Managing COVID-19 transmission risks in bars: an interview and observation study

Abstract

Objective: Licensed premises face particular challenges to operating safely within COVID-19 restrictions. The ability and willingness of customers to comply with guidance may be compromised due to alcohol intoxication, increasing virus transmission risks. Government responses include guidance, closure orders, curfews, or prohibition of alcohol sales. Following a UK national lockdown from 20th March 2020, we explored and observed business practices and behaviours in licensed premises to inform COVID-19 policies. To our knowledge, no previous study worldwide has examined these issues. Method: Prior to premises re-opening in Scotland, we conducted in-depth telephone interviews (May-June 2020) with participants from hospitality trade associations, licensed premises, or in related roles (n=18). Interviews focused on anticipated business practices and challenges relevant to minimising Covid-19 transmission. Following re-opening (July-August 2020), we conducted observations of relevant practices and behaviours in 29 bars purposively sampled for diversity, using a structured schedule. Interviews and observation reports were analysed thematically. Results: Interviewees generally sought clarity, flexibility and balance in government guidance on re-opening, and cited commercial and practical challenges to doing so safely. Alcohol consumption was perceived as an additional but potentially manageable challenge. Most observed premises had made physical and operational modifications, however, practices were variable. Observed incidents of concern included close physical interaction between customers and with staff, frequently featuring alcohol intoxication and rarely effectively stopped by staff. Conclusions: Despite the efforts of bar operators and guidance from government, potentially significant risks of COVID-19 transmission persisted in a substantial minority of observed bars, especially when customers were intoxicated.