Is it safe to lick the ballot envelope? Public health officials take on the new challenge of making voting safe amid a pandemic

In their efforts to stem the spread of the coronavirus, public health departments are taking on a new responsibility: helping make voting as safe as possible.

Normally, these agencies don’t get involved in election logistics, but now they’re collaborating with local elections officials to set up polling places and training poll workers and volunteers on what behaviors to encourage and what to caution against. After all, one of the key Covid-19 precautions we’ve been encouraged to take is to avoid crowds, particularly indoors. Voting can pose a challenge to that, and in turn, to the health of both voters and poll workers.

“Certainly this is a little bit more unique during a pandemic,” Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials, said about the role health departments are playing this election. NACCHO, for example, partnered with groups including the American Public Health Association and We Can Vote to create the Healthy Voting website, with tips for voters and specific pages for states and territories.

“We even went down to the level of, if you have to lick an envelope, is it safe for the person who’s licking the envelope?” Freeman said. “Is it safe for the person opening the envelope?”

At this point, the precautions that public health officials have encouraged polling places to embrace will be quite familiar to people. A plexiglass shield might divide you and the worker who checks you in. Some voting booths might be cordoned off to increase spacing. Pens will be sanitized between ballots. People will have to line up outside. Hand sanitizer might be offered on the way in and out. Voters are being encouraged to wear masks, keep their distance, and not to dawdle — know how you’re going to vote before you show up.

And with those steps, voting should be a comparatively safe activity, experts say.

“With these particular precautions in place, it seems to me like this would be similar to going grocery shopping or going into a restaurant and picking up a takeout order but having to wait for the order to come up,” said Stephen Kissler, an epidemiologist at Harvard’s T.H. Chan School of Public Health. “Both of these things are considered not zero risk, but relatively low risk in the spectrum of things that we can do with respect to Covid.”

Record numbers of Americans have already voted, of course, whether in person, by mailing in their ballots, or by slipping them into drop boxes. But with millions more expected to head to their local polling places Tuesday, certain issues could arise.

Some Americans still bristle at wearing masks and dismiss the threat of the coronavirus. In Ohio, Gov. Mike DeWine has said that poll workers ultimately won’t be able to deny people from voting if they’re not wearing a mask, despite the state’s mask mandate. Instead, he’s tried to emphasize that masks can help protect others, including those who are working at polling sites for hours and face higher exposure risks than voters just stopping in for a few minutes.

Plus, not all states are adhering to principles the Centers for Disease Control and Prevention issued for safe voting amid the pandemic. While the CDC advised states to offer a variety of ways to vote and to expand voting periods to reduce the risk of transmission, Mississippi, for example, limits absentee voting to select groups; the only option available to all residents is to vote in person on Election Day itself.

“Elections with only in-person voting on a single day are higher risk for Covid-19 spread because there will be larger crowds and longer wait times,” the CDC’s guidance states.

Election Day is also arriving at a time when transmission of SARS-CoV-2 — the virus that causes Covid-19 — is surging in many parts of the country, both urban and rural. Experts are pointing to the increase in cases to stress that people planning to vote in person need to take steps to ensure their and others’ safety.

“It’s about mitigating risk,” said Umair Shah, the executive director of the public health department in Harris County, Texas, which is home to Houston and has seen record early voting numbers. “There are no zero risk activities if you’re going to be out. It’s lower risk versus higher risk, and with the real safety measures, you start to get into a lower risk category.”

In Philadelphia, the public health department first worked with election officials during Pennsylvania’s primary, which was postponed from April until June this year because of the pandemic and which “gave us a practice round,” said James Garrow, a spokesperson for the city’s health department.

“Because we had a late primary, it gave us an opportunity to really think through the protections and changes that needed to happen at polling places,” he said, noting that the precautions were similar to those that workplaces have had to adopt.

But there was some added anxiety around next week, Garrow said. The city is now seeing about 300 to 400 new Covid-19 cases a day, up from about 70 a day just last month.

With the coronavirus, researchers have found that some 10% to 20% of cases lead to the vast majority of new cases, often as a result of superspreading events that occur among crowds of people indoors. (Many people with Covid-19 do not pass the infection on to anyone.) A recent CDC study, which emphasized ways to “reduce congregation of voters in polling locations,” found that poll workers during the Delaware primary had a large number of what the agency considers “close contacts,” which, the researchers wrote, “underscores the potential for in-person voting locations to serve as mass gathering events.”

The study was based on a survey of hundreds of poll workers from the state’s primary, 73% of whom reported very rarely or never seeing improper mask use (that is, not wearing the mask over both the nose and mouth) among fellow poll workers. However, only 54% of workers surveyed said they very rarely or never saw voters wearing masks the wrong way.

“You can vote, and you can be safe,” said Harris County’s Shah. “And it’s really critical that we ensure the safety of our communities, because we want to make sure community members are making their voices heard.”