Mar 22, 2021

COVID-19 Update

World
New Cases:   426,143 (⬆︎ .34%)
New Deaths:      6,023 (⬆︎ .22%)

USA
New Cases:   39,505 (⬆︎ .13%)
New Deaths:       455 (⬆︎ .08%)

Vaccination Scorecard
Total Vaccinations:          81.4 million 
(⬆︎ 2.5%)
Total Priority Population: 66.8%
Total Population:             24.5%




Keep your guard up.

WaPo: (pay wall)

As vaccinations increase, you may want to dine indoors again. Here’s what to consider.


Not for the first time in this pandemic, the ground is shifting. This time, the news is good: After a slow start, more and more people are getting vaccinated against the coronavirus. And many restaurants around the country are reopening dining rooms, bringing back business to a hard-hit industry.

That might be worth a toast at your favorite neighborhood hangout — but these glad tidings also come with a heaping side of uncertainty.

Vaccine rollouts are happening at varying paces, meaning families and friend groups won’t all have their shots at the same time. Restaurant regulations still vary widely by jurisdiction, and a few places have pretty much lifted restrictions, which some have interpreted as permission to party like it’s 2019.

Who can dine together? Can I eat indoors again? Should I? Those are just some of the questions diners are considering as they think about booking a table during this in-between time, when millions of Americans are getting vaccinated daily but before we’ve reached herd immunity.

The answers aren’t always clear-cut.

“There’s no such thing as zero risk, and nothing is 100 percent risky,” says Leana Wen, a visiting professor of health policy and management at the George Washington University Milken Institute School of Public Health and contributing columnist at The Washington Post. “It’s a spectrum.” She has long urged people to think about their risks as expenditures from a “coronavirus budget,” and says the budgets of those who have been vaccinated just went way up. “You still have to think about how to spend it, and if your priority is seeing grandchildren and going to church, then maybe you’re not going to restaurants all that often.”

With encouraging headlines, springlike temperatures and our collective covid fatigue at an all-time high, it might be tempting to throw caution — and another round of takeout — to the wind. But experts agree that now is not the time to lower your guard, but instead to maintain your vigilance so we can return to something like normal by the fall.

For most people, who aren’t vaccinated, restaurants can still pose risks. A study released this month by the Centers for Disease Control and Prevention found that counties allowing in-person dining at restaurants saw a subsequent rise in cases and deaths. That followed an earlier CDC finding that people who were infected in July were more likely to have dined at a restaurant.

We spoke to public health experts, scientists and industry representatives about dining in this new, partially vaccinated world.

Whom can you dine with?

The CDC’s guidelines for vaccinated people, two weeks past their final shot, applies only to private settings. Anthony S. Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, has said guidance for public places is coming soon, although the agency doesn’t have a firm release date yet. In its initial advice, the CDC focused on what vaccinated people could safely do in their homes, and urged them to continue taking precautions including masking and distancing in public settings.

The agency is cautious about issuing dining guidelines because of too many unknowns, said Greta Massetti, co-leader of the CDC’s Community Inventions and Critical Populations Task Force. “First of all, if you go to a restaurant, you will not know the vaccination status of any of the other patrons or any of the people who work there,” she says. "And likewise, the restaurants themselves won’t know whether people are vaccinated who walk through their doors.”

To figure out whom you can break bread with in public, first check to see how many people are legally allowed to be seated as a party where you live. But numbers aren’t the only factor to consider. Wen notes that eating in a group means you can’t observe the usual protocols.

“When you’re dining in a group, you’re going to have your masks off, and you’ll be sitting in close proximity to one another,” she says. While it’s fine for multiple vaccinated people to be seated together, “fully vaccinated people should not be dining with unvaccinated people, and unvaccinated people should not be dining with one another.”

It isn’t yet clear to public health experts whether vaccinated people can spread the virus. That means up-close interactions between the vaccinated and the unvaccinated may still carry risk. “It’s less safe,” says Jennifer Kolker, a professor at Drexel University’s Dornsife School of Public Health. “There’s more data showing that the chance of a vaccinated person passing it on is pretty low, but we don’t know for absolutely sure.”

