Arlington, VA

Health Matters is a biweekly opinion column. The views expressed are solely the author’s.

Fall weather has arrived in Arlington, and colder temperatures mean more people migrating indoors to stay warm. For restaurants, cold weather presents a unique challenge since many patrons are still hesitant to dine indoors due to COVID. Restaurants are finding that they have to again adapt to ensure safety for their patrons and employees.

To preempt the “stay-in-your-laners,” I am clearly not a restaurateur. I am, however, a front line healthcare worker (HCW) and there is a surreal parallel between what I experience in the hospital and what I have seen in restaurants since reopening.

In the hospital, there are many of the familiar safety measures: masks for patients and HCW, constant cleaning of waiting, exam and operating rooms, hand sanitizers at every corner and conspicuous signage. In addition, appointments are staggered to minimize waiting room crowds, all patients are screened for COVID symptoms, temperatures are checked before entering areas with immunocompromised patients and chairs physically distanced in waiting rooms.

As an anesthesiologist taking care of COVID patients, I wear an N-95 respirator (usually a recycled one these days), eye shield, head cap, full gown and gloves. Every patient getting a procedure needs a COVID test within 5 days. If a known COVID positive patient comes for a procedure, it should be in a negative pressure room or at least have a large HEPA filter.

The times I have dined at my favorite Arlington restaurants, I have seen many similarities to the hospital. This is by design, as Arlington County transitioned to Phase 3 of the Forward Virginia plan on July 1, which includes distancing of 6 feet, sanitization of frequently contacted surfaces every 60 minutes and of tabletops in between patrons and employee screening before shifts.  Some restaurants supersede the requirements by doing temperature checks upon arrival, ensuring HVAC efficiency, constant filter changes and replacing reusable menus with QR coded smartphone menus. With the help of these safety measures, Arlington has maintained a relatively stable COVID count since reopening.

Perhaps the safety measure with the most impact is availability of outdoor dining. In a room with stagnant air, tiny viral droplets can stay suspended in air from 8-14 minutes. In contrast, droplets evaporate within seconds in a large room or outdoor setting with constantly circulating air, mitigating risk of transmission.

So what are restaurants doing to address COVID as it gets colder? Restaurants with outdoor dining are doubling down on what made them successful upon reopening.  For example, Clarendon fixture Pamplona is encouraging guests to continue enjoying patio dining by setting up heavy duty tents to protect against the elements along with a fleet of propane heaters to keep patrons warm. However, even restaurants with outdoor space are battling inflated heater prices (hearkening the infamous $10 toilet paper roll and $200 dumbbell) as well as waiting on city ordinances to allow for expanded sidewalk space to allow for heaters. Restaurants restricted to indoor seating can only continue mask-wearing, disinfecting, distancing and enhanced air ventilation/purification.

A study published by the CDC on Sept. 11 showed that people who tested positive for COVID were more than twice as likely to have dined at a restaurant in the two weeks before getting sick versus people who tested negative. While that may be an admonishing statistic, it should be noted that these case-patients were less likely to report other patrons in the restaurant adhering to mask wearing and distancing. In addition, the study did not detail restaurant air circulation or outdoor dining.  So while the headlining statistic may be true, it is unclear whether the dining environment would be considered safe by Arlington standards.

My take is that Arlington restaurants have done a commendable job protecting patrons and their employees, and local COVID numbers support that. Cold weather will undoubtedly be a challenge for restaurants. I am compelled to support local business and I believe there is a way to do it safely. I don’t eat out often, but if I wanted to eat at a restaurant, outdoor dining will always be the first option. I’m willing to add on a few layers of clothing if necessary. If only indoor dining is available and I still really wanted to eat out, I would call ahead to see if the restaurant is at capacity, inquire about safety measures, air circulation and filtration enhancements. In the back of my mind I know takeout and delivery are always options for most restaurants. It comes down to a judgement call and risk stratification — if it is patently obvious that restaurants and patrons are not abiding by the rules, it is probably best to avoid.

What are your thoughts about dining indoors and outdoors, particularly as it gets colder? Would you like to see other measures to ensure safety?

Dr. George C. Hwang, known to his patients as Dr. Chaucer, is a practicing anesthesiologist who also helps to run Mind Peace Clinics in Arlington. He has written for multiple journals, textbooks and medical news outlets, and has been living in Arlington for the past 15 years.

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