Restaurants - Printable Version

Restaurants - Printable Version

+- The CardBoard (https://thecardboard.org/board)
+-- Forum: Emergency (https://thecardboard.org/board/forum-11.html)
+--- Forum: Covid-19 (https://thecardboard.org/board/forum-12.html)
+--- Thread: Restaurants (/thread-20420.html)

Restaurants - BostonCard - 09-10-2020

https://www.cdc.gov/mmwr/volumes/69/wr/mm6936a5.htm?s_cid=mm6936a5_w

I wish this analysis had been reported months ago, as it could have influenced policy.

Quote:Approximately one half of all participants reported shopping and visiting others inside a home (in groups of ≤10 persons) on ≥1 day during the 14 days preceding symptom onset. No significant differences were observed in the bivariate analysis between case-patients and control-participants in shopping; gatherings with ≤10 persons in a home; going to an office setting; going to a salon; gatherings with >10 persons in a home; going to a gym; using public transportation; going to a bar/coffee shop; or attending church/religious gathering. However, case-patients were more likely to have reported dining at a restaurant (aOR = 2.4, 95% CI = 1.5–3.8) in the 2 weeks before illness onset than were control-participants (Figure). Further, when the analysis was restricted to the 225 participants who did not report recent close contact with a person with known COVID-19, case-patients were more likely than were control-participants to have reported dining at a restaurant (aOR = 2.8, 95% CI = 1.9–4.3) or going to a bar/coffee shop (aOR = 3.9, 95% CI = 1.5–10.1). Among 107 participants who reported dining at a restaurant and 21 participants who reported going to a bar/coffee shop, case-patients were less likely to report observing almost all patrons at the restaurant adhering to recommendations such as wearing a mask or social distancing (p = 0.03 and p = 0.01, respectively).

RE: Restaurants - CardinalSagehen - 09-10-2020

Thanks for this, BC. Interesting. I know everyone still assumes take-out and especially delivery are low-risk, but I'd be interested in this kind of study for those behaviors. Just to reconfirm what we think we know...

RE: Restaurants - M T - 09-10-2020

BC, thanks for posting that. I hope someone in the California Governor's office gets this onto his desk.

In the limitations of the study:

Quote:Of note, the question assessing dining at a restaurant did not distinguish between indoor and outdoor options. In addition, the question about going to a bar or coffee shop did not distinguish between the venues or service delivery methods, which might represent different exposures.

At a recent town-hall meeting of my SCC commissioner, I asked a question (regarding case tracing) at the opportunity to do so by recording the question after the meeting is over (for those with questions who didn't get called on). As before, one of the staff members called up to discuss the question. [Kudos to Joe Simitian for holding these meetings and welcoming questions!]

After discussing the question (basically where are all the cases coming from if only 33% are from known sources), I expressed my frustration that SCC has had thousands of cases, and the public isn't being told what MUST (or SHOULD) be known about them. What are the life styles of the 67% that are getting it by community spread? Are they getting take out (more than those that haven't gotten COVID), going on walks, working in construction (outdoors, indoors?), having beers with friends, sitting at home virtually all the time, etc.

Saying that 12K people have gotten COVID-19 by "community spread" without giving better information as to what these people do that let them get COVID, without warning the rest of us what is effectively risky behavior seems close to malfeasance. If they were eating purple jelly beans much more frequently than the other 1.9M people, would they tell us? Or, is there absolutely nothing about these 12,000 people that they do or experience more than others? I'd find that hard to believe (and, if there was nothing distinguishing, downright scary).

One who tends toward conspiracy theories could think that the counties are covering up what constitutes risky behavior.

For them NOT to know the characteristics of the 12K people that have gotten the disease seems like they aren't doing their job. I find it easier to believe they aren't telling the public rather than they haven't attempted to detect what some distinguishing characteristics are.

One has to tread carefully. Regarding Boston Card's quoted statistics, remember this is an association, not causal. For instance, suppose it were true the people that go to gyms also eat out more often. If you just look at who eats out, and decide that's related to getting COVID, you might miss that (in theory) it might be those that go to gyms are more strongly associated with getting COVID. Eating out may be related to whether the adult household members all work outside the home (which increases their exposure), or maybe to whether there are children in the household. It also is likely related to how concerned the household members about getting COVID-19.

But then, that L.A. sports writer that wrote about his COVID experience suggested that he got COVID from eating out, in his first (only) two times to eat out.

