Over a month after the implementation of county and state mask mandates and as most of Maryland enters stage three of reopening, COVID-19 cases are down statewide, and Baltimore County restaurants remain able to host guests inside at limited capacity and with physical distancing.
Though Baltimore County Executive Johnny Olszewski called on Governor Larry Hogan to shut down indoor dining statewide at a press conference on July 21, the state made no move to revoke allowance for indoor dining, leaving it up to local officials.
“Public health officials have consistently warned us about how indoor dining and congregating in bars can play a significant role of increased COVID-19 case counts,” Olszewski said on July 21. “We have also seen that patchwork approaches to determining which businesses should be opened don’t work. I urge Governor Hogan to reengage with local leaders so that we can work in partnership to take statewide action to protect public health and save lives.”
“Local jurisdictions across the state continue to have the flexibility to adjust their reopening plans, including adjustments to indoor dining provisions,” a Maryland Department of Health spokesperson wrote in a statement on July 30.
Now, over a month after Maryland followed Baltimore County’s lead in requiring everyone above a certain age to wear masks, in an attempt to reverse course on worsening health data, the state is seeing a continuing downward trend in COVID-19 cases, in response to which Baltimore City reopened indoor dining at 25% capacity on Aug. 7. On Sept. 4, the state entered stage three, which reopens all businesses, including movie theaters and live entertainment, though local officials can still impose restrictions on this reopening.
As the state continues to increase testing and hospitalizations drop, Sept. 3 marked the 70th consecutive day of Maryland’s reported seven-day average testing positivity rate falling below 5%, which the World Health Organization advises areas stay under for 14 days before reopening.
But on Sept. 6, Johns Hopkins, which calculates the rate differently — using the number of individuals tested rather than number of tests conducted — reported that the statewide rate had exceeded 5% for the second day in a row, following three consecutive weeks below the threshold, according to The Baltimore Sun.
Among Marylanders under 35, the positivity rate was 4.11% as of Sept. 1, while the rate among those over 35 was 2.91%. Residents in their 20s made up more than a quarter of cases on Sept. 2, nearly double that age range’s proportion in the overall Maryland population, The Baltimore Sun reported.
These numbers in Maryland follow a trend across many states of young people driving outbreaks, according to the University of Minnesota’s Center for Infectious Disease Research and Policy. Bars and restaurants in particular, at which young adults are more likely to be both patrons and employees, have served as common sites for community outbreaks and are often the “largest settings to infect Americans,” The New York Times reported on Aug. 12. In Maryland, 12% of cases in July were traced back to restaurants, per contact tracing data.
Health officials have expressed concern about this data because the many restaurant and bar employees and patrons in their 20s — and thus more likely than older Americans to have mild or asymptomatic cases of COVID-19 — could potentially carry the virus home and infect other members of their household, according to The New York Times.
Epidemiologists agree that sitting inside a restaurant or bar poses great risks of new outbreaks, much more so than being outside.
“The virus may be able to spread through the air in certain circumstances, and particularly in locations with low ventilation, with medium to large crowds, and in places where people stayed over a long period of time without any sort of protection, which you can imagine happens when you’re sitting and you’re eating or you’re drinking,” said Christopher Sulmonte Jr., project administrator for the Johns Hopkins Biocontainment Unit.
In addition, high noise levels inside restaurants and bars may cause patrons to speak loudly or yell to be heard, emitting more aerosols and, if infected, potentially transmitting the virus, according to a study by the Center for American Progress. Inebriation, too, may inhibit patrons’ understanding of COVID-19 risks and make it difficult for bar staff to enforce distancing rules. And while Baltimore County’s mask mandate requires patrons to don a mask when moving around a restaurant or bar, such a rule can be hard for restaurants to enforce, Washingtonian reported.
“In the midst of a pandemic, any large gathering poses a transmission risk, and this risk is magnified exponentially when people are not following proper safety precautions,” said Dr. Daniel Collector, a family medicine physician at the University of Maryland’s St. Joseph Medical Center. “The key to containing COVID is to be vigilant about wearing masks, maintaining proper physical distancing and keeping your hands clean.”
States that have been slower to reopen indoor dining and bars have seen lower rates of transmission than those that reopened such establishments faster, the Center for American Progress study showed.
Despite the health risks, Olszewski noted in July that Baltimore County closing down indoor dining without a statewide mandate would put local businesses at a competitive disadvantage, as neighboring counties could choose to keep indoor dining open.
“If a resident cannot eat indoors here, they will very likely travel somewhere else to do so,” Olszewski said.
The Restaurant Association of Maryland released a statement after Olszewski’s press conference arguing that indoor dining should remain open.
“We want to stress the immense negative impact that going backwards would have on our economy as well as the impact on the lives of restaurant and food service employees,” the organization wrote. “We believe that restaurants need to remain open for indoor dining to serve our customers and continue employing tens of thousands of Marylanders.”
With much of Maryland reopening for indoor dining in mid-June, the addition of nearly 50,000 jobs across the leisure and hospitality sector in June and July has helped lower the state’s unemployment rate to 7.6%, according to Baltimore Business Journal.
Some experts, such as health economist Emily Gee, worry indoor dining could end up causing more economic harm than benefit. If it opens too soon, she told Washingtonian, areas risk seeing a second wave of restaurant closures.
Baltimore County restaurants that have chosen to open indoor dining, such as Au Poitin Stil, must not exceed 50% capacity or seat more than six guests at one table, per the state’s reopening plan from earlier in the summer. According to both the state and county mask mandates, diners do not have to wear their masks while eating or drinking in their seats.
Au Poitin Stil has other safety procedures in place as well, such as taking employees’ temperatures and having them fill out a health questionnaire before every shift, measuring the distance between tables to ensure they’re six feet apart, and requiring staff to wear face masks and gloves and frequently wash their hands, according to the restaurant’s website.
Other restaurants, like Hightopps Backstage Grille with its 50 tables for outdoor seating, have opted to keep indoor dining closed until the weather gets too cold to sit outside.
In late July, as businesses tried to adjust quickly to the new mask mandates, the Baltimore County liquor board fined seven restaurants and bars for coronavirus-related violations, such as operating over capacity, employees or patrons not wearing masks, or a lack of social distancing, The Baltimore Sun reported. The owner of one such establishment, Left Field Pub’s Nshiant Shah, expressed a desire for the county and state to offer more resources to help these businesses implement the necessary restrictions, as policing patrons can prove difficult.
With indoor dining remaining an option across Maryland, patrons will have to decide for themselves how best to be socially responsible.
“I caution everyone to think carefully before attending any public event,” Dr. Collector said. “Consider your risk factors and the state of your health before going anywhere. By taking personal responsibility, you can support your community’s better health.”