Did shutting down outdoor dining contribute to California’s COVID-19 surge?

Late last week, Chicago mayor Lori Lightfoot — typically cautious on COVID-19 policy — raised some eyebrows after calling for restaurants and bars to reopen "as soon as possible."

Her logic: The current COVID-19 surge has been primarily fueled by at-home gatherings and parties, and if people are going to gather regardless of what any stay-at-home order dictates, state and local governments should try to provide spaces where at least some mitigation efforts will be taken.

"If we have people and give them an outlet for entertainment in the restaurant space, in the bar space, we have much more of an opportunity, in my view, to be able to regulate and control that environment," Lightfoot said. "People are engaging in risky behavior that is not only putting themselves at risk, but putting their families, their co-workers and other ones at risk. Let's bring it out of the shadows."

Lightfoot is specifically talking about reopening indoor dining — an activity that has been directly linked to increased COVID-19 transmission. There has been no such linkage between outdoor dining and COVID-19 transmission, but California banned the activity in most of the state in early December, despite being one of the few states with a winter climate that would support it.

Despite the ban, California has had one of the worst winter COVID-19 surges in the country, which begs the following question: Is it possible that shutting down outdoor dining made the state's surge even worse?

Dr. Monica Gandhi, an infectious disease expert at UCSF, believes it's highly likely.

"We won't be able to know the exact percentage it drove, but I would say closing outdoor dining certainly did not help and likely hindered efforts to avoid a surge," she said. "It shut down in early December, and things did not get better from there; things actually got worse. Restrictions should be about understanding the human condition and keeping places that are safe open. Those of us who argue for a harm reduction approach have the same goal as the lockdownists: We want to reduce transmission, but we understand the human condition and the need to be with people."

When announcing the new stay-at-home order, Gov. Gavin Newsom and California Secretary of Health and Human Services Dr. Mark Ghaly were repeatedly asked to show evidence that outdoor dining contributes to the surge of COVID-19. They provided no such evidence and said that the new business closures were about sending a message to minimize mixing.

Californians apparently didn't get the memo. Gandhi, like many who live in the state, knows of several people in her social circles who continued to meet up despite the stay-at-home order, turning outdoor dining plans into much riskier at-home gatherings.

"I do know that people were far less compliant with this last order," she said. "The state had less of an understanding that people were going to gather, and not because they weren't worried, or because they didn't believe in COVID, but they believed they had a knowledge base from the media about what keeps us safe. With outdoor dining closed, they said, 'Let's go inside with masks and distancing.' Of course, not everyone stuck to their masks and distancing plans once they went inside. You obviously have to take your mask off to eat, and the virus spreads much more easily indoors."

It will be difficult, if not impossible, to quantitatively determine how much of an impact banning outdoor dining had on the surge. But Gandhi believes that logic and overwhelming anecdotal evidence are enough to tell us it had a clear impact.

Some saw this coming.

"It actually seems these sorts of Draconian measures are pushing people into unsafe situations in private homes where safety guidelines cannot be guaranteed, enforced or even expected," Tony Granieri, owner of the Oakland restaurants Brotzeit Lokal and the now-shuttered Magpie, told SFGATE of the stay-at-home order in December.

"We constantly hear that the spread is occurring through private parties and yet we small business owners, doing everything we can to uphold the health standards, are being forced to cut staff and close down without any evidence that we are contributing to the spread," added Sean Sullivan, owner of the Port Bar, the last LGBT bar still open in Oakland.

Gandhi's "harm reduction" approach calls for recognizing that people are going to gather regardless of any decrees the state and counties might issue. In her view, officials should work to provide guidance on how to make activities as safe as possible.

"At this point in the pandemic, people will gather because they're lonely," she said. "We should have instead figured out how to mitigate risk instead of giving people an absolute no."