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Indoor Dining and COVID-19 in Spain and the United States

image of an indoor restaurant

April 7, 2021

Despite mounting evidence in support of restricting indoor dining to reduce COVID-19 transmission, many cities and states in the United States have recently begun loosening restrictions on indoor dining, even with persistently high COVID-19 infection rates. In Europe, Spain has seen similar issues in regard to the opening of bars and restaurants.

Usama Bilal, MD, PhD, MPH, assistant professor at the Urban Health Collaborative (UHC), was recently tasked, along with Javier Padilla, MD, MPH, MSc, and former postdoctoral fellow at the UHC Pedro Gullón, MD, PhD, with creating a report on the evidence about indoor dining and COVID-19 transmission for the health commissioner of the Asturias region of Spain. After the region closed indoor dining, the restaurant industry sued the regional government in Asturias in hopes of loosening restrictions. The team’s report sent to the health commissioner, using data from the United States, South Korea, China, and the UK was instrumental in the court’s decision to keep restrictions in place to limit transmission from indoor dining. The national government in Spain has recently adopted similar restrictions on indoor dining, citing this same report.

Domestically, an op-ed from Bilal and colleague Alina Schnake-Mahl, ScD, MPH, postdoctoral research fellow at the UHC, further elaborates on the implications indoor dining has on the pandemic. The article mentions that a CDC study found that people who tested positive for COVID-19 were twice as likely to have reported eating at a restaurant in the past two weeks as those who tested negative. A brief, created in partnership between the UHC and the Big Cities Health Coalition, highlights how state governments have at times limited cities’ ability to regulate indoor dining, potentially leading to higher case rates in cities that re-opened dining. 

Public health interventions are vital to help stop the spread of COVID-19 and reopening indoor dining “flies in the face of increasing evidence that restricting indoor dining is among the most effective measures for reducing COVID-19 spread,”Dr Bilal and Dr. Schnake-Mahl noted about the costs of reopening.  

Read more about Dr. Bilal and Dr. Schnake-Mahl’s work.