Whether it’s the mall, restaurants, concerts, ballparks or even drive-in movie theaters, Americans are making it clear: They won’t be ready to go out to their favorite destinations until they feel confident about being able to go.

To the bathroom, that is.

The idea of a return to life in public is unnerving enough for many people. But it turns out that one of the biggest obstacles to dining in a restaurant, renewing a doctor’s appointment or going back to the office is the prospect of having to use a public restroom — a tight, intimate, and potentially germ-infested space.

It’s a hurdle vexing many business owners as they prepare to reopen in a time of social distancing, reduced capacity, and heightened anxiety about the very air we breathe.

A Texas barbecue restaurant reopened only after hiring for a new job category: a bathroom monitor, who assures that people waiting their turn are spaced well apart. In Florida, malls are installing touch-free sinks and hand dryers in restrooms before opening their doors. McDonald’s is requiring franchisees to clean bathrooms every 30 minutes. Across the country, businesses are replacing blow dryers with paper towels, decommissioning urinals that now seem too close together, and removing restroom doors to create airport-style, no-touch entrances.

In San Luis Obispo, California, the Sunset Drive-In is holding back from reopening — even though the health department gave it the green light — because the owner hasn’t figured out how to address customers’ concerns about catching covid-19 in the bathroom.

“Before we open, we want to have the restroom problem solved for your safety,” the owner, Larry Rodkey, wrote on Facebook. “Sitting through approximately five hours of movies is a necessity for the enjoyment of the Drive-In.”

The theater is considering installing more toilets, adding port-a-potties and hiring staff to disinfect bathrooms after each use.

The Aut-O-Rama Twin Drive-In theater in North Ridgeville, Ohio, reopened this week with 10 portable toilets added to the eight existing stalls, even though movie attendance was limited to 25% of the usual capacity. On its marquee facing the highway, the theater touted the advantages of outdoor, in-car movie watching: “Social Distancing Since 1965.”

Owner Deb Sherman has instituted new policies, leaving plenty of space between cars, requiring masks, and enforcing six-foot distancing in the restrooms.

“Anyone not following established safe policies set forth may be asked to leave the theatre without a refund,” the policy says.

She doubled her staff from 10 to 20 to keep queues to a minimum and let customers see that someone was constantly disinfecting the restrooms and concessions stand.

“If we can give them some confidence about safety, people are ready to get out of the house and try and have a little more normal life,” she said. “The restroom situation didn’t bother me personally, but it was the Number 1 concern people had on our Facebook page, so I had to take action to make them comfortable.”

Such comfort might be hard-won. Laura Maxwell is eager to find an entertainment option that would let her take her children, ages 11 and 13, out of the house safely. Maxwell, who lives in San Luis Obispo, would happily return to the Sunset Drive-In, but the prospect of restroom queues is bothersome.

“Bathrooms are a problem,” she said. “They’re huge contact places, and if you’re shedding the virus, it’ll be all over. Maybe they could just open up without bathrooms and people would know in advance and make the decision not to go, or to wear Depends.”

Solutions to people’s anxieties might not be quite so simple, said Steven Soifer, president of the American Restroom Association, which advocates for safer and more-private public bathrooms.

“Americans have always had a fear of contamination from public restrooms,” said Soifer, who also is a professor of social work at the University of Mississippi. “What we’re seeing now is part just heightened anxiety, but it’s also part reality-based. Public restrooms in this country generally have open toilet seats — no lids — and high-pressure flushes create a plume of droplets that extends at least six feet.”

The coronavirus has been found in human waste up to a month after a victim has recovered. And a study published last week concluded that droplets from human speaking can hang in the air for at least eight minutes.

Soifer’s group seeks a retooling of public facilities that would place toilets inside fully enclosed unisex stalls, as is more common in Europe and parts of Asia. There would be larger dividers separating urinals.

“In our country, people aren’t comfortable talking about bathroom issues in general,” Soifer said. “The old frontier mentality and the emphasis on personal liberty has led to an attitude where there’s no standard for public restrooms other than the building code. Now we need to extend social distancing to restrooms, and it’s going to be very hard. Even if you limit the number of stalls, you then create a line of people outside.”

Makers of bathroom fixtures have seen a surge of restaurant owners and workplace managers ordering thorough renovations of their bathrooms — a level of attention unusual in a country where many public restrooms haven’t moved much higher up the design ladder than the stereotypically awful gas station bathroom.

“People are converting to fixtures with touchless features,” said Jon Dommisse, director of strategy for Bradley Corp., a Wisconsin-based maker of workplace washroom equipment. “They’re swapping out faucets, dryers, anything with buttons, levers, knobs. They’re reducing the number of people allowed in at a time, taking doors off and adding wash stations outside the bathroom to relieve crowding. Most of all, we’re seeing a commitment to almost relentless levels of cleaning.”

Bradley regularly conducts national surveys about bathrooms, and even in good times, 76% of Americans say they’ve had memorably bad experiences in public restrooms. The latest survey, conducted last month, found that 91% of consumers want touchless fixtures in bathrooms, Dommisse said, “a number we’ve never seen before.”

