FILE—Bella Dagdagan, left, wears a face covering as she prepares a dinner order at Cowiche Canyon in Yakima, Wash., Tuesday, Nov. 17, 2020. Gov. Jay Inslee announced on Sunday new restrictions and limitations on businesses and social gatherings in response to a rise in new cases of COVID-19.

Gov. Jay Inslee’s latest COVID-19 restrictions have been met with significant criticism and concern from those in the restaurant industry.

The new limits shut down indoor service at restaurants and bars for four weeks in an effort to curtail rising COVID-19 cases statewide.

The Washington Hospitality Association has asked Inslee to reconsider, arguing that already-impacted restaurants are being disproportionately affected without sufficient evidence that indoor dining has contributed to the rise in cases.

Health officials say the coronavirus is more likely to be transmitted inside when people aren’t wearing masks, which is why the restrictions focus on indoor spaces.

Here is what we know about the restrictions, the justification for them and their impact on the local restaurant industry:

What can restaurants do under the new restrictions?

Restaurants can offer outdoor dining and takeout. This week, several local restaurants have reworked their patios and other outdoor spaces to accommodate outdoor dining in colder temperatures.

Why has indoor dining been prohibited?

During the Yakima Health District’s COVID-19 update Wednesday, Health Officer Dr. Teresa Everson said it comes down to the “fundamentals of transmission of COVID-19.”

“The transmission is highest when there is prolonged contact indoors. It’s worse when masks are off. When you think about activities that were approved where masks are off, restaurants go to the top of the list,” Everson said, responding to a community question during the televised briefing. “That is why indoor dining has been rolled back with these newest measures.”

She pointed out that indoor dining poses more risk than other indoor activities, such as retail.

Lilian Bravo, director of public health partnerships for the Yakima Health District, said that people generally wear masks the whole time when shopping and can more easily social distance while walking around the store.

In contrast, people in restaurants sit close together and don’t have masks on for an extended period, Bravo said. They are more likely to be with people from outside their household.

That could create issues, especially with community spread ramping up again locally and throughout the state.

“All those factors together make it a risker environment,” Bravo said. “Especially now when you’re more likely to be around someone with COVID-19 than a few weeks ago.”

Why is indoor dining a target for restrictions when recent local messaging has emphasized that most cases are linked to small and large social gatherings?

Bravo said that there’s a clear need to pivot messaging to emphasize that social gatherings aren’t limited to private events. Restaurants are a venue for gatherings as well.

“It’s just people hanging out, wherever it may be,” she said.

What is important is to limit gatherings with those from outside one’s household, she said.

What do case investigations and contact tracing show regarding COVID-19 spread in restaurants?

Unfortunately, not as much as public officials would like, Bravo said.

Information gathered through contract tracing and case investigations are dependent on people’s willingness to, first, respond to calls from public health officials and, second, thoroughly answer all the questions, Bravo said.

Generally, the priority is to get necessary demographic and employment information and any close contacts they may have had with individuals and when that contact was made.

Any information with restaurants generally comes up when asking about employment or, much later in questioning about their whereabouts, Bravo said.

And when people talk about their whereabouts, they tend to remember going to a big event, like a wedding or party and identify close contacts there, Bravo said. If they manage to remember going to a restaurant, they don’t necessarily remember details, such as whether they were in contact with employees or other people in the restaurant, that could help them trace links to other cases.

“It’s just incomplete information,” she said.

What do we know about outbreaks in restaurants?

The latest state outbreak report shows that 151 outbreaks have been reported in the restaurant and food service industry, the most out of any non-health care congregate setting. Outbreaks are declared when there are at least two cases within 14 days of each other and that there is evidence of transmission through a shared location other than a household.

Bravo said reported outbreaks in restaurants generally involve employees at the restaurants, not patrons. And there hasn’t been the ability to trace close contacts between employees and customers.

Bravo said there had been some incidents in areas of the country where contract tracing has been robust enough to identify outbreaks or spread among customers in restaurants, but that has been far more difficult to do here, where there aren’t the resources to do robust contact tracing, especially with cases increasing.

In Yakima County, contract tracing is done through the Department of Health, but the Yakima Health District is working on getting those efforts done locally, Bravo said.

How has the restaurant industry responded?

In general, most local restaurants have opted to offer either outdoor dining, takeout or both. A few have decided to close while restrictions are in place. A small number of restaurants and bars have indicated on their social media pages or through word-of-mouth that they plan to defy the order and continuing operating indoor dining and bar service.

On Wednesday, the Washington Hospitality Association wrote a letter to Gov. Jay Inslee asking him to reconsider the indoor dining prohibition, arguing that restaurants can operate with safety measures in place. The association has maintained that public health officials haven’t sufficiently proven that restaurants in the state contribute to the rising COVID-19 cases.

A group of state Democratic legislators has also asked Inslee to consider allowing restaurants to reopen with strict limits. Some county commissioners in the region have indicated that they plan to work alongside business owners to challenge the restrictions.

Bravo said that indoor dining restrictions shouldn’t be seen as an indictment on restaurants’ compliance with measures so far.

“We didn’t make the decision, but these decisions aren’t being made because restaurants aren’t taking precautions,” she said. “The majority of our community is invested in taking these precautions.”

What impact has COVID-19 has had on restaurants so far?

A presentation with the Washington State Economic and Revenue Forecast Council cited data from Yelp, the popular business listing website, that showed that thousands of U.S. restaurants have closed during the COVID-19 pandemic. According to that data, more than 32,000 U.S. restaurants open on March 1 were marked as closed as Aug. 31. Out of that figure, nearly 20,000 were listed as permeant closures.

Locally, several restaurants and bars have closed, including Jack-Son’s and Gasperetti’s. The Yakima Sports Center in downtown Yakima and other restaurants have remained closed for several months.

More than 200 businesses have received more than $1.4 million in small business grants through various programs state, county and local grant programs, said Jonathan Smith, executive director of the Yakima County Development Association, which has been administering several grant programs. Most of the funds have come through the CARES Act, the federal coronavirus relief bill.

Reach Mai Hoang at maihoang@yakimaherald.com or Twitter @maiphoang