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The COVID-19 pandemic has made many Americans ask a question they’ve likely never pondered before: Is casting a ballot in person a risk to your physical health?
With the November election three weeks away and daily COVID-19 case counts rising in virtually every state, voters have been hearing a confounding barrage of mixed messages regarding the safest — and most reliable — way to cast a ballot during a pandemic.
Voting is a fundamentally local process that varies from state to state and looks different depending on where you are. Weighing whether going to vote in person is not just about whether your regular polling place is normally packed or draws long lines, but what personal risks you’re willing to take regarding potential exposure to COVID-19 and what types of voting are available to you.
Dozens of states have expanded their voting options this year to accommodate those who, out of a desire to avoid contracting or spreading the disease, wish to avoid voting in person on Election Day itself. A handful of states, including Texas, Louisiana, Mississippi, Tennessee and Indiana, are not considering general fear of COVID-19 as an accepted excuse to vote by mail, but the vast majority of states offer early in-person voting as an option for any voter who wants to avoid potentially long lines at the polls.
Five states already conduct their elections entirely by mail, and several others have adopted the practice of mailing ballots to all active voters this year in light of the pandemic. Those who are sent ballots through the mail can fill them out at home and send them back either by mail or by depositing them at a secure drop box.
In the final few weeks of the race, President Donald Trump has continued his baseless attack on the institution of mail-in voting, despite casting his own vote-by-mail ballot during Florida’s primary election in August.
Trump frequently claims that voter fraud, a felony in all 50 states, is a problem exacerbated by mail-in voting. While there are known cases of fraudulent votes being cast through the mail, the practice is exceedingly rare. It’s far more likely for an otherwise legitimate ballot to be thrown out on a technicality, like in cases where it’s missing a signature or is postmarked after a state’s deadline.
WATCH: The truth about vote-by-mail and fraud
When it comes to in-person voting, much of the risk involved depends on what safety measures are being taken by voters and poll workers — both on Election Day itself and in their daily personal lives — in addition to whether the coronavirus is spreading unchecked or is relatively under control in your community at the time.
Jessica Malaty Rivera of the COVID Tracking Project likened that type of voting to something along the lines of visiting a bank or a post office, both of which are transactional services that often involve waiting in line among other people, interacting with another person behind the counter and exchanging items across frequently touched surfaces.
Back in April, the state of Wisconsin held its primary election less than a month after President Trump declared a state of emergency over the coronavirus pandemic, and just days after the federal government began recommending the use of masks to slow the spread of coronavirus. Wisconsin Gov. Tony Evers had signed an executive order to delay the vote until June, but the state Supreme Court blocked that order, and also ruled that absentee voting for that contest could not be extended.
Multiple research teams have analyzed the rates of COVID-19 infection that occurred in the weeks following the Wisconsin primary and come to different conclusions.
An analysis published by researchers at Ball State University and the University of Wisconsin in May found a “significant association between in-person voting and the spread of COVID-19 two to three weeks after the election.” They used county-level data to look at the number of voters at any given polling location as well as the number of local COVID-19 cases in the weeks before and after the election.
“What we found is that the higher number of voters per polling location that a county had, the higher was their growth in COVID-19 cases and the percent of their tests that were positive in the weeks following the election,” said Erik Nesson, an associate professor of economics at Ball State University who was involved in the study.
However, an report from researchers at Stanford University published in August concluded that voting in the Wisconsin primary was “a low-risk activity.” Although the Wisconsin Department of Health Services reported that “71 people who either voted in person or worked the polls” during the primary tested positive for COVID-19, the authors suggest that many of those people were exposed to the virus outside of their experience at the polls, and that there is regardless “no evidence to date that there was a surge of infections attributable” to the April primary.
The Centers for Disease Control and Prevention came to a similar conclusion in July, stating that it observed “no clear increase in cases, hospitalizations, or deaths” due to COVID-19 after that primary. CDC guidance for election polling locations and voters acknowledges that given the likelihood of larger crowds and longer lines, elections that only offer “in-person voting on a single day are higher risk for COVID-19 spread.”
Lower risk options, the agency says, include permitting “a wide variety of voting options,” allowing for polls to be open for longer periods — extending voting by hours or days — and any other steps that reduce “the number of voters who congregate indoors” at one time.
Malaty Rivera said that staying home is always the safest route during the pandemic, which is why casting a ballot via mail or depositing it in a drop box is the lowest risk option.
Going to the polls in person, she said, is higher on the spectrum of risk because any time spent engaging with people who aren’t members of your household can be a source of exposure.
