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Leslie Echino, pictured in 2016, owns two restaurants and a wine bar in Calgary and is nervously waiting to see how the provincial government will respond to increasingly vocal calls for a wider lockdown.chris bolin /The Globe and Mail

Leslie Echino’s two restaurants and wine bar in Calgary have struggled since her industry was able to reopen over the summer from a combination of physical distancing rules that have reduced capacity and an unease among diners that has kept some from venturing out to eat.

Earlier this month, the province restricted operating hours for restaurants and bars, forcing them to stop serving alcohol by 10 p.m. and clear out an hour later. Ms. Echino’s revenues immediately dropped – again – by 55 per cent and now she’s nervously waiting to see how the provincial government will respond to increasingly vocal calls for a wider lockdown.

“Full-service restaurants are really taking the brunt of this. It’s had a huge impact,” said Ms. Echino, who owns Annabelle’s Kitchen, which has two locations, and a companion wine and cocktail bar called Bar Annabelle.

“If there’s going to be a shutdown, we’re gonna have to lay off about 80 per cent of all of our staff. It’s a horrible negative impact on the mental well-being of people that are out of work.”

Restaurants have become a flashpoint in the debate about how to respond to surging COVID-19 cases in Alberta, which has had some of the highest infections rates in the country for months.

Premier Jason Kenney, whose United Conservative Party government has largely resisted mandatory restrictions, has frequently cited the impact on independent restaurateurs to argue against closing down businesses. Restaurants in Calgary and across the country laid off staff after widespread closures in the spring and some have closed their doors permanently.

The Premier and Chief Medical Officer of Health Deena Hinshaw have pointed to provincial statistics that show only a tiny proportion of infections can be traced back to restaurants. They have also pointed to protocols in place, including physical distancing, which has forced restaurants to significantly reduce their capacity.

But experts have cast doubt on that data due to shortcomings in the province’s contact-tracing system. Even before the province recently suspended most of its contact tracing, due to a sudden increase in volume, health officials could not identify the source of infection in about half of all cases. Now, with contact tracing happening only in a select number of high-priority cases, the proportion of unknown infections is nearly 90 per cent. They also point to research in other jurisdictions that show links between COVID-19 infections and dining in a sit-down restaurant.

Dr. Hinshaw has said fewer than 1 per cent of infections have been traced back to a restaurant. She has also said evidence from other jurisdictions supports her belief that restaurants are not driving an outbreak that is largely fuelled by social gatherings and household transmission.

The Alberta government has faced pressure to impose stricter measures, including what has been described as a short “circuit-breaker” lockdown to bring infections under control. The province is averaging more than 1,000 cases a day and set a new record of 1,584 on Sunday, as hospitals are pushed beyond capacity and intensive-care beds fill up. Fifty people have died in the past week alone.

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Tehseen Ladha, a pediatrician and associate professor at the University of Alberta who is part of the group Masks4Canada, which has been pushing for a short lockdown, said the collapse of the contact-tracing system makes it impossible to know where people are getting infected as COVID-19 spreads uncontrolled through the community.

But she said the evidence is clear about the types of situations where the virus can spread – in places where people are close together not wearing masks for long periods of time. Those criteria, she said, all apply to restaurants.

“It’s only logical that if you’re in a restaurant and you have to take off your mask and you’re not distanced, then there is a higher risk,” said Dr. Ladha. “Eating out in a restaurant with friends is no different than eating at home with friends.”

Dr. Ladha said there is considerable evidence from other places in the world, including in Wuhan, China, where the first cases of COVID-19 were reported, that point to spread in restaurants.

The U.S. Centers for Disease Control published a study in September that asked people who were diagnosed with COVID-19 about their recent behaviour before they became ill. The report found adults who had tested positive were about twice as likely to have gone to a restaurant.

Earlier this month, researchers from Stanford and Northwestern universities using cellphone location data found that most COVID-19 infections occurred at what they described as “super spreader” sites where people remain close together for long periods: restaurants, cafes and fitness centres.

Dr. Hinshaw said studies that have linked restaurants and COVID-19 infections are from places such as the United States, where some jurisdictions have comparatively lax infection-control measures such as physical distancing, capacity limits and restrictions on how many people can be at a single table. She has previously said that the province will act on the data it has.

“If you didn’t have the measures we have in place to prevent spread in bars and restaurants, then, absolutely, it’s not surprising that in a place like the U.S., where many states have not had significant restrictions, you would see that as a significant source of spread,” she said on Friday.

She said comparable jurisdictions, such as British Columbia, have also not seen significant transmission in restaurants.

B.C. has not released specific data but has indicated that restaurants are, similarly, not a major factor there. However, in some areas the number of unknown infections is as high as 20 per cent and local health authorities have issued dozens of public warnings about potential COVID-19 exposure at restaurants and bars. The province restricted operating hours for restaurants and bars in September.

Samir Sinha, director of geriatrics at Sinai Health in Toronto, said making small adjustments to how restaurants and other businesses operate won’t have a meaningful impact on COVID-19 spread.

“Trying to say, ‘Well, maybe if we close the bar an hour early’ – that’s the equivalent of rearranging deck chairs on the Titanic,” Dr. Sinha said.

“Where you have provinces that are more business-minded and business-oriented, sometimes that doesn’t allow us to follow the science the way we should. If we play the long game here, we’ll be better off than rather than saying, ‘I’ll keep restaurants open for another week and hope this gets better.’ Hope isn’t a cure.”

Bil Bonar, owner of Rain Dog Bar in Calgary, said he thinks his small restaurant in the city’s historic Inglewood neighbourhood is safe. Diners are physically separated from other guests, staff wear masks and restaurants such as his follow strict cleaning protocols, he said.

“It is absolutely possible to do it safely, and I think that’s the reason we haven’t seen the outbreaks coming from restaurants,” he said.

Mr. Bonar said Rain Dog, which opened just before the industry was forced to shut down in the spring, has suffered through almost its entire existence and the recent announcement curbing restaurant hours hasn’t helped. He’s more worried about the possibility of another full lockdown, which he thinks is inevitable.

“We’re going to weather it as best we can,” he said. “I’m hoping for a stated end point on the lockdown this time. If we’re closed as long as we were last time, there’s no way I could survive it.”

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Editor’s note: A previous version of this story had an incorrect name for Rain Dog Bar in Calgary.