New story in Health from Time: COVID-19 Positivity Rates Appear to Be Spiking in Many States That Reopened Bars

Michael Neff sensed what was about to happen. It was late March, and Texas had surpassed 1,000 confirmed cases of COVID-19. He braced as governor Greg Abbott announced that many businesses—including gyms, restaurants and bars—would be prohibited from serving customers indoors. The Cottonmouth Club, his Houston cocktail bar, would have to close.

“We were resigned to the fact that we might not make it,” Neff says of his business. “We took a day to be really, really depressed and I locked myself in the bar and didn’t answer the phone.”

Since then, Neff has tried to bring the Cottonmouth Club experience online, by livestreaming a nightly bar-themed variety show with karaoke and cocktail-themed discussions. Customers can show support by paying into a virtual tip jar. When the governor allowed bars to reopen at 25% capacity on May 22, Neff reconfigured the furniture, set up a reservation system and designed contactless menus. The duty to keep customers and staff as safe as possible weighed on him. “You’re always having to trade some version of safety with some version of commerce,” he says. “It was hard to promote as vigorously as possible when, in your heart, you’re totally okay if only 10 people show up.”

Over the last five months, states and municipalities have issued a hodgepodge of lockdown and quarantine measures, many of which shut down bars, or limited them to take-out-only operations. The orders tightened, then loosened, and, in some places, like Texas and California, tightened once again. As politicians try to balance economic benefits with health risks, bars have become canaries in a very dangerous coal mine.

The shutdowns have taken a toll on the bar industry. Back in early April, visits to bars and similar establishments were down 89% nationwide compared with the year before, according to data from Cuebiq, a New York-based mobility analytics company that tracks consumer foot traffic. As bars began to reopen, at least some patrons returned—as of July 7, visits nationwide crawled back to 48% of last year’s rate. That’s still a bigger drop in foot traffic than at restaurants (down 24%) and department stores (down 14%), but it’s a rebound nonetheless.

However, there are big differences in bar traffic from state to state. Visits to bars in New Jersey are down 72% compared with last year, while visits to bars in Wyoming and North Dakota have almost returned to pre-pandemic levels:

Crucially, in many cases, whether people are returning to bars in a given state seems to be having a notable effect on that state’s COVID-19 outbreak. By comparing rates of positive coronavirus cases with business traffic, Cuebiq analysts found strong correlations between bars opening and spikes in positivity rates about one week later in some hotbed states, including Arizona, Florida and Georgia. Meanwhile, states like New York and New Jersey, which delayed the reopening of indoor leisure venues like bars, have had lower rates of positive cases recently.

While states lifted restrictions on bars at different times, the below chart shows each state’s year-over-year change in bar visits as of July 7 compared to its change in one-week average positive COVID-19 test rates between July 2 and July 16:

Cuebiq collects data from smartphone users who authorize apps on their phones to anonymously gather their location information. The full dataset includes 15 million phones nationwide. Cuebiq typically uses these data to help businesses track the efficacy of marketing campaigns, but since the pandemic started, it has been supplying them to researchers who want to better understand how the virus is spreading and how people are reacting to it.

Antonio Tomarchio, Cuebiq’s founder and CEO, is the first to admit that the data aren’t fully conclusive—many states reopened other establishments at the same time they opened bars, potentially skewing the data. But he says they can provide guidance for decision-makers. “Correlation is not causation, but it is insightful,” he says. “You have to take it into account.”

Still, it’s not entirely surprising that there may be a correlation between bars and viral transmission. Gerardo Chowell-Puente, an epidemiology and biostatistics professor at Georgia State University, says that bars likely pose a greater transmission risk than other indoor venues, like retail stores or movie theaters, because their patrons tend to have more close interactions with one another. In addition, he notes, people are more prone to disregard safety protocols when under the influence of alcohol.

“The highest risk is in an enclosed space, without a mask,” says Chowell-Puente. “In the bar, you are very likely to be talking to people, which involves spreading the virus.”

Whether bars are open seems to be affecting who’s getting sick, too. Early in the pandemic, outbreaks were common in places like assisted-living facilities and nursing homes. But as younger people flock to reopened bars, they’re the ones falling ill. In April, when much of the country was locked down, more than 3,000 patients were hospitalized every week for COVID-19, but only about 25% of them were under the age of 50, according to the U.S. Centers for Disease Control and Prevention (CDC). Today, about 1,000 patients are hospitalized per week, but more than 40% are under 50. While younger people tend to be less susceptible to severe COVID-19, they are not totally immune, and can carry it to other more vulnerable people.

While some bar owners are pushing back against mandatory closures—in Texas, a group of them sued the governor after the second shutdown there—others have been more understanding of the public health risk their establishments present right now. Neff, for one, has been advocating for shutdowns, given the public health risk of keeping pubs open. But many also want elected officials to take note of their sacrifices, and offer more financial support to keep them afloat amid the closures. On-again-off-again shutdowns are particularly painful, because each reopening costs time and money.

“If only 10% of your industry is leading to hundreds of cases and outbreaks, is it right to shut everyone down? From a public health standpoint, it is,” says T. Cole Newton, who owns the Twelve Mile Limit in New Orleans. Even when the rules allowed for 50% capacity, he limited his bar to 25%. Now he’s been forced to close again, but he can still offer to-go drinks. It’s less stressful, he says, to run the bar in survival mode, rather than manage the safety and behavior of his customers to keep people healthy. Still, he’s worried about the number of establishments that won’t survive the pandemic. Mass closures will be hugely detrimental—not just to bar owners and their employees, he says, but also to people who rely on local bars as a way to connect with their communities.

“On our busiest nights, it’s sweaty, and it’s loud and it’s impossible to navigate without touching a half-dozen other people,” he says. “That’s why we’re susceptible to shutdowns, but also why we’re irreplaceable.”

Newton’s fears are already being realized. In late May, The Stud, San Francisco’s longest-running queer bar, locked its doors for the last time; its owners got out of a lease early to avoid falling into debt. The Stud was the kind of place that touted great performers—from Etta James to Lady Gaga—and also great history. It opened on the forefront of the gay rights movement of the 1960s, and for decades operated as a haven for artists and the LGBTQ community.

But packed, in-person drag shows have no place in a pandemic. On May 31, as a farewell to the storied bar, its owners held a virtual funeral. On the day the affair streamed online, 11 weeks had passed since the state of California ordered all bars, wineries, nightclubs and brewpubs to close. Two weeks following the funeral, the state re-opened bars in most municipalities, just to close them again four weeks later, on July 13.

Still, the Stud’s owners are hopeful that they will find a new spot to relaunch the bar when the pandemic is over. “It was a self-preservation tactic,” says drag performer and LGBTQ activist Honey Mahogany, who, with 17 other bar patrons, bought the establishment in 2016. “We’re in it to continue the legacy of The Stud.”