COVID-Positive Adults Twice as Likely to Have Dined Out, Study Finds

Adults who tested positive for SARS-CoV-2, the virus that causes COVID-19, were twice as likely to have dined at a restaurant than those who tested negative, according to a new report from the Centers for Disease Control and Prevention (CDC). For anyone planning to dine out, experts recommend opting for outdoor seating and taking additional safety precautions. 

“[The risk] is pretty heightened in a restaurant situation,” Curtis White, PhD, a microbiologist, indoor air-quality expert, and the chief technology officer of ViaClean Technologies, tells Verywell. “You’re going to remove the mask to eat.”

What the Report Found

CDC researchers interviewed 314 adults who received a SARS-CoV-2 test in July about possible virus exposure in the 14 days leading up to their symptom onset. All adults were experiencing symptoms at the time of testing, but the sample size included 154 people who had tested positive and 160 individuals in a control group who had tested negative for the novel coronavirus. 

Researchers asked respondents whether they had been in close contact with someone who had COVID-19. And they polled participants about their mask-wearing behavior, social-distancing measures, and community activities. Respondents who had tested positive for SARS CoV-2 were twice (2.4) as likely to have said they’d dined at a restaurant in the two weeks before they experienced symptoms.

“It’s a small population,” White says of the survey report. “But the cautions and warnings that come from it are still the same. When you’re in public places, you do have to behave differently.”

Indoor vs. Outdoor Dining

The interview question about restaurant dining did not ask participants whether they had dined indoors or outside the eatery. Researchers acknowledge this factor as a limitation of their findings. 

The CDC report interviewed individuals who had received a test at one of 11 U.S. healthcare facilities located in 10 states. According to The National Restaurant Association, those states had varying restrictions on indoor dining as of late July. California did not allow dining inside, for example. Colorado, Maryland, Minnesota, North Carolina, Utah, and Washington allowed indoor seating but at a limited capacity, usually 50%. And Massachusetts, Ohio, and Tennessee allowed 100% seating capacity but with some restrictions in place. In some states, dining restrictions may have varied across counties or cities.

Although the study did not distinguish between indoor or outdoor dining, the CDC researchers write, “Direction, ventilation, and intensity of airflow might affect virus transmission, even if social distancing measures and mask use are implemented according to current guidance.” Researchers also cite a previous study that links virus exposure to restaurant indoor air circulation.

“I really like that they took the time to record the fact that the air-handling system may have been a factor in all of this,” White says. “Drawing on my experience with other disease transmission that are associated with the air and with buildings, like Legionnaires' disease, the differences are like night and day from indoors to outdoors.”

Additional Dining Concerns

Surfaces are also a concern when it comes to dining out, White says. Restaurants, even in non-pandemic times, should have sanitizing protocols in place for washing dishes and utensils and keeping eating surfaces like tabletops clean. 

But any public place also has what White refers to as the “out-of-site-out-of-mind places.” He says the undersides of tables or chairs, which we tend to grab when we sit down and scoot ourselves in, are an example. “If you don't account for those,” he explains, “you’re just leaving transfer routes for the virus.” 

Safety Tips for Dining Out

Although patrons don’t have control over a restaurant’s safety measures, a few observations may help you decide if you feel comfortable dining at a particular place. “Check and see if restaurants are taking this seriously,” Andrew Roszak, JD, MPA, EMT-Paramedic, a pandemic preparedness expert and the executive director for the Institute for Childhood Preparedness, tells Verywell. “Their waitstaff should be wearing masks. Signs should be displayed that encourage social distancing. The more visible precautions that you can see, the better.”

Eat outdoors if possible and away from other patrons. “Generally, being outside is preferred over being indoors,” Roszak says. “I would feel much safer having my family eat outdoors than inside a restaurant right now. The more access we have to fresh air, the better.”

Wear a mask as much as possible to protect yourself and those around you. “Until the food arrives, you should wear a mask,” Roszak says. “It is recommended that children over the age of two wear masks as well. And yes, put your mask back up when the server comes to the table.”

Don’t linger after eating. "The longer you’re exposed to someone with COVID-19, the more likely you are to have symptoms yourself,” Ken Perry, MD, FACEP, an emergency physician in Charleston, South Carolina, tells Verywell.

Practice good hygiene, such as washing your hands or using hand sanitizer. “For now, the tips to staying safe are similar to those for the flu and other viruses,” Perry explains. “Do not share drinks, utensils, or food with others.” 

If you witness practices that concern you, such as servers without masks, remember that you don’t have to stay and dine. “Voice your concerns and leave,” White recommends.