Going away: Push-button soap dispensers, and those high-velocity hand dryers that can blow germs across an entire room. Coming to a restroom near you: More copper fixtures — copper has antimicrobial properties — and dryers integrated into the sink so no one walks across the room dripping water.

“Maybe the multi-stall restroom is obsolete,” said Michelle Kempen, an interior designer at Kahler Slater, an architecture firm in Milwaukee. “With covid, we’re moving toward a more European model, where the WC is a single room and then you go out into a shared sink area, along with touchless design and maybe a return to restroom attendants.”

Having an employee present at all times, she said, makes cleaning ongoing and evident.

But employees cost money, and the bill for retooling a restroom can be $25,000 or more — McDonald’s is leaving it to franchise owners to foot the bill for $718 touchless sinks and $310 sensor-activated towel dispensers. Quick fixes are likely to be cheaper, such as a return to paper towels, additional signage and one-way foot traffic.

Some businesses now want cleaning done by day rather than when they’re closed, so customers and employees can see the company taking cleaning seriously, said Michelle Goret, a spokeswoman for Cintas, an Ohio-based supplier of restroom services.

“To further ease consumer anxiety around restrooms, our customers are also more interested in providing proof of service,” Goret said. “We’ve even had some customers film our technicians performing a deep clean to share with their customers and employees.”

Figuring out what might restore consumer confidence is more art than science. In a Washington Post-University of Maryland poll this month, 78% of those surveyed said they would be uncomfortable eating at a sit-down restaurant. The results were similar whether people lived in a state that is opening up businesses or one still operating under tight restrictions.

In South Florida, where many stores are reopening, the Bal Harbour Shops mall hired 14 extra people to clean. Restaurants will move their seating outdoors, but customers still need to go inside to use the restrooms, which are being renovated to include automatic doors, touchless sinks and dryers.

In Milwaukee, at Good City Brewing’s two locations, owner David Dupee plans to “control the number of people and mark off space where people should stand while they’re waiting for the restroom — whatever we can to make people feel comfortable that guests around them will be appropriately distant. But we don’t expect any return to normalcy until there’s a vaccine. We’ve all been trained in recent weeks to walk across the street when we see other people on the sidewalk. That’s just in our psyche now.”

Outdoor venues might seem to be the easiest to reopen, but whether they are sports stadiums, concert facilities or parks, visitors still eventually need to go — a packed event and beer and soda sales inevitably lead to crowded bathrooms and long lines — so managers of such spaces are focusing on how to provide relief.

The American Hiking Society has recommended that people limit their walks to places in their neighborhoods, in part to avoid having to stop to answer nature’s call. Bathrooms at many parks and beaches are shuttered, and those that are open struggle with staffing and with maintaining a supply of toilet paper, which remains difficult to find in many places.

Some mayors have even talked about hiring guards to assure that toilet paper doesn’t walk off the premises.

All beach restrooms remain closed in Emerald Isle, North Carolina, but the Outer Banks town is taking bids from private services to clean bathrooms every 90 minutes and disinfect them every night once they reopen, probably in late May.

Town Manager Matt Zapp said the added measures will cost $250 per cleaning for each of the three public restrooms, as well as the town’s fire, police and EMS stations.

Although beach crowds so far have been “substantially less than normal,” Zapp said “public demand to return to ‘life as we knew it’ is increasing weekly.”

The shuttering of many public facilities already has posed a considerable hardship to essential workers such as delivery drivers and police, and to homeless people, who say the closings of toilets in stores, restaurants and even fire stations have made it difficult to get through the day.

Truckers and food delivery drivers have filled social media with accounts of their fruitless search for open restrooms at their usual stops. Some restaurants now limiting their business to takeout service are barring delivery drivers from their bathrooms, erecting walls of tables and chairs to keep people out.

Some cities have put portable toilets on streets to serve homeless people who previously depended on restrooms in public libraries, community centers and fast-food restaurants.

Seattle opened six hand-washing stations and 14 portable toilets near homeless encampments, and San Francisco is staffing public bathrooms at 49 locations where homeless people congregate.

Even police officers are having trouble finding a place to go during their shifts. Coffee shops are closed and fire stations formerly hospitable to other first responders are taking a newly cautious approach.

In Manchester, Maine, the fire station restroom was closed to the state and county cops who usually pop in. “No law enforcement,” said the sign on the door.

“We have a small, volunteer fire department and it would be devastated if we lost a couple of guys who had to quarantine,” said Robert Gasper, who is chairman of the town board of selectmen and a captain in the fire department. “Volunteerism is down across the country, so we can’t afford to take a chance.”

Such uncertainty is likely to remain as people decide when to resume going out, and part of the calculus will be whether they can make it comfortably through a day.

“The new normal is going to be traveling with your own toiletries,” said Sonia Massey, who, with her husband Bill, developed the Restroom Kit, a packet the size of a deck of cards that includes a toilet seat cover, three feet of toilet paper, and sanitary wipes. They also sell hand sanitizer in misters and gel bottles.

The Masseys, who live in Clinton, Maryland, have seen sales surge for their five-year-old product — a sign, they say, that people who feel they’ve lost control are eager to take charge of at least life’s most intimate aspects.

“Any restroom outside your house is a public restroom,” Sonia said. “Unless you cleaned it yourself, you just don’t know.”

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