Community and Close Contact Exposures Associated with COVID-19 Among Symptomatic Adults ≥18 Years in 11 Outpatient Health Care Facilities — United States, July 2020

COVID-19 Mitigation Behaviors by Age Group — United States, April–June 2020

“…Similarly, the survey item "washed or sanitized hands" did not specify frequency of handwashing or handwashing in situations associated with higher risk of exposure to SARS-CoV-2 (e.g., while in a public place) nor did it specify that hands were washed often with soap and water for at least 20 seconds or that sanitizer containing at least 60% alcohol was used. Second, the survey item "avoided some or all restaurants" did not specify type of restaurant service (e.g., curbside pick-up versus dining in), which might underestimate risk mitigation, as on-site dining has been associated with an increased risk for acquiring COVID-19 (10). Finally, all results depend on selfreport and thus social desirability and recall bias might result in over-or underestimation of reported mitigation behaviors.…”

COVID-19 pandemic management and the rheumatology patient

“…The authors estimate a lower estimate of 230,000 cases prevented with universal masking mandates ( 67 ). More recently, a case-control study performed by the Center for Disease Control and Prevention (CDC) showed a statistically significant association between COVID-19 diagnosis and close contact with a known COVID-19 case, dining at a restaurant or going to a bar or coffee shop ( 68 ). In those without a known COVID-19 contact, the odds ratio (OR) was greater for dining at a restaurant (OR = 2.8) or going to a bar or coffee shop (OR = 3.9) with 21% of those engaging in these activities reporting incomplete adherence to wearing masks or social distancing at the establishment ( 68 ).…”

“…More recently, a case-control study performed by the Center for Disease Control and Prevention (CDC) showed a statistically significant association between COVID-19 diagnosis and close contact with a known COVID-19 case, dining at a restaurant or going to a bar or coffee shop ( 68 ). In those without a known COVID-19 contact, the odds ratio (OR) was greater for dining at a restaurant (OR = 2.8) or going to a bar or coffee shop (OR = 3.9) with 21% of those engaging in these activities reporting incomplete adherence to wearing masks or social distancing at the establishment ( 68 ). There are limitations to this study, however the data suggest activities where masking by many individuals may be inconsistent, such as places where people are eating or drinking, may be associated with COVID-19.…”

Evidence to Support Further Public Health Measures in High Transmission Areas in Ontario

“…In adjusted analyses restricted to the 225 people who did not have contact with people with known COVID-19, the adjusted odds ratio of being positive for SARS-CoV-2 was 2.8 for dining at a restaurant (95% confidence interval (CI) 1.9 to 4.3) and 3.9 for going to a bar or coffee shop during the previous 2 weeks (95% CI 1.5 to 10.1). 5 Figure 10 shows the approximate risks of SARS-CoV-2 infection during the first half of the week of October 11, 2020, in regions with low, moderate, and high levels of transmission under the conservative assumptions that the average doubling time of 14 days applies to all regions in Ontario, that one out of three actual cases of SARS-CoV-2 infection will eventually be detected, 6 that 30% of people go to restaurants, bars, and/or coffee shops for indoor dining or drinking, or to an indoor entertainment venue at least once in 2 weeks, 5 and that the observed adjusted odds ratio for dining at a restaurant of 2.8 in the U.S. study 5 is representative for associations of transmission with indoor dining in restaurants, and visiting bars, coffee shops or indoor entertainment venues in Ontario. In regions with low transmission, the estimated absolute difference in the risk of transmission between the current situation and a hypothetical scenario with closure of indoor dining in restaurants, bars, coffee shops, and indoor entertainment venues is 0.…”

“…For the high risk scenario, new SARS-CoV-2 infections were assumed to occur principally among older adults and hospitalization rates were assumed to be similar to the average observed in March and April 2020 in Ontario. To apply the results of the U.S. case-control study 5 to regions with low, moderate, and high levels of transmission in Ontario during the first half of the week of October 11, 2020, we conservatively assumed that the average doubling time of 14 days applied to all regions in Ontario, that one out of three actual cases of SARS-CoV -2 infection will eventually be detected, 6 that 30% of people go to restaurants, bars, and/or coffee shops for indoor dining or drinking, or to an indoor entertainment venue at least once in 2 weeks, 5 and that the observed adjusted odds ratio for dining at a restaurant of 2.8 in the U.S. case-control study 5 was representative for associations of transmission with indoor dining in restaurants, and visiting bars, coffee shops or indoor entertainment venues in Ontario.…”