{"id":266154,"date":"2020-08-22T08:05:54","date_gmt":"2020-08-22T12:05:54","guid":{"rendered":"https:\/\/canadianinquirer.net\/v1\/?p=266154"},"modified":"2020-08-22T08:05:54","modified_gmt":"2020-08-22T12:05:54","slug":"deadly-mix-how-bars-are-fueling-covid-19-outbreaks","status":"publish","type":"post","link":"https:\/\/canadianinquirer.net\/v1\/2020\/08\/22\/deadly-mix-how-bars-are-fueling-covid-19-outbreaks\/","title":{"rendered":"Deadly Mix: How Bars Are Fueling COVID-19 Outbreaks"},"content":{"rendered":"
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Many other states moved to reopen bars on a faster timeline \u2014 only to shut them down again as viral case counts rebounded this summer. (Pexels photo)<\/figcaption><\/figure>\n

From the early days of the U.S. coronavirus outbreak, states have wrestled with the best course of action for bars and nightclubs, which largely have their economic prospects tied to social gatherings in tight quarters. As the virus has pinched the industry\u2019s lifeblood, bar owners in a handful of states are fighting in court against government orders that they stay closed.<\/p>\n

But public health experts and top health officials, including the nation\u2019s top infectious diseases official, Dr. Anthony Fauci, have said: When bars open, infections tend to follow.<\/p>\n

Some states moved quickly to shutter bars early in the pandemic for months or longer, keeping them entirely closed or open only under very strict conditions. Many other states moved to reopen bars on a faster timeline \u2014 only to shut them down again as viral case counts rebounded this summer.<\/p>\n

\u201cWe\u2019re big targets. It\u2019s just wrong,\u201d said Steve Smith, whose Nashville, Tennessee, businesses include honky-tonks that serve alcohol and cater to tourists. But some legal experts said public health authorities have broad power to close down any business they deem particularly risky.<\/p>\n

\u201cThey can\u2019t regulate in ways that are arbitrary or capricious,\u201d said Lawrence Gostin<\/a>, a law professor at Georgetown University. \u201cBut if there\u2019s good evidence that a certain class of establishment is causing the spread of infectious diseases, it\u2019s absolutely clear that they have the right \u2014 in fact, they have the duty \u2014 to do it.\u201d<\/p>\n

The evidence that bars are a particular problem has continued to grow, said Dr. Ogechika Alozie<\/a>, an infectious disease specialist in El Paso, Texas.<\/p>\n

\u201cIf you were to create a petri dish and say, How can we spread this the most? It would be cruise ships, jails and prisons, factories, and it would be bars,\u201d said Alozie. He was a member of the Texas Medical Association committee that created a COVID-19 risk scale for common activities<\/a>, such as shopping at the grocery store.<\/p>\n

Bars top the list as the riskiest.<\/p>\n

\u201cYou can\u2019t drink through the mask, so you\u2019re taking off your mask. There are lots of people, tight spaces and alcohol is a dis-inhibitor \u2014 people change their behaviors,\u201d said Alozie.<\/p>\n

\u2018What Am I Going to Do?\u2019<\/strong><\/p>\n

At The Beer Junction<\/a> in West Seattle, the stools are stacked in the corner. These days the craft brewery\u2019s taps flow for to-go drinks only.<\/p>\n

\u201cIt would be very lively,\u201d owner Allison Herzog said about the brewery\u2019s pre-pandemic days. \u201cIt is weird to come in here and not feel that vibrancy.\u201d<\/p>\n

The coronavirus pandemic has compromised the bedrock of Herzog\u2019s business: people gathering together to drink, talk, laugh and let loose in one another\u2019s company.<\/p>\n

\u201cI wake up and I think, every day, what am I going to do to keep going?\u201d Herzog said.<\/p>\n

In the spring, The Beer Junction shut down indoor service as the coronavirus swept through Washington state. Then, as coronavirus numbers improved, restrictions on restaurants and bars were eased in the early summer. Finally, Herzog was allowed to open up a few tables and serve a limited number of customers indoors.<\/p>\n

\u201cI could hear people laughing in the bar,\u201d she recalled. \u201cIt just touched my heart and it felt like something was normal again.\u201d<\/p>\n

But the reprieve did not last long.<\/p>\n

By late July, the coronavirus had made a resurgence in the Seattle area and Washington Gov. Jay Inslee soon put another ban on indoor service at places that sold alcohol \u2014 including Herzog\u2019s bar.<\/p>\n

Even though it\u2019s hard on her bottom line, she said, she believes the risk of the coronavirus justifies the decision.<\/p>\n

\u201cI trust that they will open when it\u2019s responsible and scale back when it\u2019s responsible,\u201d Herzog said.<\/p>\n

What the Evidence Shows<\/strong><\/p>\n

There are now many examples across the U.S. of bars and nightclubs that have fueled outbreaks.<\/p>\n

