The types of places that carry the biggest risk for COVID-19 transmission have changed over time ― partly because experts have learned more about how the virus works and partly because the virus itself has changed. The delta variant is more than two times as contagious as previous strains, which has obvious implications for transmission.
Also, nearly 60% of the population in the United States is now fully vaccinated, which impacts the virus’s spread. Fully vaccinated people are not only less likely to become hospitalized or die, they’re also far less likely to spread the virus (despite some confusing public health messaging around this second point).
So here’s what we know about the places where transmission is the highest right now, and places where the spread isn’t as bad as people might think:
Where COVID Is Spreading The Most Right Now
Inside restaurants and bars
Throughout the pandemic, it’s been pretty clear that restaurants and bars are sources of COVID-19 transmission, and recent evidence suggests that continues to be the case.
“You have decreases in cases and deaths when you wear masks, and you have increases in cases and deaths when you have in-person restaurant dining,” Rochelle Walensky, director of the Centers for Disease Control and Prevention, said in March in response to CDC data showing a link between indoor dining and increased COVID-19 cases. During the delta summer surge, there were clusters linked to restaurants that occurred in various parts of the country, including some among restaurant staff (though it’s not easy for health officials to pinpoint where exactly COVID-19 is spreading when there is a lot of it in the community).
And of course the risk of contracting COVID-19 when you’re enjoying a meal indoors depends a lot on local transmission and vaccination rates. Some places, like New York City, require proof of vaccination, if you’re eligible, before you can dine indoors. (Younger children are exempt.) If you’re going to eat inside, pay attention to both of those factors, as well as where you’re sitting. Avoid crowded areas (like the bar) and sit by an open window or door if possible.
Small, informal get-togethers
Experts have long warned that small get-togethers seem to be driving transmission, and research suggests that continues to be the case. One 2020 study found that in areas with high transmission, households that had recently held a birthday party had a 30% higher risk of COVID-19 infection than those that did not host a get-together. (The researchers didn’t have information on where the parties were hosted, attendees, etc.) It’s not easy to study spread from informal gatherings, because they’re hard to track, but health experts definitely believe that delta has made getting together with others riskier.
That is why the CDC still recommends that small gatherings be held outdoors if possible, and that people living in areas with substantial or high transmission mask up if they’re spending time indoors together. Even though new COVID-19 cases have declined dramatically over the past month, most of the country still falls into that substantial or high transmission category.
“Most people are getting COVID in their free time,” Alexa Mieses Malchuk, a North Carolina-based family physician, told HuffPost, by which she means that people are getting sick when they’re together socially rather than in schools or office buildings.
Very crowded outdoor settings
Outdoor settings are less risky than indoor settings, but “it’s not like being outdoors is a magic wand,” said Mieses Malchuk. If you’re outdoors with a small group of people maintaining physical distance, that’s very different than if you’re at a crowded outdoor event spending a lot of time in close quarters with others.
“The more people we add, the more variables come into play. Naturally as crowds grow, it is harder and harder to keep that physical distance,” she said. “What’s more, you don’t know the vaccination status of everyone around you.”
That’s why there have been coronavirus clusters linked to outdoor music festivals, for example. Experts are also looking into COVID-19 spread associated with youth sports leagues, though they’ve said cases linked to outdoor sports probably have more to do with kids spending time together off the field than with games and practices.
Where COVID Does Not Appear To Be Spreading
Schools with mask mandates
Throughout the pandemic, research has shown that schools were not major sources of COVID-19 transmission — but there were concerns that might change as schools across the U.S. reopened this fall amid the delta surge.
Early evidence suggests that schools with mask mandates appear to be faring well, while schools without them have seen more cases. “Nationwide, counties without masking requirements saw the number of pediatric COVID-19 cases increase nearly twice as quickly during this same period,” according to a recent CDC study.
Public transportation
Studies conducted in 2020 found that public transportation in places like New York City does not seem to be a big driver of COVID-19 transmission, and research also suggests that extends to other types of group transport, like school buses. That probably has a lot to do with the fact that the CDC has required the use of face masks on public transportation and indoor transportation hubs.
All of this really depends on where you live
While it’s helpful to have a big-picture view of the types of activities that have been linked to greater COVID-19 transmission — and to stay on top of national trends — Mieses Malchuk said it’s probably much more useful for anyone making decisions about their own risk during certain activities to continue checking out their local health department data. You can do this by searching online for your city and the phrase “COVID cases.” The CDC also tracks community spread by county, and updates it daily.
Also, know what your local regulations are regarding mask mandates and other preventive measures. Your risk of getting COVID-19 is very different if you’re dining indoors in an area with no mask mandates and high transmission than if you’re dining indoors in an area with relatively low transmission and where you’re required to wear a mask indoors — or maybe even be vaccinated to eat indoors.
Ultimately, those two factors — your local transmission rates and regulations — probably tell you more than any one study can about where you’re at a higher risk of contracting the coronavirus. Studies take time, and the virus is so widespread at this point it’s difficult to pinpoint where exactly people are getting it. Also, while national health organizations like the CDC and American Academy of Pediatrics are tracking COVID-19 transmission, a lot of the tracking is done at the local level — and different states, counties and even institutions (like schools) have different ways of collecting and disseminating that information.
“We don’t just have one centralized place in which all schools or community organizations report,” Mieses Malchuk said.
So do your best to stay on top of what’s happening around you, follow local and national recommendations, and talk to your doctor if you have specific unanswered questions about your own risk.
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.
This article originally appeared on HuffPost and has been updated.
