States boost restaurant capacity despite feds, experts urging caution. What we know

David Robinson
New York State Team

Many Northeast and Mid-Atlantic states are rapidly moving toward resuming indoor dining at greater capacity despite experts warning that prematurely returning to bustling eateries could help spark a COVID-19 resurgence.

Federal health officials and national infectious-disease experts have urged governors in New York, New Jersey, Pennsylvania, Maryland and Delaware to delay the push to relax, or eliminate entirely, limits on restaurant occupancy capacity.

Rising COVID-19 vaccination rates, experts said, are expected to make indoor dining exponentially safer in a matter of weeks, if not months.

“The overall preponderance of evidence shows indoor dining is risky while vaccination penetration remains lower in the community,” said Dr. Luis Ostrosky, an Infectious Diseases Society of America expert.

In this Sept. 30, 2020, file photo, Waiter Lenworth Thompson serves lunch to David Zennario, left, and Alex Ecklin at Junior's Restaurant in New York.

“What we ask is for a little bit more patience,” he added, describing reopening restaurants as the nation’s latest test in balancing public health and economic interests amid the pandemic.

Governors and restaurant owners, however, asserted mounting vaccinations, declining coronavirus cases and continued safety measures, such as socially distanced restaurant seating and mask wearing while not eating or drinking, justified the push to revive the pandemic-ravaged food service industry.

Indeed, an estimated 110,000 restaurants across the country have closed over the last year, as bars and restaurants finished 2020 about 2.5 million jobs, or 20%, below pre-pandemic levels, according to the National Restaurant Association.

“It’s time to allow our restaurants, bars and other service businesses to get back to more normal operations,” Pennsylvania Gov. Tom Wolf said Monday, announcing indoor dining in the Keystone state would rise to 75% capacity on April 4, up from its current 50%.

Meanwhile, Massachusetts and Maryland have already fully reopened indoor dining on March 1 and 12, respectively. And on Friday, Connecticut restaurants opened at 100%, while New Jersey increased indoor dining from 35% to 50% and New York increased from 50% to 75%, excluding New York City, which remained at 35%. Delaware restaurants remained at 50%.

Amid the reopening effort, progress in the Northeast toward curbing the spread of coronavirus has slowed in recent weeks after drastic declines from the second-wave peak in January.

And federal officials were also monitoring a more contagious variant of the virus spreading in New York City as an emerging threat to reignite the smoldering outbreaks across the region.

“We need to sit tight because if we open up these indoor dining restaurants with no capacity limits, we’re going to see a surge again,” said Dr. Ravina Kullar, another expert with the national Infectious Diseases Society.

What CDC says about COVID and restaurants

Elez Hoxhaj, and his wife, Kim, of Nutley, enjoy a full breakfast on the first day of indoor dining at the Tick Tock Diner in Clifton, N.J. on Friday Sept. 4, 2020. Indoor dining was banned on March 16, 2020 due to the coronavirus pandemic.

Debates over COVID-19 risks at restaurants, in many ways, have been central to the evolving scientific understanding of how coronavirus spreads, according to a USA TODAY Network review of Centers for Disease Control and Prevention studies.

Some of the earliest public health alerts about restaurants stemmed from a COVID-19 outbreak in China, where coronavirus infections among restaurant patrons traced the pattern of air conditioning air flow, a CDC study in July found.

Over the course of 12 days, nine people who dined at the restaurant in China fell ill as a result of another patron with a COVID-19 infection, the study determined.

More: NY restaurants happy about new 75% capacity in return to normalcy

More: NJ restaurants hopeful increased indoor capacity will increase consumer confidence

Of the 91 people in the restaurant during that hour, only those at tables in the way of the air conditioner’s airflow contracted the virus, a finding that contributed to health organizations eventually recognizing that aerosolized droplets can lead to infection.

In September, federal researchers found adults with positive coronavirus test results were about twice as likely to have reported dining at a restaurant than were those with negative test results, CDC reported.

Earlier this month, CDC released a study asserting increases in COVID-19 case and death growth rates were associated with eating at restaurants after indoor or outdoor dining was allowed by a state.

One of the findings noted allowing on-premises dining at restaurants was associated with a 3-percentage point increase in the death growth rate between 81 and 100 days after restrictions were lifted.

But restaurant advocates disputed findings of the CDC analysis released this month, citing in part how it did not control for some other policies that might affect case and death rates, including other types of business closures, physical distancing recommendations and policies issued by localities.

More: Delaware restaurants still struggling a year into COVID pandemic

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The study also did not differentiate between indoor and outdoor dining, adequacy of ventilation, or adherence to physical distancing and occupancy requirements, the National Restaurant Association noted in a statement, calling it “irresponsible to pin the spread of COVID-19 on a single industry.”

“We still do not find evidence of a systemic spread of the coronavirus coming from restaurants who are effectively following our COVID-19 operating guidance, encouraging guests and employees to wear masks, social distance, and practice good hand hygiene,” the group added.

Some attempts to connect COVID-19 infections to restaurants and bars through contact tracing, however, have been hindered by people refusing to cooperate with health officials and gaps in contact-tracing resources nationally.

In New York, for example, contact-tracing data released in December showed restaurants and bars accounted for about 1.4% of 46,000 coronavirus cases traced from September through November, while household social gatherings were identified as the source of exposure in nearly 75% of cases.

Trade groups cited the data as proof of the limited risk of catching coronavirus at a restaurant.

But the findings were hindered in part by the more than 170,000 cases over the same time period where a known exposure source couldn't be determined or an infected person didn't cooperate. And they were also skewed by the high number of household infections, which are by far the easiest to trace.

What experts say about COVID and dining

At the Pour Yard restaurant in Quincy customers can enjoy outdoor dining inside a heated and lighted dome or bubble on Sunday November 8, 2020  Greg Derr/ The Patriot Ledger

Despite the focus on restaurant capacity limits, key factors to reducing risk also include improving air flow and physical distancing while enforcing mask wearing and hygiene rules, experts said.

“The capacity percentage is less relevant than the actual space and conditions at restaurants,” said Ostroksy, a professor of medicine and epidemiology at UT Health in Houston.

“It can be very different for a small bistro than a Cheesecake Factory,” he added.

Some restaurant owners pushing for higher capacity limits, for example, included smaller eateries incapable of boosting the number of patrons while still adhering to rules requiring they sit at tables separated by six feet.

More: Outdoor seating isn't always safer than indoor dining. Here's why.

Ventilation experts have also recently released recommendations spanning everything from how long to wait between seating patrons to filter types and outdoor airflow standards for temporary structures like igloos and tents being used to expand outdoor dining spaces.

In calling on authorities to postpone fully resuming indoor dining, many experts have also noted the same options for supporting restaurants financially over the past 12 months still exist.

“There’s alternatives that are very safe like takeout, and outdoor dining is turning out to be pretty safe as well,” Ostrosky said. “Yes, we need to support our restaurants and restaurant workers, but we need to think about safety.”

USA TODAY Network Atlantic Group reporters contributed to this report.

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David Robinson is the state health care reporter for the USA TODAY Network New York. He can be reached and followed on Twitter:@DrobinsonLoHud