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Juan Reyes lives at the corner of fear and financial ruin. The 38-year-old sous chef worries as much about the job he desperately needs drying up as he does about contracting COVID-19 while preparing salads and pasta dishes.

As the temperature drops and coronavirus infections rise across Massachusetts, not only are restaurant owners deciding whether they can stay afloat, but employees are wondering whether they can remain healthy working inside with patrons who — by necessity — are not wearing masks as they eat and drink.

Five months after restaurants began reopening in Massachusetts, there’s scant up-to-date information from the state about any connections between COVID-19 infections and dining out. But data from Boston’s Inspectional Services Department show reported infections at restaurants are rising. And a study published in September from the US Centers for Disease Control and Prevention found adults who tested positive were roughly twice as likely to have reported dining at a restaurant in the two weeks before than those with negative test results.

Local health department directors say the job of keeping the public safe while helping restaurants — often vital economic engines in their communities — remain solvent has grown increasingly difficult.

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“We are walking on the edge of a razor blade between economic health and public health, balancing the city’s economy and the health of the people,” said Dan Manning, Boston’s Inspectional Services Health Division assistant commissioner. “It’s a situation we have to take into full consideration when decision-making. It’s the jobs, it’s the business owners, it’s the real estate.”

Through it all, patrons are left to scrounge for what limited information is available about restaurant-related COVID-19 infections. And legions of employees are in limbo amid an uptick in the number of temporary restaurant closings following coronavirus cases.

“My hours are slowing. And my money, too," said Reyes, who is down to three days a week because of the declining number of customers at the Brookline restaurant where he works. He’s looking for a second job as the hours aren’t enough to support his wife and 9-year-old son and pay the bills for their East Boston apartment.

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Juan Reyes, a sous chef in Brookline, with his mother-in-law, Lucia Aleman, in his East Boston home.
Juan Reyes, a sous chef in Brookline, with his mother-in-law, Lucia Aleman, in his East Boston home. John Tlumacki/Globe Staff

There haven’t been any reported COVID-19 infections where he works (he didn’t want the name made public). But Reyes is anxious that younger colleagues don’t seem to be as careful about precautions while outside of work.

Food service employees often work multiple jobs, hopping from one restaurant to another, especially as hours dwindle. It’s not clear whether this is fueling the spread of the virus among restaurants, but social media postings seem to be popping up daily from owners about closing temporarily and deep cleaning after a coronavirus infection among staff or their families.

“We’re all kidding ourselves if we think that all the other restaurants haven’t had a situation yet," said Joshua Childs, owner of Trina’s Starlite Lounge in Somerville, which temporarily shut down earlier this month after learning that the spouse of one of his kitchen staff tested positive for COVID-19.

“Everyone is doing the best we can, but the reality is if you talk to everyone in your restaurant, chances are someone has had COVID or they know someone who has,” Childs said.

The state health department provides sparse information about coronavirus infections by occupation and industry but indicates at least 150 infections among food service workers in July alone, the most recent such data available. In Boston, restaurant-related COVID-19 infections reported to the Inspectional Services Department show a steady climb in cases since late June, when the state allowed indoor dining to resume. The numbers have grown from eight in June to 34 in August and 49 in September.

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The recent CDC study about restaurant dining and infections did not find a similar pattern for other activities, including shopping, working in an office, going to a salon or a gym, or using public transportation. The CDC study noted that masks cannot be effectively worn while eating and drinking, as they can be during shopping and numerous other indoor activities.

“Everyone is doing the best we can, but the reality is if you talk to everyone in your restaurant, chances are someone has had COVID or they know someone who has,” said Joshua Childs, the owner of Trina's Starlite Lounge in Somerville.
“Everyone is doing the best we can, but the reality is if you talk to everyone in your restaurant, chances are someone has had COVID or they know someone who has,” said Joshua Childs, the owner of Trina's Starlite Lounge in Somerville.John Tlumacki/Globe Staff

“As the weather changes and people are weighing options for eating in, it’s important to reinforce the guidelines,” said Brendan Flannery, coauthor of the study and an epidemiologist at the CDC. The agency’s guidelines encourage outdoor dining over indoor when possible, increased ventilation inside, seating at least 6 feet apart, and mask use whenever possible.

Some restrictions, such as keeping tables 6 feet apart and limiting the number in a party to 10, remain in place in the state.

Manning, Boston’s Inspectional Services Health Division assistant commissioner, said complaints about crowded seating are fairly common. His team spends a lot of time working with restaurant owners to address coronavirus concerns, rather than issue fines or close businesses.

Still, he said, there has been an unmistakable increase in the number of restaurant-related coronavirus infections this fall.

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If state or city leaders decide indoor dining is too risky this winter, Manning said, his team “will be supportive of the people who make the tough decision. It’s not something I envy.”

Leaders in other city health departments report similar concerns.

In Lawrence, Mike Armano, the city’s health and inspectional services director, said officials are struggling to even collect comprehensive data on the occupations experiencing the most infections because undocumented workers often are nervous about sharing information with authorities.

“In our community, people don’t even want to admit where they work because they’re scared they’ll lose their job," Armano said.

Childs, the owner of the recently reopened Trina’s Starlite Lounge, said one of his biggest challenges is reconciling state coronavirus rules for restaurants with what owners are now encountering.

“The state has dictated that you need everyone to have a negative test and you can open up 24 hours later, but there’s really clear evidence that rapid testing is not very useful and it has a high percentage of false negatives," Childs said. “You really need to get a PCR test,” which takes days longer.

“You want to do the right thing, but from a financial perspective we need to be open," he said. "So we’re erring on the side of caution, which is not only the right but the responsible thing to do.”

Andrea Pentabona, who was working as a bartender in Somerville before the pandemic and now works in sales at a liquor company, has been building a coalition called All Day to advocate for the health and wellness of local restaurant workers. She said that the health risks are significant for restaurant workers, who often shoulder a financial toll as well.

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“The average server or bartender makes $30,000 to $40,000 a year, and not only is that not enough to live in Boston, but it’s also too much to qualify for MassHealth,” she said.

And even while restaurants install plexiglass barriers for patrons, working conditions in local restaurants aren’t easily made safer, Pentabona said. Because so many are in old buildings, it’s difficult, for instance, to update ventilation systems.

Amid all the uncertainty for restaurants, their workers, and patrons, the few concrete tools are safe distancing, robust ventilation, and masks, said Swannie Jett, Brookline’s director of Health and Human Services.

“We are going to have this up and down, unfortunately, of businesses open and closed," Jett said. "That is the nature of the way we are living now.”


Kay Lazar can be reached at kay.lazar@globe.com Follow her on Twitter @GlobeKayLazar. Janelle Nanos can be reached at janelle.nanos@globe.com. Follow her on Twitter @janellenanos.