Outbreaks at restaurants and retail spaces fell drastically during the most recent stay-at-home order, according to new San Diego County public health data — a finding that suggests COVID-19 regulations, as painful as they may be, are effective at slowing the spread of the virus.
In the wake of California’s regional stay-at-home order, which required the closure of many business operations, outbreaks in community settings fell by just over 25 percent, from 347 to 258. A significant decrease in outbreaks at restaurants and retail spaces accounted for most of that drop.
In the six weeks leading up to the Dec. 3 order, 72 outbreaks were reported at restaurants and 40 were noted at retail locations, the data show. In the six weeks after the order went into effect, there were only four outbreaks at restaurants and three at retail spaces.
Outbreaks at grocery stores also dropped sharply — from 21 to three.
Epidemiologists say this steep decrease isn’t a reflection of a greater risk of infection at these locations — a lot more data and analysis would be required to sort that out — but it does suggest that people heeded the stay-at-home order, and limited trips to these locations.
That shift in behavior is especially reflected in the drop in outbreaks at retail and grocery stores.
Unlike restaurants, which were relegated to take-out only during the stay-at-home order, operations at retail locations and supermarkets changed very little under the order. People could still go to these businesses, but fewer outbreaks suggest they may have chosen to go less.
“To me, I think the pain of stay-at-home orders are worth it,” said Dr. Davey Smith, chief of infectious disease research at UC San Diego. “Hopefully the vaccine and other therapies are going to be the cavalry that’s going to come in and save us, but in the meantime, we have to hold the fort and that means not going to restaurants and retail places when things are really out of control.”
Local restaurateurs, though, have long challenged the logic behind shutting down their businesses — especially outdoor dining — to stem the spread of COVID-19.
Some restaurant owners have even gone to court in an effort to quash such regulations. As for outbreaks, of course, there would be a decline at restaurants, they argue, because their venues were shut down for in-person service, except for a select number of eateries whose owners chose to defy the order.
“The stay-at-home order could have had an impact in general because people were going out less but I don’t think it affected restaurants, it just killed us,” said Jeff Rossman, who owns Terra American Bistro and is past president of the local chapter of the California Restaurant Association.
Likewise, Jon Weber, co-owner of the Cowboy Star and Butcher Shop in downtown San Diego, took issue with drawing any conclusions from a decline in COVID-19 outbreaks at restaurants during the now-lifted lockdown.
“If the stay-at-home order had truly worked, we would have seen a decrease in the case rate after two weeks of everyone staying home,” said Weber, who is part of a lawsuit filed by gym and restaurant owners seeking an injunction preventing the state and county from prohibiting indoor dining. “It’s been two months and it’s just now coming down. It was less of a stay-at-home order and more of a ‘don’t-go-to-restaurants/gyms/salons/barbershops order.’”
Both Weber and Rossman argue, as have other restaurateurs, that shutting down in-person dining only drives people who are eager to eat out to gather in their homes with individuals from different households, a behavior they say is even riskier than going to a restaurant.
“A lot of what happened is people were itching to go out, so you had people holding social gatherings on their own and those are really hard to enforce,” Rossman said.
Statistics on community outbreaks from household gatherings, though, show only a very modest increase, going from one outbreak before the order to five after.
Other industries saw increases inCOVID-19 outbreaks as well.
Outbreaks at health-care facilities more than doubled, climbing from 12 before the order was imposed and 29 while it was in effect. Warehouses associated with distributers like UPS and Amazon also saw outbreaks nearly double, from seven to 13.
Businesses — the sector that fueled most of the region’s outbreaks before and after the order — saw little change. Faith-based and government locations also recorded little movement in the number of outbreaks.
Declining outbreaks isn’t the only measure suggesting the stay-at-home order succeeded in slowing the spread of the virus.
Early this week, when the state announced the end to the order, officials cited a decline in infection rates that should result in significant decreases in the number of intensive care patients. Models show that Southern California, which the state recently estimated had 0 percent ICU capacity, is expected to improve to 33 percent by Feb. 21.
Those decreases are reflected locally, as well. Although case and hospital totals are still high, they are trending downward.
By definition, a community-setting outbreak — the type that occurs at places like restaurants, schools and businesses — must include at least three COVID-19 cases within a 14-day period. They also must involve people who are from different households or who are not considered close contacts in some other way.
Identifying outbreaks is an extension of the county’s contact tracing efforts, and it’s far from a perfect process. Local disease detectives try to ask everyone who tests positive about the things they did in the two weeks before they got sick, but there are many reasons why that information might be incomplete or unreliable.
People may not be able to remember all the places they went, or they may omit things they do not want to disclose. People may leave out locations to protect their places of employment or worship. They may not mention people who would be forced to quarantine should they test positive — a hardship that some workers may feel they can’t afford.
The process is even more challenging when the virus is spreading widely like it is in San Diego County.
“There was so much transmission in December and January that it was really everywhere, which makes it very difficult to do contact tracing,” Smith said. “It’s like figuring out which mosquito gave you malaria when you’re being bit all the time.”
Even declaring an outbreak is not always definitive. Outbreaks do not always mean everyone included got sick in the same place. It simply means they were at the same place within a 14-day period.
Over the course of the pandemic, the county has identified more than 1,100 community-setting outbreaks, accounting for more than 7,600 cases and 27 deaths. That’s a little over 3 percent of total cases and about 1 percent of all deaths.
Although the county has released a lot of information about outbreaks, officials have refused to release specific locations in most cases even though other jurisdictions such as Los Angeles County do so.
Health officials have stated that COVID-19 outbreaks rarely pose an active threat to the public. When the county experts determine that a particular location presents an ongoing risk, they release the name of the location.
The county also said regularly releasing specific outbreak locations could make business owners and others more reluctant to come forward if they do experience an outbreak, making it harder for contact tracers to accurately identify those who were exposed.
“Releasing the names of these locations and the addresses will have a chilling effect on the open communication necessary to ensure the Public Health Officer is able to effectively combat active outbreaks,” county officials said in explaining their decision to withhold specific locations.
The San Diego Union-Tribune and other media organizations have challenged that stance in court. In November, San Diego Superior Court Judge Joel R. Wohlfeil sided with the county, a ruling that is currently being appealed.
This article was originally published on Outbreaks at restaurants, retail spaces plummeted during stay-at-home order