RE: Restaurants - teejers1 - 09-10-2020

(09-10-2020, 06:55 PM)M T Wrote: BC, thanks for posting that. I hope someone in the California Governor's office gets this onto his desk.

In the limitations of the study:

Quote:Of note, the question assessing dining at a restaurant did not distinguish between indoor and outdoor options. In addition, the question about going to a bar or coffee shop did not distinguish between the venues or service delivery methods, which might represent different exposures.

At a recent town-hall meeting of my SCC commissioner, I asked a question (regarding case tracing) at the opportunity to do so by recording the question after the meeting is over (for those with questions who didn't get called on). As before, one of the staff members called up to discuss the question. [Kudos to Joe Simitian for holding these meetings and welcoming questions!]

After discussing the question (basically where are all the cases coming from if only 33% are from known sources), I expressed my frustration that SCC has had thousands of cases, and the public isn't being told what MUST (or SHOULD) be known about them. What are the life styles of the 67% that are getting it by community spread? Are they getting take out (more than those that haven't gotten COVID), going on walks, working in construction (outdoors, indoors?), having beers with friends, sitting at home virtually all the time, etc.

Saying that 12K people have gotten COVID-19 by "community spread" without giving better information as to what these people do that let them get COVID, without warning the rest of us what is effectively risky behavior seems close to malfeasance. If they were eating purple jelly beans much more frequently than the other 1.9M people, would they tell us? Or, is there absolutely nothing about these 12,000 people that they do or experience more than others? I'd find that hard to believe (and, if there was nothing distinguishing, downright scary).

One who tends toward conspiracy theories could think that the counties are covering up what constitutes risky behavior.

For them NOT to know the characteristics of the 12K people that have gotten the disease seems like they aren't doing their job. I find it easier to believe they aren't telling the public rather than they haven't attempted to detect what some distinguishing characteristics are.

One has to tread carefully. Regarding Boston Card's quoted statistics, remember this is an association, not causal. For instance, suppose it were true the people that go to gyms also eat out more often. If you just look at who eats out, and decide that's related to getting COVID, you might miss that (in theory) it might be those that go to gyms are more strongly associated with getting COVID. Eating out may be related to whether the adult household members all work outside the home (which increases their exposure), or maybe to whether there are children in the household. It also is likely related to how concerned the household members about getting COVID-19.

But then, that L.A. sports writer that wrote about his COVID experience suggested that he got COVID from eating out, in his first (only) two times to eat out.

In the category of information obfuscation, I would add this:

How many patients, between the ages of 20-30, who had zero comorbidities died from Covid 19?
Same question for each decade of age.

It's incredible to me that they are not sharing this information because they clearly have it: they report how many people died and what age group the decedents fall into; they also relay how many of those dying were known to have at least one comorbidity; but for some reason, they refuse to connect the two data sets. It's ridiculous, really, and only adds to the mistrust of those providing the numbers.

I mean, I think it's mathematically possible that the number of those dying with zero comorbidities under the age of 50 is . . . 0.

P.S. The "community spread" category I view as a catchall, as I don't think contact tracing is worth a damn in this county - so that's the easy/default category.

RE: Restaurants - Farm93 - 09-11-2020

(09-10-2020, 10:05 PM)teejers1 Wrote:
(09-10-2020, 06:55 PM)M T Wrote: BC, thanks for posting that. I hope someone in the California Governor's office gets this onto his desk.

In the limitations of the study:

Quote:Of note, the question assessing dining at a restaurant did not distinguish between indoor and outdoor options. In addition, the question about going to a bar or coffee shop did not distinguish between the venues or service delivery methods, which might represent different exposures.

At a recent town-hall meeting of my SCC commissioner, I asked a question (regarding case tracing) at the opportunity to do so by recording the question after the meeting is over (for those with questions who didn't get called on). As before, one of the staff members called up to discuss the question. [Kudos to Joe Simitian for holding these meetings and welcoming questions!]

After discussing the question (basically where are all the cases coming from if only 33% are from known sources), I expressed my frustration that SCC has had thousands of cases, and the public isn't being told what MUST (or SHOULD) be known about them. What are the life styles of the 67% that are getting it by community spread? Are they getting take out (more than those that haven't gotten COVID), going on walks, working in construction (outdoors, indoors?), having beers with friends, sitting at home virtually all the time, etc.