In July, Louisiana rolled back its limited opening of bars, reporting<\/a> that more than 400 people had caught the coronavirus from interactions at those businesses. Texas and Arizona ordered bars to close down when infections skyrocketed and customers continued to crowd into bars. In Michigan, public health authorities have traced nearly 200 cases back to a now-infamous East Lansing pub.<\/p>\n

While bars can ask customers to wear masks and sit at tables, Alozie is skeptical that such guidance, however well-intentioned, can be successful, even when bargoers plan to be prudent.<\/p>\n

\u201cThe reality is, man proposes, God disposes,\u201d he said. \u201cAlcohol disposes even more.\u201d<\/p>\n

An outbreak linked to a bar and grill in southwestern Washington state is instructive. For karaoke night, the staff spaced the tables, checked temperatures at the door, even put up plexiglass barriers near the singers. Nonetheless, a few weeks later, close to 20 customers and employees had been infected.<\/p>\n

\u201cYou\u2019re asking customers who are drinking and doing karaoke to follow the physical distancing and masking requirements,\u201d said Dr. Alan Melnick<\/a>, director of the Clark County Health Department, which conducted the investigation. \u201cSo that was challenging in this particular situation.\u201d<\/p>\n

The chance of catching the virus through tiny airborne respiratory droplets, known as aerosols, goes up significantly in indoor spaces. When some states reopened bars after the first round of lockdowns, Jose Luis-Jimenez<\/a>, who studies the behavior of aerosols, was dismayed.<\/p>\n

\u201cI thought these were superspreading events waiting to happen, and look \u2014 that\u2019s what happened,\u201d said Luis-Jimenez, a professor at the University of Colorado-Boulder. \u201cIt was irresponsible.\u201d<\/p>\n

Many of the risk factors for airborne transmission of the coronavirus come together in a bar \u2014 think of each one like a \u201ccheck mark\u201d that adds to a person\u2019s overall risk.<\/p>\n

And behavior matters, said Luis-Jimenez. It can determine whether an indoor gathering becomes a superspreading event, which is why a bar is more problematic than even a restaurant.<\/p>\n

\u201cI would put my money that a bar is where the transmission is most likely to occur [compared with a restaurant] because that\u2019s where you\u2019re most likely to have people that are shouting and who are not wearing masks,\u201d he said.<\/p>\n

Bars Are Fighting Back<\/strong><\/p>\n

Bars and taverns have brought legal challenges to coronavirus restrictions in Colorado<\/a>, Florida<\/a>, Arizona, Tennessee<\/a>, Texas and Louisiana<\/a>.<\/p>\n

In Arizona, more than 60 bars filed a lawsuit to overturn the governor\u2019s order to shut them down. Ilan Wurman<\/a>, an associate professor of law at Arizona State University, is representing the bar owners who argue that the state has unfairly singled them out, while letting restaurants stay open late and serve alcohol.<\/p>\n

\u201cEither treat them all equally and shut them all down \u2014 or treat them all equally and allow them all to conform to reasonable health measures,\u201d Wurman argued. \u201cWhat you can\u2019t do is pick out a criterion, something like alcohol, that\u2019s totally arbitrary and that totally discriminates.\u201d<\/p>\n

Gostin, the Georgetown University legal scholar, said courts historically have sided with public health decisions \u2014 even as recently as last month.<\/p>\n

The U.S. Supreme Court rejected a Nevada church\u2019s challenge<\/a> to limitations on holding services, although attorneys for the church had argued that the restrictions on worship services were more onerous than the ones placed on casinos and restaurants.<\/p>\n

\u201cWe have to remember we\u2019re in an emergency,\u201d Gostin said, regarding the court\u2019s decision. \u201cThe health department should have reasonable discretion so as long as it\u2019s acting on the basis of good evidence.\u201d<\/p>\n

Closing bars has a \u201cdouble effect,\u201d according to Dr. Joshua Sharfstein<\/a>, vice dean for Public Health Practice and Community Engagement at Johns Hopkins\u2019 Bloomberg School of Public Health.\u00a0\u201cIt reduces the spread of the virus within the bar and it makes everyone take this situation more seriously.\u201d<\/p>\n

Sharfstein, who is a former secretary of health and mental health services for the state of Maryland, said he thinks, in most communities, keeping bars open will only set back other efforts to reopen society.<\/p>\n

\u201cYou can\u2019t look at the decision about bars separate from the need to save lives in nursing homes or to be able to open schools,\u201d Sharfstein said. \u201cThey\u2019re all connected.\u201d<\/p>\n

This story is part of a partnership that includes NPR<\/a> and Kaiser Health News.<\/em><\/p>\n

Kaiser Health News<\/a> (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation<\/a> which is not affiliated with Kaiser Permanente.<\/em><\/p>\n

USE OUR CONTENT<\/h3>\n

This story can be republished for free (details<\/a>).<\/p>\n

Subscribe<\/a> to KHN’s free Morning Briefing.<\/p>\n

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