COVID-19 contact tracing in Charlotte zeroes in on restaurants, breweries. Here’s what it means.

Health officials in Charlotte have sharpened their understanding of where residents are getting infected with the coronavirus, sparking renewed focus on COVID-19 safety and enforcement at businesses.

Beginning about one month ago, case investigators involved with contact tracing in Mecklenburg County began tracking new data on where people with COVID-19 said they’d been — for example, a restaurant or gathering at a friend’s house.

The new software function from HealthSpace — a data vendor that also automates some of Mecklenburg’s contact tracing messages — helped piece together trends for about 3,500 recent infections from late summer.

A broad analysis showed 36% of infected people had frequented restaurants and breweries, and 38% went to gatherings with family and friends. Less than 10% of people reported going to weddings, funerals and places of worship.

The data revealed in detail for the first time locally what health officials have, for months, been cautioning: The risk of getting sick or getting others sick from the coronavirus is highest in group settings and in places where long lengths of time are spent near strangers.

But county officials still aren’t saying exactly which businesses have been linked to multiple COVID-19 cases.

Both North Carolina and Mecklenburg health officials have refused to provide to the Charlotte Observer some records related to contact tracing. The Observer asked for data and reports that would show how often contact tracers pinpointed where someone likely contracted COVID-19 and how many cases were connected to a single infectious person.

Those reports, according to county and state officials, are confidential. The Observer requested the records be released without patient information or names of people diagnosed with COVID-19.

Through the contact tracing software, Mecklenburg keeps a running list of places tied to known cases or that are not compliant with coronavirus restrictions, such as crowd capacity limits, keeping customers six feet apart or enforcing required face coverings. And North Carolina health officials announced just this week they’re encouraging the public to use a smart phone app that would alert people if they were previously in proximity, based on cellular phone data, to someone who later tested positive.

Some events, like a 200-person wedding with scant social distancing, require more contact tracing follow-ups than a small dinner party, says Raynard Washington, Mecklenburg’s deputy health director.

“It is very difficult to narrow down,” Washington told the Observer. “The reality is the more and more you do those interactions with individual groups of people, the more exposure you have. The more exposure you have, it’s just a matter of statistics.”

As residents weigh their coronavirus-risk tolerance — such as whether dining out is worth it — health officials and hospitality experts agree there is nothing inherently unsafe about restaurants.

It largely depends on how customers behave and whether they and employees follow precautions.

Ben Chapman, a professor and food safety specialist at North Carolina State University, said people should consider:

▪ Coronavirus safety measures, including mask wearing and distanced tables, or contact-less ordering.

▪ Indoor versus outdoor dining options, with more airflow being generally safer.

▪ Dinner companions — the risk is lower when members of a household eat together instead of friends meeting up in small or large groups.

”I think people are looking at public health officials to say (dining) is OK. We really can’t,” said Chapman, who helped develop coronavirus safety training for restaurants.

The “most important question that helps us understand risk,” he said, is knowing whether specific businesses are linked to multiple infections or whether contact tracing reveals a cluster, meaning multiple people exposed at one location.

Still, contact tracing has proven difficult.

Some people who were possibly exposed to COVID-19 don’t pick up the phone when contact tracers call. Others who test positive and hear from a contact tracer are reluctant to share information about who they’ve been near or where they’ve been in public.

Mecklenburg Public Health Director Gibbie Harris defended the prevention effort last week, telling county commissioners that contact tracing is “essential.”

A new report from the Centers for Disease Control and Prevention found that almost half of infected people interviewed in Mecklenburg didn’t report close contacts in June, when the county was “experiencing high and increasing COVID-19 incidence.” About one-fourth of known close contacts were “lost to follow-up.” Less than 2% of the close contacts studied during this period, the report states, ultimately tested positive for COVID-19. But that number could be an under-count, due to the way data was collected, according to the report, which is co-authored with Harris, Washington and Meg Sullivan, Mecklenburg’s medical director.

What’s causing spread?

At restaurants and breweries, the most discernible exposure likely happens at individual tables, health experts say. That means everyone sitting in proximity to an infected person should quarantine and get tested for COVID-19 — but not necessarily those situated across the establishment.

Mecklenburg is not tracking in its data whether a person who went out to eat dined indoors or outdoors. Washington said that while the newest data shows many people infected were customers at restaurants and breweries, it’s unclear if residents went to business in the county or elsewhere.

But that’s exactly the kind of information Chapman wants to calculate risk within the restaurant industry.

”Right now, it’s analogous to, ‘Eating is risky for food-borne illness,’” Chapman. “Tell me the specifics. If the answer is ‘we don’t know,’ then it’s really hard.”

