Is It Safe to Eat at a Restaurant If You’re at High Risk for COVID-19?

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As restaurants have moved from curbside pickup and takeout only to socially distanced outdoor or indoor dining throughout the country, you may be wondering when you can enjoy your favorite eatery’s food again, especially if you’re in a high-risk group for COVID-19 complications.

The Global Healthy Living Foundation and CreakyJoints recently conducted a poll of our members — many of whom live with underlying health conditions that increase the risk of severe illness from COVID-19 — to understand what risks people living with chronic illness are willing to take when it comes to resuming everyday activities.

As you might expect, responses varied by region of the country — for example, people living in the Northeast were less likely to eat inside at a restaurant compared to respondents as a whole (11 percent versus 17 percent, respectively).

Individuals living outside of the United States were less likely to say that they have or would soon get takeout from curbside pickup or delivery compared to respondents as a whole (59 percent versus 80 percent, respectively). They were also less likely to eat inside at a restaurant soon (12 percent versus 17 percent).

It’s no surprise that those living with chronic illness in our community were more wary of taking risks that may expose them to COVID-19.

Just 17 percent of participants in our poll said they have eaten out at a restaurant or would soon, which is much lower than the 39 percent reported by Civic Science, which polled the general public. In fact, our survey takers were more hesitant to eat outside at a restaurant than they were to go to a salon, shop in-person at a small business, or pick up takeout from inside a restaurant.

If you live with underlying medical conditions or take medication that can affect your immune system, you’re likely well aware of the risks you need to balance when deciding what to do and where to go during the COVID-19 pandemic. The general guidance to follow is simple, yet not always easy to adhere to:

• Maintain a social distance of six feet or more from people outside of your household whenever possible.
• Wear face coverings when out in public and when you can’t be socially distant.
• Wash or sanitize your hands frequently and disinfect commonly touched surfaces.
• Avoid large groups or situations when it will be hard to be socially distant.
• When spending time with others, being outdoors is safer than indoors.

Dining at a restaurant is tricky because it means you’ll be in close contact with others and you won’t be able to wear a face covering while you eat.

Your measure of risk will depend on the business, whether you eat outdoors or indoors, and how often you go, but there are precautions you can take if you do decide to pick up food or dine at a restaurant.

Here are the risk factors and safety precautions you need to take into consideration.

Picking Up Food for Takeout

The risks: Ordering food ahead of time and picking it up to take home is likely your safest option for enjoying restaurant food (other than getting a contactless food delivery to your door). The U.S. Centers for Disease Control & Prevention (CDC) considers food service limited to drive-through, delivery, take-out, and curbside pickup the “lowest risk” of COVID-19 spread for restaurants.

In our survey, participants were more likely to get takeout from curbside or delivery than other activities such as walking or biking with others, shopping at a grocery store, or picking up takeout from inside a restaurant.

“I think people should feel confident in supporting their neighborhood restaurants and picking up food, whether it’s cooked or cold food,” says David Aronoff, MD, director of the Division of Infectious Diseases at Vanderbilt University School of Medicine in Nashville, Tennessee. “While it’s true that the heat required to cook food inactivates the virus, the likelihood of getting COVID-19 through food transmission is overall really, really low. It has not been definitively shown to occur.”

What’s more, employees at restaurants are already accustomed to taking precautions to avoid spreading germs, such as wearing gloves, washing hands regularly, and keeping surfaces clean.

However, you should make sure the staff is wearing masks and maintaining social distance from customers when you go inside to pick up your food.

Precautions to take: Wear a face covering when going into the restaurant to pick up your food (if curbside pickup is not available). Clean your hands once you put your food down in the car (say, with hand sanitizer) and again after you bring it inside your home. You can then transfer the food to your own dishes and wash your hands with water and soap for at least 20 seconds before eating.

Also take the following precautions:

• Wait in your car or away from the restaurant while your food is being prepared. You can ask the restaurant to call you when it’s ready.
• Stay six feet away from other customers and employees when getting your food. Some restaurants may leave your order on a table for you to pick up to enforce social distancing.
• Avoid using shared items, such as condiments and salt and pepper shakers.
• Ask a loved one who is not in a high-risk group for COVID-19 complications to go inside for you.

Dining Outside

The risks: It’s possible that a breeze could help move other people’s breath — the respiratory droplets that could contain virus — away from you or toward you, says Dr. Aronoff. While restaurants can often create six feet of distance between tables outside, you’re exposing yourself to other people for an extended period of time, especially if you dine with people outside of your household.

“The advantage of taking food away from a restaurant and bringing it home is that you’re not doing much to increase your risk of getting infected or spreading the virus to others,” says Dr. Aronoff. “But once you get into a public area like a restaurant, you are by nature now surrounding yourself with more people. That creates more transmission opportunities.”

The CDC considers food service that includes on-site dining limited to outdoor seating (with tables at least six feet apart) to be “more risk” than food service limited to drive-through, delivery, take-out, and curbside pickup.

