Eating at a restaurant could present a bigger risk for coronavirus exposure than many may realize. In fact, according to new data from the Centers for Disease Control and Prevention (CDC), those who tested positive for COVID-19 were significantly more likely to have eaten at a restaurant in the previous 14 days than those who tested negative.
The study, just published in the CDC's Morbidity and Mortality Weekly Report, looked at data for 154 people who had tested positive for COVID-19 and 160 controls who tested negative at 11 health care facilities around the country. Specifically, the researchers analyzed participants' data regarding demographics, underlying medical conditions, possible exposure to the coronavirus, mask-wearing habits, and other community behaviors, such as going to a restaurant, going to a salon, or attending an indoor gathering.
After analyzing the data, there actually were not a ton of statistically significant differences between the participants who tested positive and those who tested negative. But there were some: People who tested negative were more likely to be white, have a college degree, and have at least one underlying health condition compared to those who tested positive.
But, on the other hand, people with positive COVID-19 tests were significantly more likely to report close contact with people who also had COVID-19 compared to controls. Those who tested positive were also significantly more likely to report eating at a restaurant in the two weeks before they became ill. Of those who tested positive, about 41% said they'd eaten onsite at a restaurant, whereas only 28% of the controls reported eating at a restaurant.
When it came to masks, about equal amounts of participants in each group reported always wearing a mask or face covering of some kind when in public. But among those who went to restaurants, bars, or coffee shops, people who tested positive were significantly less likely than those who tested negative to report that most or all of the customers there were wearing masks. Although the data can't trace exactly where the participants picked up the coronavirus, these results suggest that eating a restaurant could have been a potential source of COVID-19 exposure for those who tested positive—especially at restaurants where most people were not wearing masks.
There are some limitations to this study, of course. For instance, this study only includes people who actively sought out testing, so it may not include those with milder illnesses or those who simply don't have access to a testing site. The study also relies on participants' self-reported behaviors, which may not have been entirely accurate.
And one of the most frustrating limitations is that the data do not separate those who sat indoors at a restaurant from those who sat outdoors. So it's possible that the majority of the trend we're seeing with regards to restaurants is due to indoor seating, which we already know comes with more risk. But it does make sense that restaurants—even those with outdoor seating only—could help fuel the spread of COVID-19 in some unique ways.
When thinking about managing COVID-19 risks, a restaurant can be a tricky situation to navigate—especially those restaurants with indoor seating. For instance, "masks cannot be effectively worn while eating and drinking, whereas shopping and numerous other indoor activities do not preclude mask use,” the study authors write.
So, even if participants in both groups wore their masks about the same amount of time when in public overall, simply eating at a restaurant introduces a situation in which you're probably not wearing a mask and is, therefore, a higher-risk activity. And, whether you're indoors or outdoors, it can also be difficult to stay properly socially distanced in an environment where you don't have control over the distance between tables or seats.
As local governments continue to open up restaurants—including some with indoor seating—it's important to remember that we're still learning about exactly how this virus spreads. So it's crucial to remember what we do know about eating out—sit outside if at all possible, wear a mask as much as possible, opt for takeout or delivery if you can—and to keep in mind that, even with what may seem like proper precautions, you might not be able to eliminate all the risks.