Most restaurants were forced to balance public health and business amid the coronavirus pandemic, and there are clear tensions across the U.S. as restrictions increase as transmission surges.

Outdoor dining has become a popular option for restaurants, as it offers patrons better ventilation and more opportunities to stay more than six feet apart. But with the winter approaching, some outdoor dining experiences look conspicuously indoor.

“We know that outdoor spread is about 1/20th as risky as indoor spread,” Dr. Steven McDonald, an emergency medicine physician based out of New York City, said on Yahoo Finance Live (video above) “You would think outdoor dining should be a relatively safe activity. That said, when you actually look at what constitutes outdoor dining in New York City, a lot of these restaurants have put up structures that are questionably outdoors any longer.”

To protect against rainy or cold weather, many places set up tents to hold their tables inside. These restaurants are supposed to keep at least one side open to ensure that air is circulating properly.

“They’re supposed to be open on at least one side,” McDonald said. “I think two is best for ventilation. And now we’re seeing many that are actually completely enclosed structures. So that does raise a question of what actually is outdoor dining any longer and how much is this contributing to spread.”

Restaurants have become reliant on these accommodations as a means of keeping their businesses open and workers employed. The restaurant industry is poised to lose $240 billion by the end of 2020, according to the National Restaurant Association.

‘You really don't have any choice’

Whether or not walled-in outdoor dining has contributed to the recent surge in coronavirus cases remains a point of debate among public health experts.

A September 2020 report from the Centers for Disease Control and Prevention (CDC) found that adults who test positive for coronavirus are twice as likely to have eaten at a restaurant in the two weeks prior. It also noted that both indoor and outdoor dining pose some risk since patrons can’t eat or drink with masks on.

California Gov. Gavin Newsom recently sparked controversy after imposing stay-at-home orders to combat the rise of cases. These orders meant that restaurants offering outdoor dining also had to shut down in Los Angeles, causing outcry from many local business owners.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), voiced support for Newsom’s decision, arguing that it was necessary given the latest surge in cases and record-high hospitalizations in the state.

"I have been in discussion with the health authorities from the state of California who called me and asked," Fauci told CNN. "You know, they said, 'We feel we need to do this, what do you think?' And I said, 'You know, you really don't have any choice. When you have the challenge to the health care system, you've got to do something like that.'"

Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells.

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