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Op-ed: Two doctors explain how America can vote safely on November 3

Daniel Carlin, MD, is a national leader in the field of telemedicine and a recognized pioneer in the delivery of connected medical care to distributed populations and workforces. He is a board-certified emergency physician and a former US Navy medical officer.

Dr. William Lang is the Medical Director of WorldClinic and a former Director of the White House Medical Unit and Deputy Physician to the President and Associate Chief Medical Officer of the Department of Homeland Security.

Imagine that it’s November 24, 2020, three weeks after a presidential election in which a record 73% of eligible voters participated in our democracy’s most fundamental process.

Yet, the widely predicted wave of post-election day infections never happened.

The secret? Governments across America followed doctor’s orders — creating much safer polling stations that prioritized the health of all voters during this most unusual election year.

The first step was understanding how COVID-19, the disease caused by the coronavirus, works. Early on, science thought COVID was a heavier-than-air droplet infection that would require a lot of surface cleaning.

Voters fill out ballots during the primary election in Ottawa, Illinois, U.S., March 17, 2020. The polling station was relocated from a nearby nursing home to a former supermarket due to concerns over the outbreak of coronavirus (COVID-19). REUTERS/Daniel Acker     TPX IMAGES OF THE DAY
Voters fill out ballots during the primary election in Ottawa, Illinois, U.S., March 17, 2020. REUTERS/Daniel Acker TPX IMAGES OF THE DAY

But now we know the real threat is in the air: this is an aerosol virus, and the more viral particles floating in the air, the greater the chance of voters inhaling enough to cause an infection.

Knowing this, the polling stations were rigorously designed to limit the density of viral particles in the atmosphere.

On Election Day, voters arrived to find an entirely different environment than they’d ever seen before.

Jocelyn Bush, a poll worker at the Edmondson Westside High School Polling site, cleans each station after a ballot is cast, during the special election for Marylands 7th congressional district seat, previously held by Rep. Elijah Cummings (D-MD), in Baltimore, Maryland, U.S., April 28, 2020. REUTERS/Tom Brenner     TPX IMAGES OF THE DAY
Jocelyn Bush, a poll worker at the Edmondson Westside High School Polling site, cleans each station after a ballot is cast, in Baltimore, Maryland, U.S., April 28, 2020. REUTERS/Tom Brenner

9 a.m.: Get out and vote!

The first thing voters noticed was that the wait would be entirely outdoors this year. Masks were mandatory and 6-feet markers punctuated the length of each line.

Voters who forgot their masks found them freely available alongside a seemingly endless supply of hand sanitizers and gloves. For older or higher-risk voters, there were N95 masks available and express lines to move them through quickly. Waits were amazingly short: With so many more voting booths than usual and ample space between them, voting was a breeze, literally.

Speaking of which, in most of the country, voting booths were outside in the open-air. Where it was too rainy, open but heated tents had been erected for the occasion. In the few places where it was simply too cold, indoor voting happened with windows flung open wide, and heaters going full blast. A bit bracing, to be sure, but really not bad at all. In older buildings, intake and exhaust window fans were used to ensure a fresh circulation of air through each space.

Voters wait in line outside Riverside University High School to cast ballots during the presidential primary election held amid the coronavirus disease (COVID-19) outbreak in Milwaukee, Wisconsin, U.S. April 7, 2020. REUTERS/Daniel Acker
Voters wait in line outside Riverside University High School to cast ballots during the presidential primary election held amid the coronavirus outbreak in Milwaukee, Wisconsin, U.S. April 7, 2020. REUTERS/Daniel Acker

It seemed odd to some people, but voters who were doctors or engineers instantly recognized the strategy: Everything possible was being done to maximize air exchange. By changing out the atmosphere with constant fresh air or high-flow air exchange systems, voting facilities were able to reduce and dilute the number of virus particles in the air.

Get in. Vote. Get out.

The third big difference voters noticed was that voter validation was streamlined, and there were so many booths it was easy to get in, vote, and get out.

One gloved and masked voter after the next stepped into booths across the United States to vote. Things were as touchless as possible, and nothing that one voter touched was touched by another without being sanitized. Pencils, markers, and styluses were all disposable or cleaned after each voter.

BEMIDJI, MN - SEPTEMBER 18: Signage about COVID-19 procedures sits in a ballot booth at the Beltrami County Administration building on September 18, 2020 in Bemidji, Minnesota. Early voting starts today in Minnesota as President Donald Trump and Democratic presidential nominee and former Vice President Joe Biden are both campaigning in the state. (Photo by Stephen Maturen/Getty Images)
Signage about COVID-19 procedures sits in a ballot booth at the Beltrami County Administration building on September 18, 2020 in Bemidji, Minnesota. (Photo by Stephen Maturen/Getty Images)

Between voters, poll workers pulled open the curtain at the voting booth and wiped down all contact surfaces with an antiseptic.

The whole voting experience, far from being unsafe or a hassle, turned out to be faster and more fun than ever. On their way out of the polling place, voters discarded their gloves in handy receptacles and stepped out feeling fine.

Democracy was healthy. And so were they.

UNITED STATES - SEPTEMBER 18: Sen. Mark Warner, D-Va., right, waits in line to cast his ballot during early voting at the Voter Registration Office in Alexandria, Va., on Friday, September 18, 2020. (Photo By Tom Williams/CQ-Roll Call, Inc via Getty Images)
Sen. Mark Warner, D-Va., right, waits in line to cast his ballot during early voting at the Voter Registration Office in Alexandria, Va., on Friday, September 18, 2020. (Photo By Tom Williams/CQ-Roll Call, Inc via Getty Images)

In this ideal future, the government had gotten four key things right:

  1. They maximized air exchange: changed out the atmosphere with constant fresh air or high flow air exchange systems to reduce and dilute the number of virus particles in the air.

  2. They limited the ability of infected voters to exhale virus into the air.

  3. They limited the ability of uninfected voters to inhale or contact the virus in the polling station.

  4. And most importantly, they made voters feel safe and welcome. No Americans hesitated when deciding what to do on November 3. This was not a choice between their personal health and America’s future.

We can vote safely this November. We just need to follow doctor’s orders.

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