“You can reduce your risk when you make sure that that time spent is outdoors, that everybody’s wearing a mask, that there’s physical distancing. But no two polls look the same,” Malaty Rivera said. “So you have to consider the fact that you are entering a kind of unknown and uncontrolled environment and there’s risk involved.”
She said she would want to see the typical safety measures we’ve all become familiar with over the course of the pandemic enforced at any given polling place — social distancing indoors and outdoors in the event of a line, spaced out poll booths and mandatory masks for everyone.
That last measure will not be universally enforced in states like Florida that do not have a statewide mask mandate, or like Texas, which does have a mandate but where the governor has said masks will be encouraged, not required, at the polls. Although surfaces aren’t a primary route of transmission for coronavirus, Malaty Rivera noted that any high-traffic areas and items like voting machines and pens should be sanitized regularly out of “an abundance of caution.”
The risks associated with in-person voting will likely not be evenly distributed across communities.
A Human Rights Watch analysis of the 2020 primary season found that polling place closures and relocations, failure to “overcome bureaucratic, linguistic and other barriers to absentee voting or voting by mail” and failure to inform voters of those changes in a “timely fashion” disproportionately impacted the ability of Black, Latinx and Native voters in multiple communities to cast their ballots.
During Georgia’s primary election in June, mostly non-white voters in metro Atlanta faced long lines as a result of “polling place closures, poll worker shortages and issues with a new $104-million voting system exacerbated by the coronavirus pandemic,” according to Georgia Public Broadcasting. But the Atlanta Journal Constitution reported that nearly half of all voters — 1.15 million people — voted absentee by mail in that primary, a more than 40 percent increase compared to the state’s 2018 general election.
Concerns over exposure to the virus have led to an exacerbated shortage of poll workers in many states, a problem that can heighten risks associated with in-person voting by whittling down the number of available polling sites and potentially causing longer lines. During Wisconsin’s primary in April, the city of Milwaukee pointed to that shortage “as a major reason it opened only five polling sites” as opposed to its usual 180 sites.
The number of sites in the rest of the state dropped by 11 percent, according to the Brennan Center, which noted that the closures directly reduced voter turnout, with a particularly clear impact on communities of color. Polling place consolidation “reduced turnout among Black voters by 10.2 percentage points” compared to 8.5 points among non-Black voters.
Texas Gov. Greg Abbott has ordered each county in the state to offer just one ballot drop-off site per county for voters who want to personally deliver their mail-in ballots. That means counties with millions of residents would have the same number of sites compared to those with a population of just a few thousand. Multiple organizations have filed a lawsuit against Abbott’s directive, calling it an “unconstitutional burden on the right to vote that will disproportionately impact voters of color in the state’s biggest cities,” according to the Texas Tribune.
On Friday, Oct. 9, a federal judge in Texas struck down Abbott’s order. But the following day, an appeals court issued a temporary stay allowing it to remain intact, meaning that absentee voters in Texas are for now still limited to one drop-off site per county. A federal appeals court upheld the rule again on Monday.
How Americans vote this election is a personal choice that depends on what options are available to them.
If you’re not sure how to go about voting this year, resources like the Healthy Voting guides assembled by the National Association of County and City Health Officials (NACCHO), the American Public Health Association and other collaborators can help. Those guides aim to “cover best practices for mail voting and in-person voting,” allowing voters “to learn their state’s voting options and rules before they cast a ballot.”
NACCHO CEO Lori Tremmel Freeman explained that the goal of the guides is to help ensure that voters can vote however they choose in a safe way that protects themselves and their communities. She emphasized that it’s up to each individual voter to assess their personal risk when it comes to voting, and that those with underlying conditions that make them vulnerable to severe disease “should take every possible measure” to avoid contracting COVID-19 or flu — which will likely be in full swing by early November — if they go to the polls.
“No matter how you vote, just do it smartly and understand what your risks are and understand how to protect yourself,” Tremmel Freeman said. “And you can ask questions of the polling sites and make sure you understand what steps they’ve taken to assure your health.”
Those steps could include allowing voters to wait in their cars rather than a long line, monitoring the number of people coming and going from a polling site at any given time or establishing protocol for isolating those who are sick or appear to be sick from other voters.
Tremmel Freeman noted that at this point in the pandemic, most of us are aware of the fundamental practices that are necessary to reduce our chances of contracting coronavirus in public. If you’re concerned about safety, you can call your election officials to learn what precautions will be in place that day.
“Don’t give up, because there’s a wealth of information — particularly this year, maybe more than others — about how you can vote,” Tremmel Freeman said. “And usually, there’s always somebody who can help you in your community. There are election officials, there are volunteers, and those people really want you to vote.”
Bella Isaacs-Thomas is a digital reporter on the PBS NewsHour's science desk.
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