Saying that 12K people have gotten COVID-19 by "community spread" without giving better information as to what these people do that let them get COVID, without warning the rest of us what is effectively risky behavior seems close to malfeasance. If they were eating purple jelly beans much more frequently than the other 1.9M people, would they tell us? Or, is there absolutely nothing about these 12,000 people that they do or experience more than others? I'd find that hard to believe (and, if there was nothing distinguishing, downright scary).

One who tends toward conspiracy theories could think that the counties are covering up what constitutes risky behavior.

For them NOT to know the characteristics of the 12K people that have gotten the disease seems like they aren't doing their job. I find it easier to believe they aren't telling the public rather than they haven't attempted to detect what some distinguishing characteristics are.

One has to tread carefully. Regarding Boston Card's quoted statistics, remember this is an association, not causal. For instance, suppose it were true the people that go to gyms also eat out more often. If you just look at who eats out, and decide that's related to getting COVID, you might miss that (in theory) it might be those that go to gyms are more strongly associated with getting COVID. Eating out may be related to whether the adult household members all work outside the home (which increases their exposure), or maybe to whether there are children in the household. It also is likely related to how concerned the household members about getting COVID-19.

But then, that L.A. sports writer that wrote about his COVID experience suggested that he got COVID from eating out, in his first (only) two times to eat out.

In the category of information obfuscation, I would add this:

How many patients, between the ages of 20-30, who had zero comorbidities died from Covid 19?
Same question for each decade of age.

It's incredible to me that they are not sharing this information because they clearly have it: they report how many people died and what age group the decedents fall into; they also relay how many of those dying were known to have at least one comorbidity; but for some reason, they refuse to connect the two data sets. It's ridiculous, really, and only adds to the mistrust of those providing the numbers.

I mean, I think it's mathematically possible that the number of those dying with zero comorbidities under the age of 50 is . . . 0.

P.S. The "community spread" category I view as a catchall, as I don't think contact tracing is worth a damn in this county - so that's the easy/default category.

HIPAA, general expectations of privacy in the USA, and our fragmented healthcare system make that more difficult than you might guess. In the USA it is more than possible for a physician in a hospital to not know a lot about a patient's long term medical history.

Perhaps if we ever get to a place where we are not playing whack an outbreak between the different states the Federal Government could compile that information. Since USA citizens are not following the basics at the moment, we would be well served to have everyone in government stay with ~3 sticky messages. The basics, if you will.

#1 - Wear a mask
#2 - Socially distance
#3 - Avoid large crowds

However, we likely won't even see that simple messaging across the USA because all three interfere with President Trump's favorite USA activity, MAGA rallies.

RE: Restaurants - Goose - 09-11-2020

(09-11-2020, 10:12 AM)Farm93 Wrote: HIPAA, general expectations of privacy in the USA, and our fragmented healthcare system make that more difficult than you might guess. In the USA it is more than possible for a physician in a hospital to not know a lot about a patient's long term medical history.

Possibly true, but as the Teejers1 points out, if they know the percentages of each age group, and they know what percentage of the patients have comorbidities, they had to get the data from patient reports. So it is clearly possible to break it down in a two dimensional manner. One may question the accuracy and completeness of the data due to the effects you point out, but subject to those questions, the 2D data is clearly available. The fact it isn't made public is indeed curious, given that the one dimensional data is made available.

(09-10-2020, 06:55 PM)M T Wrote: Saying that 12K people have gotten COVID-19 by "community spread" without giving better information as to what these people do that let them get COVID, without warning the rest of us what is effectively risky behavior seems close to malfeasance. If they were eating purple jelly beans much more frequently than the other 1.9M people, would they tell us? Or, is there absolutely nothing about these 12,000 people that they do or experience more than others? I'd find that hard to believe (and, if there was nothing distinguishing, downright scary).

One who tends toward conspiracy theories could think that the counties are covering up what constitutes risky behavior.

Scott Morrow from SMC has previously stated that the Counties don't have the resources and expertise to do this kind of "study" and that the State does. He also says the State isn't doing it. It is pretty clear he believes that this isn't his or the county's role. While that may not be a useful answer, it may at least explain why we aren't hearing about such analysis.

RE: Restaurants - 82lsju - 09-11-2020

(09-10-2020, 10:05 PM)teejers1 Wrote: In the category of information obfuscation, I would add this:

How many patients, between the ages of 20-30, who had zero comorbidities died from Covid 19?
Same question for each decade of age.

