How to stay safe in restaurants and cafes

(CNN) – As restaurants and bars reopen to the public, it is important to understand that eating out will increase the risk of exposure to the new coronavirus.

The two most important public health measures minimizing illness are almost impossible in these situations: First, it is difficult to eat or drink while wearing a face mask. Second, social distancing is difficult in cramped spaces usually filled with back-to-back seats and waiters weaving among busy tables all evening.

So what to look out for and how can you and the restaurant reduce the risk? Here are answers to some common questions.

How much should there be tables and bar stools?

There is nothing magical about the height of six meters, as we often hear in the official instructions of government agencies. I would consider the minimum distance required for a safe distance.

The “six-foot” rule is based on old data on how droplets can spread respiratory viruses remotely. These droplets are deposited from the air within six feet, but this is not always the case. Aerosols can spread the virus over longer distances, although there is still uncertainty about how frequent this spread is. Particles formed by sneezing or someone running can cross up to 30 feet.

It has been shown that just talking creates respiratory droplets that could be contagious.

If a fan or electricity is generated in an enclosed space, such as a restaurant, the particles will also travel further. This was shown in a paper from China: People in a restaurant downwind of an infected person became infected even though the distance was more than six feet.

The greater the distance and the longer it is exposed to a person contagious, the greater the risk.

If servers wear masks, is that enough?

If servers wear masks, it will give them a layer of protection, but customers who eat and talk could still spread the virus.

One way to reduce the risk in this imperfect situation, at least from a public health point of view, would be to place tables surrounded by protective barriers, such as plexiglass or screens, or to place tables in separate rooms with doors that can be closed. Some states encourage restaurants to limit each table to just one server that delivers everything.

Restaurants could also screen guests before entering, either with a temperature check or questions about symptoms and their close contacts with those recently diagnosed with Covid-19. It’s debatable, but restaurants in California have tried it. The state of Washington tried to ask the restaurant to record the contact details of visitors in case epidemics were discovered, but this was withdrawn and they only recommended it.

It is easier to inspect employees. In fact, the Centers for Disease Control and Prevention guidelines recommend that restaurants be inspected before employees before reopening. But while testing employees for a possible infection could reduce the risk, it’s important to remember that people can be contagious six days before they develop symptoms. That is why masks, eye protection, social distancing and hand hygiene are key measures to prevent infection.

Should I request disposable utensils and wipe everything down?

Regular washing of dishes, glasses and utensils and washing napkins and tablecloths will inactivate the virus. There is no need for disposable supplies here.

The table should also be cleaned and disinfected between uses and marked as sanitized.

Menus are a little more problematic, depending on the material. Plastic menus can be disinfected. Disposable menus would be more ideal. Remember, even if someone touches the surface with an infectious virus, until they touch their mouth, nose, or eyes, they should be safe. Therefore, when in doubt, wash your hands or use a cleanser.

Can I get the virus from food from the kitchen?

The risk of contracting a new coronavirus from food is very low.

This is a respiratory virus whose primary mode of infection is access to the upper or lower respiratory tract via droplets or aerosols that enter the mouth, nose or eyes. It needs to enter the airway to cause an infection, and it cannot do so through the stomach or intestinal tract.

The virus is also not very stable in the environment. Studies have shown that it loses half of its virus concentration after less than an hour on copper, three and a half hours on cardboard and just under seven hours on plastic. If food becomes contaminated during preparation, the cooking temperature is likely to inactivate much, if not the entire virus.

The use of masks and the maintenance of good hand hygiene by food preparation should significantly reduce the risk of food contamination.

Is sitting outdoors or driving safer?

Vulnerable people may want to switch to dinner and focus on picking up or perhaps out of lunch, if conditions are appropriate.

Upgrade or performance windows are probably the safest; transient interaction with one person when everyone is wearing masks is a lower risk situation.

All in all, outdoor dining is safer than dining indoors, and everything else is equal to a non-working day due to the larger volume of air. Maintaining eye protection through goggles and occasional use of masks between bites and sips would further reduce the risk.

Thomas A. Russo is Professor and Head of Infectious Diseases in the Department of Medicine, University of Buffalo, New York State University.