Christina Proctor is a clinical assistant professor of Health Promotion and Behavior in the College of Public Health at the University of Georgia. She teaches Human Sexuality, Effects of Drug Use and Abuse, and Research Methods to undergraduate students.
In this guest column, Proctor voices concerns over the role bars could play in spreading COVID-19 in Athens as UGA students return to campus.
By CHRISTINA PROCTOR
In a few short weeks, college campuses will open their doors to eager undergraduates. These individuals are eager to earn their degrees, to be sure, but perhaps more eager to socialize and party with friends and new acquaintances after months removed from the college campus life. Like it or not, alcohol and bars take center stage in this culture.
Here in Athens, we know all about the college campus life. The University of Georgia is one of the best public universities in the country, and, perhaps more importantly, UGA is on the list for top “party schools.” Downtown Athens consists of about one square mile, yet you’ll find more than 100 alcohol vendors ready to serve any and all comers.
Credit: UGA
Credit: UGA
It’s Willy Wonka’s Factory for undergraduate students. Alcohol rivers and fizzy-lifting drink rooms help students float away from the stresses of college life. That’s Athens. At least that was Athens before the COVID-19 pandemic. Now when I envision 40,000 students coming back to Athens, I think about the scary parts of “Willy Wonka and the Chocolate Factory.” The parts that made you question whether or not this was a movie suitable for children to see. Take the Tunnel scene, for example. Remember this?
By the fires of hell a-glowing,
is the grisly reaper mowing?
Yes! The danger must be growing,
For the rowers keep on rowing,
And they're certainly not showing,
Any signs that they are slowing!
Our ride through the COVID-19 tunnel shows no signs of slowing in Georgia, either. In fact, the tunnel is more dangerous now than it has been in months, ramping up after the Memorial Day and Fourth of July festivities. Widespread community transmission in Athens leaves us with a rate of 1,562 cases per 100,000 people. That means if you know 100 people in Athens, you most certainly know at least one person who has had or has COVID-19. You probably know more than one.
Athens took on another 587 confirmed cases over the past two weeks. Recently, UGA was listed as having the third highest number of COVID-19 cases at public, four-year universities in the country. And most students have not returned to campus yet.
The backdrop of the state of Georgia is scarier still. The number of positive cases exploded in the past four weeks, up 97,661 (+102.2%). The number of new deaths in the past four weeks reached 980 (+34.3%). The positive test rate hovered around 12%.
Ideally, positivity rates should be below 5% before schools reopen. Widespread transmission makes it difficult for manageable control without enforcing social distancing and limiting the availability for people to gather indoors in large groups.
Recently, experts are noticing a pattern of younger Americans bringing COVID-19 infections home or unknowingly spreading it in the community because they are asymptomatic/presymptomatic and in turn getting older individuals sick. In Georgia, larger numbers of younger individuals tested positive within the last month.
If we allow our bars to open without limiting hours of operation, we will provide a catalyst to the spread of COVID-19 in our college towns. We don’t have to look far to find evidence that college towns will be COVID-19 hotspots in the fall. Public health authorities have identified bars as the locus of outbreaks in Louisiana, Florida, Wyoming and Idaho.
Some of these outbreaks were tied to bars catering to college students like this incident at Louisiana State University or this one at University of Central Florida. Athens tried to enact a last call time of 10 p.m. for bars earlier this month to prevent the spread of COVID-19, but that effort was temporarily suspended by a lawsuit from multiple bar owners. Bar owners and other business that rely on late-night activities downtown will lose revenue if they have to close early. But enacting policies that prevent spread right now will allow business to get back to normal sooner and could potentially prevent complete shutdowns this semester and in the spring.
This morning the Athens-Clarke County government and bar owners reached a compromise to move last call to 11:30 p.m. While this is moving in the right direction, an earlier call time would ensure more safety to the Athens community. Timing is everything in this case. If we pushed those last calls closer to 9 or 10 p.m., we’d see fewer students venturing out. If they did they would have less time to bar hop and potentially spread COVID in multiple locations. Typically, college students wait until later hours to hit bars due to late classes, other activities, and, let’s be honest – social pressure.
We have to limit the operation hours of bars in college towns for two reasons:
- Students will not be able to take necessary precautions to limit/prevent spread of COVID-19 while under the influence at bars (maintaining six-feet separation, using hand sanitizer, wearing masks, and limiting contact with those outside of the house/dorm unit).
- Alcohol significantly affects the immune system which will increase susceptibility to illness and could also increase complications of disease.
Both the environment and the behavior of individuals while under the influence of alcohol are problematic for controlling the spread of COVID-19. We know from numerous studies that duration of contact, physical proximity and environmental conditions are the main factors leading to transmission.
Cramped indoor spaces with poor ventilation are riskier than outdoor spaces. Many bars in Athens are located in tight indoor spaces with few windows and no room to move around. You can’t space tables or chairs far apart because most bars have fixed-bar stool seating, which forces people to cluster in one area to get their drinks. They are purposely created that way to increase socializing and provide intimacy, which is fine when we aren’t in the middle of a pandemic.
Bars provide optimal conditions for spread of COVID-19: tight quarters, loud music that requires projection of voice (which has been linked to aerosol emission), difficulty enforcing social distancing rules, and alcohol impairment that leads to risk taking and decreased ability to take precautions to prevent spread (washing hands, mask wearing, social distancing, etc).
Even if bars can somehow address the environmental risk factors, there are issues with controlling (intoxicated) human behavior. Inebriated bar patrons are not ideal candidates to stay six feet apart from each other.
They are risk-takers making potentially poor decisions, free from the constraints of expectations about negative consequences. People go to bars to drink, socialize, and meet other people.
When I go out in Athens, I don’t see many George Thorogoods, drinking alone. In a college town, alcohol and COVID-19 are powder keg material.
Further COVID-19 outbreaks in Athens will cripple our community. The city is home to over 26,000 residents living in poverty, and COVID-19 data shows that lower socio-economic populations are the hardest hit by this pandemic.
You also have to think about why people drink in the first place. Alcohol or drug intoxication permits a period of “time out” from normal life. It’s an excuse for individual behavior that is unacceptable. It is important that we do not provide an outlet for individuals to engage in behavior that will disrupt their decision making, that will allow people to act without thinking, that lowers inhibitions and increases impulsivity, reduces self-control, and makes it hard to consider the consequences of their actions. Any event or outlet that provides that during a pandemic is a danger to everyone and must be controlled.
In addition, we must limit the opportunities for people to engage in activities that would significantly affect their immune system. Alcohol has a negative effect on the immune system and the lungs and can also damage the intestinal lining which decreases absorption of nutrients that boost the immune system and increases the risk of bacterial infections. Binge drinking can also suppress bone marrow and decrease white blood cell production, which damages the immune system and opens individuals up for viral infections.
Going back to the Willy Wonka analogy, how do we get out of the Tunnel? Life in Athens right now is surreal and frightening. It’s not magical. It’s not filled with Pure Imagination. We can’t give that illusion to our returning college students, even if they have seen worse in other places in the country or the world.
Most college students will get it. I teach an undergraduate course on the Effects of Drug Use and Abuse where we discuss risky behaviors, motives for alcohol use, and social norms around campus. Students in my class want more college activities that don’t revolve around alcohol and acknowledge that policies are the best way to change behaviors.
I believe if we ask them, they will return to a town where bars close at 10 p.m. and completely understand why. We are in the midst of a global pandemic. It is a shared human experience, and it is hurting all of us, including college students. They will follow the rules if the correct policies are in place. And closing bars early is the best place to start.
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