The National Restaurant Association in an online statement Sept. 11 refuted findings from the CDC linking the spread of the coronavirus to restaurants. The restaurant group said there are “numerous flaws” in the study and no clear evidence the virus was contracted at a restaurant.

“There’s really no evidence of systemic spread coming from restaurants who are following protocols and practicing good hygiene,” said Lynn Minges, president and CEO of the North Carolina Restaurant and Lodging Association.

“We are seeing that it is customer behavior — not the restaurants — that may be causing spread.”

Recently, in Cabarrus County, health officials linked eight cases of COVID-19 to an exposure at the Old Armor Beer Company in downtown Kannapolis. All patrons from the last two weeks should “monitor for COVID-19 symptoms and consider getting a COVID-19 test,” officials said in a news release. But the business owner says he and his workers have been diligent about reducing exposure, and he believes it’s unfair that the brewery was singled-out.

To date, Mecklenburg officials have not publicly issued such a warning about any particular restaurant or business. The health department acknowledged five cases among county employees and temporarily shut down operations at the county’s Aquatic Center last month.

And in other instances, the Charlotte-Mecklenburg Police Department has released lists of places where owners or others were cited for violating stay-at-home orders or COVID-19 alcohol restrictions.

But Washington says there’s no specific criteria the county uses to issue public notices on clusters at restaurants or other businesses.

“We would need to have enough evidence to say there was substantial risk and exposure at that place, and most likely it would need to be more than a single case,” Washington said. “It just depends. We unfortunately have to make really sort of case-by-case decisions at what point that happens.”

‘Doing the right thing’

Mohammad Jenatian, president of the Greater Charlotte Hospitality and Tourism Alliance, said the majority of local restaurants are “doing everything they can” to keep customers safe.

But spotty enforcement of local coronavirus-related ordinances can hurt consumer confidence as businesses reopen, he said.

“We need to do a better job of letting people know about the restaurants that are doing the right thing,” Jenatian said. “If people realize there are restaurants that are not doing what they need to and are getting closed down, that’s a good message ... (But) we don’t have a system of rewards or penalty.”

Kyle Lingafelt, co-founder of Old Armor Beer Company, told the Observer this week that the health department’s announcement about a string of infections is unfair.

“We’re just a small business trying to survive. It’s frustrating because we have all the safety procedures in place,” he said.

The brewery has added a third-party deep clean, on top of daily sanitizing, requiring and providing masks and following social distancing measures like no seating at the bar. There’s also hand sanitizer at tables.

“We’re trying to do the right things,” he said.

Lingafelt learned of one employee testing positive for the virus last week. That person had last worked Sept. 13. Another employee tested positive who got sick while on vacation Aug. 6, Lingafelt said, but hadn’t been back to work. Still, co-workers who worked with that staff member before the vacation were quarantined and tested.

Lingafelt said it’s misleading to name the brewery as a source for the COVID-19 cases.

“Did they just happen to pass through here?” he asked. “There should be proof.”

Cautious reopening

North Carolina law doesn’t require restaurants to disclose when employees test positive for COVID-19. In Charlotte, that hasn’t stopped restaurants — like Futo Buta and The Juice Bar — from taking it upon themselves to disclose cases to loyal patrons, the Observer has previously reported.

That’s one reason Steve Casner held off reopening Alexander Michael’s on West Ninth Street in uptown until Friday. He said he didn’t want to risk having to close again if a staff member tested positive for the virus.

Still, he’s taking it slow with plans to open for take-out only, which also will help staff get up to speed after six months of being closed.

“I’m starting to feel good about things,” he said. “Masks are going to be required. I’m not going to argue about that. We’re a small place.”

The 37-year-old restaurant, a former general store, is 1,800 square feet with a bar on one side.

He said when North Carolina dining rooms were ordered closed March 17, Alexander Michael’s shifted to to-go. But on March 28 he shut it down because there were too many unknowns about COVID-19.

“It seemed like a risk not worth taking for me or my staff,” he said.

When restaurants could reopen dining rooms at 50% capacity on May 22, Casner decided not to because of “people not doing the right thing.”

Now, he said, health officials know more about the virus, plus North Carolina has reopened more businesses and schools are opening for in-person classes.

“Most everything I’m seeing is positive,” he said. “The numbers aren’t great but they’re heading in the right direction.”

Casner said along with safety protocols like sanitizing high-touch areas frequently and employee wellness checks, hours will be shortened and inventory will be tight to keep everything fresh. He also plans to have online ordering available soon and install Plexiglas at booths.

“I really do think it’s time, and I really hope I’m right,” Casner said.

This story was originally published September 25, 2020 at 7:28 AM.