Obviously I agree this can make the case that these transmission paths can happen. But using the existence of any reports as the basis for policy decisions would ban outdoor dining as well, along with schools, etc.
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Replying to @WesPegden
I'm aware of very few documented outdoor transmission events—and we understand mechanisms here—plus we have many studies from schools showing age differences. We do have many restaurant/bar/nightclub transmission events. Proportions are indeed unknown, but we do have an idea.
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Replying to @zeynep
I don't mean to suggest that we don't have reason to think indoor dining is higher risk; the increased risk of indoor settings seems to be one of the few things that is relatively clear. For me individual reports like this are a small part of the picture though. 1/
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Replying to @WesPegden @zeynep
In particular the risk of cross-table transmission does seem unclear currently, rather than transmission between people at the same table, or staff in close contact with customers. Highest risk environment not within-table is likely the kitchen, whether for takeout or dine-in./2
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Replying to @WesPegden
Cross-table contamination seems to depend on ventilation and air flow in the room, hence a bit of a crap shoot. (Though ventilation can be measured with CO2 devices). I would guess that kitchen=masked workers<unmasked diners, especially if masks are better grade/fit.
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Replying to @zeynep
I suspect that a loud kitchen with people talking to each other is likelier to be much worse than the risk of cross-table transmission regardless of who is wearing cloth masks. This is a case where better evidence on the quantitative effectiveness of masks would matter though.
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Replying to @WesPegden @zeynep
Sorry, I somehow missed your reference to "better grade" masks. I agree that better masks for people in these environments should be a high priority. The messaging on this is terrible right now! I'm still not sure we should think a quick service cook is "safe" in a mask.
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Replying to @WesPegden
Yeah, close quarter work is probably not great, but I've been chatting with restaurant owners who tell me that a professional kitchen has frequent air exchanges. I still did give him a bunch of KN95s for the kitchen/cooking staff based on similar logic to yours.
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Replying to @zeynep @WesPegden
This seems likely - every cooking station has an exhaust fan, and the NFC requirements are pretty intense: 12' of cooking space probably involves 4000 CFM of exhaust. Kitchens with sufficient exhaust will also use a make-up air fan to draw in extra external air.
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Replying to @dave_andersen @zeynep
On the other hand I'm not aware of any epi data showing kitchens are low-risk. In the Swedish occupational hazard study in the spring, kitchen staff did have much higher relative risk of infection. 2.5x risk. Pizza chefs were at 4.5x risk, second only to taxi drivers.
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Sweden doesn't use masks, also making comparisons harder.
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Replying to @zeynep @dave_andersen
Right (not for any occupations though). To me this just suggests that at least in some restaurant environments, the ventilation doesn't put the kitchen on comparable footing with other workplaces. If a friend asked me if the kitchen was a low-risk job, I'd say "probably not".
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