The Impact of Keeping Indoor Dining Closed on COVID-19 Rates Among Large U.S. Cities
A Quasi-Experimental Design
Table of Contents
Table of Contents
Report Publish Date: March 2022
This journal article describes a study comparing COVID-19 rates in cities that prohibited indoor dining in summer 2020, during the pandemic, and cities that were forced to reopen by their states.
Primary Takeaways
In cities that kept indoor dining closed, COVID case rates declined by 55% compared to cities where indoor dining was allowed. The authors found that cities not allowing indoor dining prevented 130 cases of COVID a day on average.
“Had all cities kept indoor dining closed (and holding all other nonpharmaceutical interventions at their actual levels), we estimate that approximately 39,661 (95% CI = –79,925, –602), or 189 per 100,000, cases would have been averted over the 4-week period,” the authors write, though they say these are general approximations.
Overview and Objectives
During the first year of the COVID-19 pandemic, cities reopened indoor dining at different times. Some states preempted, or overrode, city policies that would have kept indoor dining closed for longer during the summer and fall of 2020.
The authors wanted to know whether allowing or not allowing indoor dining had an effect on a city’s COVID rates.
Hypothesis or Approach
The authors studied four cities that stayed closed even after their states allowed them to reopen, and seven cities that would have kept indoor dining closed but were forced to reopen by their states. Cities reopened or were allowed to reopen between March 30 and October 1, 2020. The authors used COVID case rates and death counts from Johns Hopkins University’s Center for Systems Science and Engineering and population estimates from the Census Bureau’s American Community Survey. They controlled for other nonpharmaceutical interventions such as stay-at-home orders, mask mandates, and eviction moratoriums.
How This Influences Change
This study adds to the evidence that indoor dining bans likely helped reduce COVID infections. Understanding what policies helped reduce infections before vaccines were available could help public health officials and policymakers prepare for future infectious disease outbreaks.
Research: Go Deeper
Background
Indoor dining is one of the potential drivers of COVID-19 transmission. We used the heterogeneity among state government preemption of city indoor dining closures to estimate the impact of keeping indoor dining closed on COVID-19 incidence.
Methods
We obtained case rates and city or state reopening dates from March to October 2020 in 11 U.S. cities. We categorized cities as treatment cities that were allowed by the state to reopen but kept indoor dining closed or comparison cities that would have kept indoor dining closed but that were preempted by their state and had to reopen indoor dining. We modeled associations using a difference-in-difference approach and an event study specification. We ran negative binomial regression models, with city-day as the unit of analysis, city population as an offset, and controlling for time-varying nonpharmaceutical interventions, as well as city and time fixed effects in sensitivity analysis and the event study specification.
Results
Keeping indoor dining closed was associated with a 55% (IRR = 0.45; 95% confidence intervals = 0.21, 0.99) decline in the new COVID-19 case rate over 6 weeks compared with cities that reopened indoor dining, and these results were consistent after testing alternative modeling strategies.
Conclusions
Keeping indoor dining closed may be directly or indirectly associated with reductions in COVID-19 spread. Evidence of the relationship between indoor dining and COVID-19 case rates can inform policies to restrict indoor dining as a tailored strategy to reduce COVID-19 incidence.
Epidemiology, March 2022. DOI: 10.1097/EDE.0000000000001444
Research Team
This study and report was conducted and created by the following people.
- Schnake-Mahl AS
- O’Leary G
- Mullachery PH
- Vaidya V
- Connor G
- Rollins H
- Kolker J
- Diez Roux A
- Bilal U
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