Medical experts say bars are places with a high risk of easily spreading COVID-19.
Among other factors, this is primarily due to the fact that they’re spots where large numbers of people gather indoors with little ventilation over long periods of time.
When people are drinking in a bar, they can often become too relaxed, leading to safety rules and protocols falling by the wayside.
Experts also point out that activities like going to church meet a lot of the same risk level criteria as going to a bar.
It’s last call at many bars across the country.
As COVID-19 cases reach new daily records in many places, states like Texas and Arizona have closed bars in an effort to slow the spread.
Why are they a hotbed for infection? Lack of physical distancing and mask-wearing are thought to have contributed to the spread of the virus to more than 100 people who visited an East Lansing, Michigan, bar in June.
“Congregation at a bar inside is bad news,” Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said at the U.S. Senate Committee hearing on Tuesday. “We really have got to stop that.”
While surges have prompted states like Michigan to roll back their reopening plans, we asked more experts why bars are one of the worst places for spreading COVID-19.
Bars are a cocktail of risks
“There’s this nice little rhyme that Dr. Bill Miller (an epidemiologist) at The Ohio State University coined — people, place, time, and space — to think about the four dimensions of risk of transmission,” Eleanor J. Murray, ScD, an assistant professor of epidemiology at Boston University School of Public Health in Massachusetts, told Healthline. “Bars hit on the worst end of all of those.”
The phrase refers to metrics by which risk can be measured.
First, analyze the “people” in the situation you’re engaging in. In a bar, you’re often surrounded by strangers.
“Place” refers to the circumstances of the bar. They’re “often indoors, and they often don’t have a lot of ventilation,” Murray explained.
“Time” refers to how much time you’ll be in proximity to people while hanging out at the bar. “You’re not just hopping into a bar for 5 minutes,” she said. “A lot of people go for quite an extended period of time.”
Finally, “space” is about how much personal space you’re able to keep around you. “For a lot of bars, people are packed in reasonably tightly, and you don’t have that 6 or 10 feet of space all around you,” she noted.
“In all four of those metrics, bars are at the worst case scenario end,” Murray said. “I don’t think bars are the only risky place, but they seem like one of the most risky places.”
Socializing and pandemics don’t mix
“People go to bars to drink and socialize, a good combination,” said Durland Fish, PhD, professor emeritus of epidemiology at the Yale School of Public Health in Connecticut. “But it is probably the worst thing you can do during the COVID epidemic.”
It’s tough to physically distance at a bar, and wearing a mask isn’t conducive to bar behavior.
“How can you meet someone 6 feet away, and how can you drink wearing a mask?” he asked. “Bars are also noisy, especially if there is a band or music and everyone has to shout at close range to communicate, spewing aerosolized virus particles.”
Young people doing these things in a group can spell trouble. “That, plus the prevalence of asymptomatic infections in the participating age class, is a recipe for disaster,” he said.
Dr. Sandra Kesh, deputy medical director and infectious disease specialist at Westmed Medical Group in Westchester, New York, points to additional risks.
“When you are drinking in a bar, you can often be disinhibited, which can lead to PPE rules and protocols falling by the wayside,” she said.
“In a bar you’re also side by side with total strangers, and you have no control over who is there with you and whether or not they are well and following infection control guidelines,” Kesh said.
Also consider the bathrooms used by a stream of people.
“Knowing what we know now about public washrooms and toilet plumes, and the fact that bar washrooms are notoriously not well cleaned, it’s best to avoid bars altogether,” she said.
Kesh also sheds light on what tends to happen after you leave a bar.
“People also use ride-shares to get home, which is another way for people to contract the virus,” she added. “It is likely you may be in close, confined quarters with people, and you don’t know where they have been, or if they, or even your driver, will wear a mask. If you do a ride-share, make sure you are with people you know.”
Citing the outbreak at Michigan’s Harper’s Restaurant and Brew Pub, Fish added, “I do not understand why anyone would not anticipate that reopening bars would be a problem. They should be the last to open.”
Is closing them now going to stop the spread of the virus? Not by themselves, says Kesh.
“We got control in New York and Connecticut because we clamped down quickly,” she said. “Anytime you have people congregating, the risk for spread of COVID-19 goes up.”
Restaurants closing indoor dining is important, Kesh notes, as is the closure of schools, camps, stores, malls, office spaces, and more.
“It’s not what people want to hear, but when the curve is going up, you need to clamp down,” she explained.
“Phased and slow reopening with low- to high-risk phases allows you to have control over the spread and manage it appropriately. You also need to have sufficient testing to get a clear picture of what is going on,” Kesh said.
Think about alternatives
There are some ways to be safer in a bar setting, “but there is no way to completely remove the risk,” Kesh said.
If you decide to go to a bar, she suggests wearing a mask, using physical distancing rules, avoiding close contact with strangers, limiting your alcohol intake so you’re more aware, and washing your hands really well.
“Ideally, also go with people you know and trust so you are not sharing airspace with strangers,” she said.
It’s also important to think about the activities in your life and decide what you want to take the risk on.
“With a lot of activities, there are these trade-offs in terms of, is this something people need to do? Or [is] this something that’s important for mental health or emotional health or physical fitness and things like that?” Murray said. “In a lot of ways bars don’t really fall into any of those important to-do categories either.”
Activities like going to church meet a lot of the same risk level criteria as going to a bar, says Murray, “but for a lot of people church has a really important spiritual function in their lives that is really hard to substitute with something else.”
This is why experts encourage people to attend virtual church services or seek other, safer, alternatives, such as services where people remain in their cars.
Rethinking how we socialize in large groups, whatever the occasion may be, is vital to ending the spread of COVID-19.
Ask yourself: Could I substitute going to a bar with some other, safer activity? Like meeting friends at a distance outside with a mask.
“Thinking about how you get what you were getting from that activity in a lower-risk way, I think those are things that we should think about,” Murray said.
“We need to prioritize keeping open or opening up those things that we can’t really substitute for, like child care, elementary school. People aren’t going to be able to get back to work while they’re watching their 6-year-olds,” she said.