Even if you’re gathering your friends for a celebration of everyone’s newly vaccinated status, keep the party on the small side. “The larger the group, the harder it is to know and trust that they’re fully vaccinated,” Wen says.

What to consider before you go

Before you make a reservation, think about the infection rate in your community, Kolker advises. High rates increase the infection risk for anyone. “Being vaccinated when there’s a lot of disease in your community means you’re highly protected ... but there’s still more disease coming at you,” she says.

The consensus is that outdoors is safer than indoors, though some people have become infected by eating too close to asymptomatic carriers on patios and the like. The CDC recommends that you eat on patios or in well-ventilated tents because you “are less likely to get or spread Covid-19 during outdoor activities.” But the agency cautions that even outdoor diners should wear masks when not eating or drinking, and maintain six feet of social distance.

Whether you’re thinking about dining inside or out, first check out the restaurant to see its setup and safety precautions. Is there a touchless payment system? A time limit for diners? Distance between tables? Some restaurants are spelling out covid protocols on their websites or on social media. But if you’re unsure, pick up the phone.

“Customers … should be calling the restaurant and saying, ‘What are you doing? What are you doing to make me feel safe?’ ” said Larry Lynch, senior vice president for science and industry at the National Restaurant Association.

That can help you decide if you’re comfortable — and lessen the chance of conflict or confusion.

Tiffanie Barriere, a brand and bar consultant in Atlanta, advises patrons to be more mindful than ever about restaurants’ rules. “Call before you come and see what’s the protocol if you want to bring your friends, or if you want to bring a baby,” she says. “See if it’s for you. It might not be.”

The adage that the customer is always right has gone out the window, she says: “It’s not your place, it’s theirs. The second you want to make it your place, all hell breaks loose, and we’ve all seen those viral videos.”

If all this fact-finding sounds like too much, or you still don’t want to take a risk, remember: You can always support your favorite restaurant with takeout.

Sanitation still matters


By now we know that there’s only a small risk of surface transmission of the virus — that is, via commonly touched surfaces, such as menus or credit cards. Still, restaurants offering hand sanitizer and frequently wiping down spaces may not just be engaging in “sanitation theater.” “If they’re paying attention to this, there’s a good chance they’re being attentive to the virus in other ways,” Wen says.

Restaurants and bars have long operated under health codes that require proper food handling, storage, sanitation, hot water, hand-washing, hygiene and more to prevent the spread of food-borne illnesses. But Lynch says the pandemic has required managers to expand their thinking about sanitation. Servers now wipe down everything and make sure they’re “familiar with the kinds of chemical compounds that can be used safely and effectively against covid-19,” he said.

Air quality and environment

Unless you’re an environmental engineer, it’s almost impossible to judge the quality of a dining room’s ventilation and filtration systems based on appearances alone, and even specialists need to conduct tests and review data. The best a diner can do is ask about a system and whether owners regularly service it.

“Think about your own home system,” Lynch said. “The moment they come in and service it for the season, whether it’s for the winter or summer, you automatically get this better air flow. ... It’s the same thing in a commercial structure.”

This subject gets very complicated very fast. Some restaurants, like a South Korean one that was the subject of a well publicized study on air flow last year, have no ventilation system at all. The restaurant relied on air conditioning units to move air throughout the dining room; two diners were infected with coronavirus because they sat in the direct air flow from a third, asymptomatic customer.

Diners may feel as if they are playing Russian roulette, because they can’t determine what indoor environments are safe. What kind of filtration system does the restaurant have, and how often is the air exchanged? Does the restaurant have a carbon dioxide detector, which may indicate how well-ventilated a room is and whether there is a concentration of coronavirus aerosols?

Donald Milton, professor of environmental health at the University of Maryland School of Public Health, says one of the safest units is also one of the rarest: an upper-room ultraviolet germicidal system, which disinfects the air with UV light. But it can cost thousands of dollars to install per room, and it works only in high-ceiling spaces. But Milton says these systems could benefit restaurants even after the pandemic by protecting against seasonal flu, which kills tens of thousands of Americans annually.