It's incredible to me that they are not sharing this information because they clearly have it: they report how many people died and what age group the decedents fall into; they also relay how many of those dying were known to have at least one comorbidity; but for some reason, they refuse to connect the two data sets. It's ridiculous, really, and only adds to the mistrust of those providing the numbers.

I mean, I think it's mathematically possible that the number of those dying with zero comorbidities under the age of 50 is . . . 0.

P.S. The "community spread" category I view as a catchall, as I don't think contact tracing is worth a damn in this county - so that's the easy/default category.

it would also be good to know the % of people in each age group estimated to have a least one condition that could be made worse when combined with COVID-19

RE: Restaurants - teejers1 - 09-11-2020

(09-11-2020, 10:12 AM)Farm93 Wrote:
(09-10-2020, 10:05 PM)teejers1 Wrote:
(09-10-2020, 06:55 PM)M T Wrote: BC, thanks for posting that. I hope someone in the California Governor's office gets this onto his desk.

In the limitations of the study:

Quote:Of note, the question assessing dining at a restaurant did not distinguish between indoor and outdoor options. In addition, the question about going to a bar or coffee shop did not distinguish between the venues or service delivery methods, which might represent different exposures.

At a recent town-hall meeting of my SCC commissioner, I asked a question (regarding case tracing) at the opportunity to do so by recording the question after the meeting is over (for those with questions who didn't get called on). As before, one of the staff members called up to discuss the question. [Kudos to Joe Simitian for holding these meetings and welcoming questions!]

After discussing the question (basically where are all the cases coming from if only 33% are from known sources), I expressed my frustration that SCC has had thousands of cases, and the public isn't being told what MUST (or SHOULD) be known about them. What are the life styles of the 67% that are getting it by community spread? Are they getting take out (more than those that haven't gotten COVID), going on walks, working in construction (outdoors, indoors?), having beers with friends, sitting at home virtually all the time, etc.

Saying that 12K people have gotten COVID-19 by "community spread" without giving better information as to what these people do that let them get COVID, without warning the rest of us what is effectively risky behavior seems close to malfeasance. If they were eating purple jelly beans much more frequently than the other 1.9M people, would they tell us? Or, is there absolutely nothing about these 12,000 people that they do or experience more than others? I'd find that hard to believe (and, if there was nothing distinguishing, downright scary).

One who tends toward conspiracy theories could think that the counties are covering up what constitutes risky behavior.

For them NOT to know the characteristics of the 12K people that have gotten the disease seems like they aren't doing their job. I find it easier to believe they aren't telling the public rather than they haven't attempted to detect what some distinguishing characteristics are.

One has to tread carefully. Regarding Boston Card's quoted statistics, remember this is an association, not causal. For instance, suppose it were true the people that go to gyms also eat out more often. If you just look at who eats out, and decide that's related to getting COVID, you might miss that (in theory) it might be those that go to gyms are more strongly associated with getting COVID. Eating out may be related to whether the adult household members all work outside the home (which increases their exposure), or maybe to whether there are children in the household. It also is likely related to how concerned the household members about getting COVID-19.

But then, that L.A. sports writer that wrote about his COVID experience suggested that he got COVID from eating out, in his first (only) two times to eat out.

In the category of information obfuscation, I would add this:

How many patients, between the ages of 20-30, who had zero comorbidities died from Covid 19?
Same question for each decade of age.

It's incredible to me that they are not sharing this information because they clearly have it: they report how many people died and what age group the decedents fall into; they also relay how many of those dying were known to have at least one comorbidity; but for some reason, they refuse to connect the two data sets. It's ridiculous, really, and only adds to the mistrust of those providing the numbers.

I mean, I think it's mathematically possible that the number of those dying with zero comorbidities under the age of 50 is . . . 0.

P.S. The "community spread" category I view as a catchall, as I don't think contact tracing is worth a damn in this county - so that's the easy/default category.
HIPAA, general expectations of privacy in the USA, and our fragmented healthcare system make that more difficult than you might guess. In the USA it is more than possible for a physician in a hospital to not know a lot about a patient's long term medical history.

Perhaps if we ever get to a place where we are not playing whack an outbreak between the different states the Federal Government could compile that information. Since USA citizens are not following the basics at the moment, we would be well served to have everyone in government stay with ~3 sticky messages. The basics, if you will.

