can’t always be differentiated.  There are also anecdotes, which are not data but get published for their inherent interest.  One oft-cited case involved a restaurant in Germany, where a diner leaned over to a neighboring table to ask to borrow the salt shaker.  That was claimed sufficient to allow the borrower to get not only the salt shaker but also the infection from his neighbors.  Probably very rare, but reminds us to keep our guard up (which I think, sadly, takes much of the fun out of eating out).”

According to recent data conducted by researchers at the University of Alabama at Birmingham and published in the Open JAMA Network, the US could have experienced 220% higher rates of infection and a 22% higher mortality rate without stay-at-home orders (SAHO).

This is important because the severity of commercial restrictions is dependent on daily case averages. States who have demonstrated an ability to keep cases low are justified in their decision to ease limitations.

“This cross-sectional study used daily, state-level data on COVID-19 cases, tests, and fatalities from the COVID Tracking Project. Data from March 1 to May 4, 2020, for all states (except Washington state) as well as the District of Columbia were used,” the authors wrote in the new paper. “During March and April, most states in the United States imposed shutdowns and enacted SAHOs in an effort to control the disease. However, mixed messages from political authorities on the usefulness of SAHOs, popular pressure, and concerns about the economic fallout led some states to lift the restrictions before public health experts considered it advisable.”

This disparate reaction to communal outbreaks is believed by many to be the reason cases in the US only plateaued as opposed to meaningfully decreasing. Last week, national coronavirus cases reached an all-time high.

Cases peaked for the first time back in early April with 30,000 new cases across a rolling seven-day-average. This peak briefly lost its pace only to rise to 66,000 new cases by July 19th.

Alabama, Delaware, Hawaii, Kentucky, Louisiana, Maine, Texas, and Vermont are currently the only states evidencing a reduced growth curve.

A new model developed by the Institute for Health Metrics and the University of Washington School of Medicine posits that COVID-19’s death toll might rise to 389,087 in the US by February 2021 if no major interventions are initiated and adhered to nationwide.

“The winter surge appears to have begun somewhat later than the surge in Europe. Daily deaths will reach over 2,000 a day in January even with many states reimposing mandates before the end of the year,” the researchers wrote.

Facts like these are often critiqued as fear-mongering or doomsaying, but only by those who have not experienced the destruction of COVID-19 first hand.

Who doesn’t miss ranking diner coffee and googling perfect first date locales? Sadly, normalcy is lethal to a larger majority of Americans.

Recently, the CDC updated its guidelines in light of commercial easing initiatives.

To design a new risk model the agency launched an investigation that included adults aged 18 years and older who received the first test for SARS-CoV-2 at an outpatient testing center between July 1st and July 29th, 2020.

The analysis found that those who tested positive for the virus were twice as likely to have visited a hospitality establishment (both indoor and outdoor) in the past two weeks. Eating and drinking activities and those done without masks increased dramatically this likelihood.

From the report:

“Community and close contact exposures continue to drive the coronavirus disease 2019 (COVID-19) pandemic. CDC and other public health authorities recommend community mitigation strategies to reduce transmission of SARS-CoV-2, the virus that causes COVID-19. Characterization of community exposures can be difficult to assess when the widespread transmission is occurring, especially from asymptomatic persons within inherently interconnected communities. Potential exposures, such as close contact with a person with confirmed COVID-19, have primarily been assessed among COVID-19 cases, without a non-COVID-19 comparison group.”

It’s not that there aren’t safe ways to dine indoors, it’s more that you can’t account for everyone’s understanding of the seriousness of the pandemic.

Let’s say 10 people visit a dining establishment and 2 don’t believe the novel coronavirus is real, 3 believe they’re effectively immune to it and one can’t be bothered to be informed about the relevant parameters (it’s hard to blame them).

The remaining four might not have visited the said-establishment had they been privy to the mentality of the others beforehand–saying nothing of the technical overhauls establishments need to undergo to safely host patrons.

“Indoors, good ventilation also becomes essential, with as much air movement as possible (open windows, fans, or good A/C).  My general rule is as much ventilation as feasible, although there will always be hard choices.  For HVAC (building air systems), there are a number of recommendations from ASHRAE, the Association of Heating, Refrigerating, and Air-Conditioning Engineers, including high-efficiency filters in the system, and fairly frequent air exchange in the room (for offices, they recommend at least 4 replacements of the room air per hour, but for multi-occupancy spaces, like restaurants, that would be higher). All of these do their part to reduce risk,” Morse continued.

“Dining out should be an enjoyable experience, and it’s heartbreaking to see so many of our local attractions – including neighborhood restaurants – closing or on the verge of going under.  We’ve seen so many empty storefronts. On the other hand, I haven’t personally mustered the courage for indoor dining, “In any situation, we’re reducing the risk. There are few, if any, guarantees in life.  The current ceasefire with the virus can change at any time and should remind us not to be complacent, but we’re probably better off than some other places that have more virus currently circulating.”

The restaurant industry accounts for 11 million jobs and more than 4% of the GDP. There is no economic recovery without it. Even the most radical SAHO concede that.

“While the high economic cost makes SAHOs unsustainable as a long-term policy, our findings could help inform federal, state, and local policymakers in weighing the costs and benefits of different short-term options to combat the pandemic,” The University of Alabama researchers concluded.