Fear of coronavirus transmission and reports of vast reductions in the number of polling locations have driven a disproportionate number of Americans to opt for mail-in voting this year. Still, a recent NPR/PBS NewsHour/Marist poll and a Citizen Data poll say only 35 percent of Americans plan to vote by mail — implying that a large percentage of voters will still show up in person.
For many Americans, especially those who fall into the high-risk category of having more severe symptoms of COVID-19, it has been months since they've been inside a room with strangers, some of whom could harbor coronavirus, and not know it. Certainly, the anxiety and concerns around voting in person are valid. At the same time, the coronavirus has become weaponized by the GOP and used as a tool of voter suppression. As Trump continues to attack mail-in voting and spread lies about its legitimacy, you may be wondering if there is any real risk to vote in person — or if the fear is overblown.
"I do think it's safe to vote in person," Dean Blumberg, an associate professor in the Department of Pediatrics at the University of California–Davis, told Salon. "I think for most voting situations, the interactions that you're going to have with people where you're not gonna be socially distanced will be brief, and then wearing a mask when you are close to other people provides an extra layer of protection for when you have to be close to other people."
The Centers for Disease and Control (CDC) lists on its website a compilation suggested guidelines for polling stations to follow for in-person voting. This includes, but is not limited to, providing alcohol-based hand sanitizer with at least 60 percent alcohol at each step in the voting process, encouraging poll workers to wash their hands frequently, recommending and reinforcing face masks for both poll workers and voters, social distancing, and to have clearly mark points of entry and exit "to avoid bottlenecks." Frequently touched surfaces, such as door handles, registration pens and clipboards, should be disinfected frequently, too, according to the guidelines. The U. S. Election Assistance Commission has also created a guide for election officials to clean and sanitize voting equipment as well as make sure that poll workers practice good hygiene.
"I think that with their recommendations around cleaning, disinfection, mask wearing and physical distancing, there are really reduced risks to people who are voting in person," Dr. Annabelle de St. Maurice, an infection-prevention specialist at the University of California-Los Angeles, told Salon.
The greatest risk, de St. Maurice said, is not when you're actually voting in the polling place, but when you're waiting in line.
"If that line is indoors, that's probably the scenario where people might be closer together, and waiting in line for a long amount of time," she said. "But I think if people can maintain a physical distance, if everyone is wearing a mask, and if ventilation is increased, meaning that people are maybe outdoors or there's adequate ventilation in the polling place, those risks are really reduced."
Blumberg said for situations where you have to break social distancing, like when you're grabbing a ballot from the poll worker, that exchange will be so brief that the risk is low of getting infected even if one of you is asymptomatic—assuming you're both wearing masks.
"If you're having these brief interactions, or you're just coming up to somebody and taking a ballot from them or handing the ballot to them that's, that's so brief, that the risk is there but it's very low for transmission under those circumstances," Blumberg said.
Exposure to the coronavirus isn't a black-and-white situation, scientists say. Specifically, being exposed to the coronavirus is not the sole risk, but rather how much of the virus one encounters. Those who inhale more viral particles, either because they're not masked or are in the presence of an infected person longer, are at higher risk.
For this reason, public health officials recommend wearing masks, staying at least six feet apart and avoiding crowds to reduce the amount of the coronavirus you come up against.
As far as surface contact is concerned, the CDC states that surfaces are no longer believed to be the main source of transmission, and that one is more likely to get infected via respiratory droplets from person-to-person contact.
Yet Dr. Georges Benjamin, executive director of the American Public Health Association and former Maryland Secretary of Health and Mental Hygiene, told Salon by email that people do need to be cautious about touching voting machines.
"Any surface can get infected," Benjamin wrote to Salon, including a link to a website about healthy voting. "So they need to continually clean them and you should either wash your hands afterward or use hand sanitizer. Avoid touching your face, mouth or eyes until you clean your hands. Also bring your own pen or pencil with eraser depending on the way the ballots are marked."
However, Dr. Russell Medford, Chairman of the Center for Global Health Innovation and Global Health Crisis Coordination Center, wrote to Salon that voters should take special precautions—like wearing gloves.
"I suspect that each voting jurisdiction will have mitigation programs in place: social distancing, masks, gloves, frequent machine cleaning," Medford explained. "Personally, I would make sure I wear gloves when I 'punch' my votes into any machine."
At the same time, as Dr. Monica Gandhi, infectious disease doctor and professor of medicine at the University of California — San Francisco, wrote to Salon, "the surface issue is essentially going away ,as we realized that the main route of spread is asymptomatic transmission – people are not worried about surfaces/fomites anymore." She pointed specifically to a recent article in the scientific journal The Lancet on how concerns about people being infected through fomites (meaning objects or materials likely to carry infections) has been "exaggerated."
"The issue of touching stuff and potentially getting infected by touching an infected surface then touching your eyes, your nose, your mouth, that's a theoretical risk, but we know that the vast majority of transmission is via the respiratory route," Blumberg told Salon. "And that's why social distancing and masking are the primary things that people can do to prevent themselves from getting infected; there's very little if any transmission from contacting surfaces."
Indeed, the most effective way to reduce transmission in polling stations will come from the physical mitigation strategies, like wearing masks and social distancing. There have been several studies that show wearing masks can reduce the risk of transmission, even when someone in a group of people is infected. A peer-reviewed study published in the Canadian Medical Association Journal examined the case of a man who flew from China to Toronto and then tested positive for COVID-19. He had a dry cough on the flight, but wore a mask. All 25 people closest to him tested negative for COVID-19.
Another simulation showed that when at a minimum 80 percent of a population is masked, the risk of transmission is greatly reduced.
According to CDC guidelines, poll workers are encouraged to reinforce the use of masks among voters. In the state of California, poll workers will have extra masks for voters who show up without a mask. However, in parts of the country that have been resistant to wearing masks it's possible that some people will show up and vote without wearing masks. If this happens while voting, Blumberg said to give that person without a mask a "wide berth."
"Maybe there's just one or two people and you can avoid them," Blumberg said.
But what if you're in a high-risk category, and more likely to have more severe symptoms if infected with COVID-19?
"Anybody who's at risk for more severe disease, then they should make sure to follow all the appropriate precautions, but I would still encourage them to vote even if they're older and they have underlying conditions, I'd still encourage them to vote," Blumberg said. "Voting is the cornerstone of our democracy, and so we really want to encourage everybody, I would encourage everybody to vote."