#1 - Wear a mask
#2 - Socially distance
#3 - Avoid large crowds

However, we likely won't even see that simple messaging across the USA because all three interfere with President Trump's favorite USA activity, MAGA rallies.

I like your 3 sticky messages. Really, the overwhelming majority of us should be able to do that; and I think a majority does.
And it might even be a significant majority . . . but it needs to be an overwhelming majority.

RE: Restaurants - BostonCard - 09-11-2020

(09-11-2020, 10:12 AM)Farm93 Wrote: HIPAA, general expectations of privacy in the USA, and our fragmented healthcare system make that more difficult than you might guess. In the USA it is more than possible for a physician in a hospital to not know a lot about a patient's long term medical history.

HIPAA just prevents disclosure of personally identifying information.

Quote:This includes common identifiers such as full name, date of birth, street or email address, and biometric data.

Additional direct indicators could include:
Maiden name and mother’s maiden name
Alias
Fingerprint and voice print
Telephone and fax number
Social security number
Passport number
Driver’s license number
Taxpayer identification number
Financial accounts/records
Account numbers
Credit card/debit number
Medical/health records
IP and MAC address
Personal property records
Vehicle registration/title
License plate number
Full-face photograph
Employment records
Education records

None of this information is needed to figure out how many patients within a particular age group (so long as it doesn't narrow it down to date of birth) with particular co-morbidities, die.

BC

RE: Restaurants - Goose - 09-11-2020

(09-11-2020, 12:28 PM)teejers1 Wrote: I like your 3 sticky messages. Really, the overwhelming majority of us should be able to do that; and I think a majority does.
And it might even be a significant majority . . . but it needs to be an overwhelming majority.

I also like the three sticky messages. I disagree that the majority does them. Masks are generally not worn among contractor work crews, even in cases where the management really does try to make it happen. They are certainly not worn if management is "neutral" or worse on the subject. I have five or six constructions sites I pass each day while walking. I am sure about this. I strongly suspect, but can't prove that in many facilities where teams of people work together to assemble products, pack meat, etc. a similar situation exists.
The majority does social distance most of the time, except when they don't. San Mateo County Health agrees with me on this one. People get complacent or just plain careless. I see it regularly in my neighborhood. See https://www.smchealth.org/health-officer-updates/july-20-2020-health-officer-statement item #3. You might really like the last sentence in that item.

(09-11-2020, 02:22 PM)BostonCard Wrote: None of this information is needed to figure out how many patients within a particular age group (so long as it doesn't narrow it down to date of birth) with particular co-morbidities, die.

BC

Very true, yet we still don't have that 2D breakdown. Is it another case of the government (at all levels) not wanting to tell us something for fear we will react to it in a way they don't want? What if it is true that essentially nobody without a comorbidity in the 20-30 year old age group dies? Maybe those people will completely give up on avoiding infection. I would still like to see the breakdown, but it makes me wonder what possible other reasons could exist that would explain why we don't have it.

RE: Restaurants - M T - 09-13-2020

Some data that hasn't been highlighted about the Vanderbilt study:

The study was of 154 COVID cases, 160 control participants. That seems like a very low number considering how many cases a day we have. I am uncomfortable that their control participants were representative of the general public -- 14.5% of their control had close contact to COVID cases in the last 14 days. 5 of the 160 had a COVID case in their family in the last 14 days.

"Among adults with COVID-19, 42[.2]% reported close contact with a person with COVID-19, similar to what has been reported previously". That compares to 36.3% for Santa Clara County. Of that 42%, only 50.8% had contact with a family member (I wish they'd asked about a household member). So it seems that little of the spread that is within a family. Nearly 4x as many cases that aren't family spread as are. If every person were part of a family that was a couple, and there was certain spread in a family, then you'd have equal cases that are family spread than aren't. If families were bigger, then there'd be even more family spread than not.

It is hard to fathom why they lumped bars with coffee shops. Maybe it was because the study was very under-powered for such data (only 13(COVID) and 8(non-COVID) went to bars/coffee shops).

The reported mask usage was pretty similar between those that got COVID versus those that didn't.
Never: 3.9% 3.1%
Rarely: 3.9% 3.8%
Sometimes: 7.2% 4.4%
Often: 14.4% 14.5%
Always: 70.6% 74.2%