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expert reaction to qualitative study on pubs and whether SARS-CoV-2 transmission risks can be minimised

An interview and observation study published in the Journal of Studies on Alcohol and Drugs looks at managing COVID-19 transmission risks in bars.


Dr Julian Tang, Honorary Associate Professor/Clinical Virologist, University of Leicester, said:

“Despite the best will and intentions in the world, pub owners and their clients are not very good at reducing social contact within the pubs during drinking hours – and the virus is likely to spread amongst unvaccinated, unmasked, non-socially distanced adults because of this.  We need to reduce the community levels of the virus to very low levels – AND – also increase the vaccination coverage of the young adults who attend pubs, restaurants, etc.

“We need both because even though the case numbers were as low as 300-500 cases/day in the first week of July last year (, we saw that by the end of August, the numbers were surging again – because most of the population were still susceptible to the virus.

“The ongoing COVID-19 vaccination of most the adults in this age group will be needed to prevent such a surge again to avoid another local or national lockdown – with these potentially more transmissible and partial vaccine-escape new variants co-circulating now, the ideal proportion to be vaccinated might need to be quite high to prevent any possible resurgence of the virus in this pub-going population – though the exact percentage is difficult to estimate.

“The roadmap out of the lockdown restrictions needs to be slow and careful – taking into account what we see in terms of case numbers and vaccine coverage.  This should hopefully become more and more ‘inversely proportional’ (i.e. case numbers go down as vaccine coverage goes up) over time – as long as the vaccine escape mutants do not become too predominant.

“What we don’t want to see is pubs, bars, restaurants opening up too early, ordering large amounts of stock – only to have to see this go to waste if there is another surge of cases leading to a local or national lockdown, again.”


Dr Simon Clarke, Associate Professor in Cellular Microbiology at the University of Reading, said:

“This interesting study relied on interviewing workers in various roles in the Scottish hospitality industry before the reopening of pubs in the summer of 2020, about anticipated measures to reduce coronavirus transmission.  The research team, posing as regular customers then observed the operation of various establishments with reference to behaviours that might affect spread of the virus.

“Despite efforts by the bars studied, and detailed guidance from government, potentially significant behaviour, increasing the likelihood of COVID-19 transmission was reported in a substantial minority of establishments, especially when customers were drunk.  Close physical interaction between customers and staff occurred and were rarely stopped by staff.  It is already well established that the virus spreads easily indoors and that close physical proximity is a significant risk factor, hence the rules on personal distancing.  Pubs and bars also present a number of touch points that can act as sources of infection, even when people remain seated.  Alcohol is a diuretic, making people pass urine more frequently, so increased trips to the toilets will mean increased touching of door handles, taps, etc.

“While this sort of behaviour was not reported in all establishments, the very fact that it occurs in some places will make it harder to justify the re-opening of bars and pubs.  Measures which are regarded as harsh, like blanket closures, curfews, or alcohol sale bans are more likely to be implemented if the risks cannot significantly and effectively be reduced by management of licensed premises.”


Prof Paul Hunter, Professor in Medicine, The Norwich School of Medicine, University of East Anglia, said:

“The study in the paper is a qualitative rather than a quantitative study.  But it was an entirely appropriate approach to address the aspects that were being investigated.  What this study cannot tell you is how common inadequate control was across a range of establishments.  However, it does give valuable insights into the types of failings that can occur and why these failings happen.

“In many ways the findings within this research are not surprising and most of us would have intuitively guessed what those findings would have been.  Nevertheless, the way that Fitzgerald and colleagues documented these findings give a clearer understanding of what those failings are and how these failing often came about.  What comes across from the interviews is that managers of the bars are committed to providing COVID-secure environments and many venues had made substantial improvements upon reopening.  However, in a number of venues these commitments may not stand up to real world exposure.  Physical and operational modifications were generally implemented well but ensuring compliance with those requirements by customers and at times their own staff proved difficult.  Poor compliance by customers seemed to be associated with alcohol consumption which should not surprise anyone.

“There is now quite a lot of evidence that crowded indoor venues like pubs and bars are places where transmission of COVID does occur.  What this paper highlights are the difficulties that will be faced as we open hospitality venues in coming months.  How to open hospitality venues over coming months so that all provide safe environments will be a key challenge for the UK.”



‘Managing COVID-19 Transmission Risks in Bars: An Interview and Observation Study’ by Niamh Fitzgerald et al. was published in the Journal of Studies on Alcohol and Drugs at 01:00 UK time on Tuesday 16 February 2011.

DOI: 10.15288/jsad.2021.82.42



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