In our survey, 35 percent of respondents said they have eaten outside at a restaurant or would do so in the next month or two. However, 65 percent said they would only do so when the threat of coronavirus is much lower or completely gone.

Wearing a mask to and from your table at the restaurant will help protect those around you, but you’ll of course need to take it off to eat. Unmasking with your dining partner is likely safe, as long as you eat with someone from your own household.

“Now is really not the time to be going to restaurants with people you don’t live with,” says Dr. Aronoff. “Getting close at a table without masks and eating a meal together with someone you’re not cohabitating with is risky. It is not advisable behavior if you’re at a higher risk for COVID-19 complications.”

Precautions to take: “Keeping your meal brief reduces your risk of being a victim of COVID-19 or transmitting the virus to other people,” says Dr. Aronoff. “Get in and get out. Don’t sit at the table chatting after your meal or wait a really long time to order.

You can try to minimize your time at the restaurant by looking at the menu online beforehand, calling ahead to order, and saving long discussions with your dining partner for after you leave the restaurant.

This will also benefit restaurants operating at reduced capacity (and thus bringing in less revenue), whose staff may be eager to get the next diners seated.

Check the weather before you go to make sure you won’t be forced to move inside a restaurant if it offers indoor seating. Ensuring you can remain outdoors is key. Most COVID-19 transmissions appear to happen indoors, says Chunhuei Chi, MPH, ScD, director of the Center for Global Health at Oregon State University in Corvallis, Oregon.

“If you want to venture out to restaurants for the first time, opt for a restaurant with outdoor seating that is at less than half of the regular occupancy to allow safe distance,” says Chi. “Safe distance is especially important for restaurants, since we can’t wear masks while eating.”

The virus (SARS-CoV-2) that causes COVID-19 can be spread through shouting and speaking, so try to avoid noisy restaurants with loud outdoor music playing. This will likely cause diners around you to raise their voices, which is a problem when they are unmasked and eating.

Also take the following precautions:

• Only dine with those you live with.
• Make sure the staff is wearing masks before you decide to eat at a given restaurant (checking in with friends who already visited the restaurant may be helpful).
• Call ahead to see if you can order before you get to the restaurant to limit the amount of time you spend there.
• Ask for disposable or digital menus.
• Clean your hands before eating, after you leave the restaurant, and when you get home.
• If you need to get up from your table (such as to use the bathroom) wear a mask.
• Avoid using shared items, such as condiments and salt and pepper shakers.

Dining Inside

The risks: Dining indoors is the riskiest type of restaurant experience you can have right now.

If the restaurant is not well-ventilated, it could pose a higher risk for airborne transmission of the virus. Better ventilation of spaces substantially lowers the airborne time of respiratory droplets, which are produced during speaking and coughing and have been shown to contain viral particles that remain infectious in aerosols (tiny droplets suspended in the air) for three hours, per a May 2020 study published in The Lancet Respiratory Medicine.

“That’s most dangerous because when there’s aerosol in the air, there’s no such thing as safe distance, and even eating six feet away from the infected person is not enough,” says Dr. Chi.

The CDC considers food service that includes on-site dining with both indoor and outdoor seating to be “even more risk” than dining outdoors, drive-through, delivery, take-out, and curbside pickup. On-site dining with indoor and outdoor seating in which capacity is not reduced and tables are not spaced at least six feet apart is considered “highest risk.”

Our survey respondents were more likely to stay at a hotel, swim in an outdoor pool, or attend an indoor gathering of 10 to 20 people than to eat inside at a restaurant. Only 17 percent of participants said they have eaten inside at a restaurant or would soon, while 83 percent said they would only do so once the threat of coronavirus is much lower or completely gone.

As with dining indoors, those living in the West and Northeast were more likely to wait than other regions of the United States.

“My general opinion, particularly for people at higher risk, is to wait and get opinions from friends who have already visited that particular restaurant about how well it’s practicing hygiene,” says Dr. Chi. “Every restaurant is doing trial and error right now, and it’ll take at least a month or two for each one to learn and adapt. Don’t be the first person to try eating inside in a restaurant.”

Precautions to take: If you do dine indoors at a restaurant, many of the same precautions as eating outdoors apply. Dine only with those in your household, limit your time inside the restaurant as much as possible, wear a mask when getting up from your table, and clean your hands thoroughly before and after eating.

Also take the following precautions:

• If there’s a window, ask the staff if it’s possible to open it for better ventilation.
• Only dine with those you live with.
• Make sure the staff is wearing masks before you decide to eat at a given restaurant (checking in with friends who already visited the restaurant may be helpful).
• Call ahead to see if you can order before you get to the restaurant to limit the amount of time you spend there.
• Ask for disposable or digital menus.
• Clean your hands before eating, after you leave the restaurant, and when you get home.
• If you need to get up from your table (such as to use the bathroom) wear a mask.
• Avoid using shared items, such as condiments and salt and pepper shakers.

Speak to your doctor for help assessing your risk level of complications due to COVID-19, and for more safety precautions that may be specific to your particular city or condition.

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