Short of the UV systems, Milton says, restaurants could use portable HEPA filter units. “Even if they’re not particularly well-placed, as long as they’re not all just on the perimeter, that’s going to create a much better environment," he said.

Are restaurant workers vaccinated?

If you’re vaccinated, and the servers are fully masked, they probably don’t pose much of a risk to you, Wen says. But dining indoors is not just about your safety; it’s about the servers, back waiters, bussers, bartenders and anyone else who comes in contact with customers. In some places, such as New York and Kentucky, food service workers are getting vaccinated, but in others, such as Florida and Louisiana, they are still waiting for an eligibility date.

“Unfortunately, we’ve got this patchwork quilt of regulations around the country, so there’s no solid way we can get everyone vaccinated in the same way at the same time,” said Lynch of the National Restaurant Association.

That is why the association asks members to maintain protocols that have been in place for months, including encouraging diners to wear a mask at the table when not eating or drinking. That’s especially important where food service workers — who spend hours exposed to the breath of countless diners — are still waiting for vaccine appointments.

The national association and state groups are educating workers to communicate with customers that the server-diner relationship is not as one-sided as before the pandemic. The goal is to convince diners of the mutual respect needed when diners may be vaccinated (and potentially still contagious) but servers are not, and when some states have lifted mask mandates but President Biden has issued a nationwide one.

The idea, said Lynch, is to have servers explain that they’re protecting customers by wearing a mask — and that they need the same protection from diners in return.

A year ago in the Lone Star State, a similar spirit led to a social contract called the Texas Restaurant Promise. By posting the promise on their door, restaurants agree to have employees pass health screenings and wear face coverings, to maintain safe distances between parties, and to disinfect tables between seatings. In return, by entering the restaurant, diners agree to follow protocols and instructions from employees, including distancing rules.

The gist is simple: “Don’t be a jerk,” said Anna Tauzin, chief revenue and innovation officer at the Texas Restaurant Association.

Texas Gov. Greg Abbott (R) recently allowed restaurants outside areas with “high hospitalizations” to open with no state requirements for mask-wearing or capacity limits, even though its hospitality workers remain ineligible for the vaccine. Tauzin noted that nearly three-quarters of the 725 members that responded to a recent survey said they would continue to require staff members to wear masks. It’s fair to say, she added, that 75 to 80 percent of the association’s 4,800 members would do the same.

Only 38 percent, though, said they would continue requiring diners to wear masks, while 42 percent said they would not and 20 percent said they weren’t sure.

“Frankly, they’re just tired of the confrontation,” Tauzin said. “And if someone comes in, they will remind them, ‘Hey, could you please put on a mask?’ And if they say, ‘No, it’s my God-given right to not wear one,’ then they’re not going to fight them. They’re going to let them sit at the restaurant. They’re going to serve them. And then hopefully those people are not going to wander around licking doorknobs or anything like that.”

A time for patience

Experts say the arrival of vaccines isn’t a moment to let up on precautions; hopefully, we’ll have to live with the stress and inconvenience for only a little while longer. The CDC hasn’t set a target yet for when the agency will declare herd immunity, but Massetti said “more than 70 percent” of Americans will need to be vaccinated. How many more remains unknown until the CDC can review more data on variants, asymptomatic transmission among vaccinated people and other key research.

“We are on the right path," said Massetti. “We want to continue to stay the course to ensure that we stay on that path.”

Kolker says public officials have a tough needle to thread as they’re warning people to stay vigilant about safety precautions even as vaccination rates rise. But there’s still a possibility that before vaccines are widespread, a spike in cases could lead to more lockdowns.

“Telling people to still be careful is a hard message right now," she says. "Because if we’re saying, ‘Get vaccinated, but there’s still doom and gloom,’ it makes it sound like there’s no reason to do it. Everyone is chomping at the bit to get out there and dine with their friends and family, and there’s reason to be hopeful that we will — but we just don’t want to blow it.”

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