Yes. Bars are fueling COVID-19 outbreaks.

Last night at dinner I discussed with socially distanced friends the story of an intelligent 24-year-old insisting on heading out to bars for the evening. As students from every area of the world return to Ann Arbor, we wondered if closing bars (and preventing campus parties) could be the most important way of limiting the back to school outbreaks seen across the country. Our county (Washtenaw) is already limiting outdoor gatherings to 25 people, but we wondered if indoor bars were a particular problem?

An excellent piece by NPR has examined the issue of whether bars are behind the cluster outbreaks of COVID-19 that have been seen in many areas. Bars were singled out as a cause of these outbreaks early on, as a bar in Lansing, MI was responsible for an outbreak that directly infected over 100 individuals and countless secondary infections. The question is, however, are bars more effective locations for transmitting COVID-19 than other establishments where individuals congregate? 

Certainly, public heath officials believe this is the case. Experts and top health officials, including Dr. Tony Fauci, say the evidence is abundantly clear. When bars open, infections tend to follow. The article also quoted Dr. Ogechika Alozie, an infectious disease specialist in El Paso, Texas. “If you were to create a petri dish and say, how can we spread this the most? It would be cruise ships, jails and prisons, factories, and it would be bars,” Alozie says. 

Dr. Alozie was also a member of the Texas Medical Association committee that created a COVID-19 risk scale for common activities such as shopping at the grocery store. Bars top the list as the riskiest. “You can’t drink through the mask, so you’re taking off your mask. There are lots of people, tight spaces and alcohol is a caution inhibitor — people change their behaviors,” Alozie says.

However, can simply closing bars, among all other actions, truly control outbreaks of COVID-19? The evidence continues to grow that this may make a significant impact. Several pieces of information supporting this idea are presented in the NPR article including the following examples.

In July, Louisiana rolled back its limited opening of bars, reporting that more than 400 people had caught the coronavirus just from interactions at those businesses. Texas and Arizona ordered bars to close down when infections skyrocketed. Cases in both states have dropped precipitously since then.

An outbreak linked to The Orchards Tap Bar and Grill in southwest Washington state is also instructive. For karaoke night, the staff spaced the tables, checked temperatures at the door, even put up plexiglass barriers near the singers. Nonetheless, a few weeks later, close to 20 customers and employees had been infected.

When some states reopened bars after the first round of lockdowns, Jose Luis-Jimenez, who studies the behavior of aerosols, was dismayed. “I thought these were superspreading events waiting to happen, and look — that’s what happened,” says Luis-Jimenez, a professor at the University of Colorado Boulder. “It was irresponsible.”

Many of the risk factors for airborne transmission of the coronavirus come together in a bar — think of each one like a “check mark” that adds to a person’s overall risk. And behavior matters, Luis-Jimenez says. It can determine whether an indoor gathering becomes a superspreading event, which is why a bar is more problematic than even a restaurant.

The NPR piece ends with a statement from Dr. Joshua Sharfstein, vice dean for Public Health Practice and Community Engagement at Johns Hopkins Bloomberg School of Public Health. He believes closing bars has a “double effect as it reduces the spread of the virus within the bar, and it makes everyone take this situation more seriously.” He also feels that keeping bars open will doom efforts to open schools.

So, if we want in person classes at colleges this fall, it is likely there will be a tradeoff for bars.