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Adoption of Strategies to Mitigate Transmission of COVID-19 During a Statewide Primary Election – Delaware, September 2020

Our take —

Although in-person voting for the U.S. presidential election concluded on November 3, 2020, there will be a handful of runoff elections around the U.S. through January 2021, including a high-profile election in Georgia. This study surveyed 522 election poll workers to describe measures to mitigate SARS-CoV-2 transmission in the Delaware statewide primary election, highlighting those with reportedly high uptake (e.g., physical spacing of voting booths) and those with room for improvement (separate portals for entry and exit, incorrect mask use by poll workers and voters, large number of close contacts experienced by poll workers). Differences between survey respondents and those who did not respond, as well as social desirability bias, may have affected the findings.

Study design

Cross-Sectional

Study population and setting

This study reported on a survey of 522 poll workers (median age 59 years, 57% male) who served in the US state of Delaware’s primary election on September 15, 2020. The survey was focused on SARS-CoV-2 transmission mitigation measures undertaken at polling locations, and included questions about supply availability, knowledge, attitudes, training, and directly observed behavior among respondents, other poll workers, and voters.

Summary of Main Findings

Of the 2,498 poll workers who participated in the primary election, 1,595 (64%) were invited to participate via email, and 522 (21%) responded and were deemed eligible. Among the 128 respondents who identified a polling location, 99 distinct polling locations were represented. Thirty-two percent of respondents had at least one underlying condition associated with higher risk of severe COVID-19. Most respondents reported spacing of voting booths at least 6 feet apart (88%), unidirectional movement of people through the location (80%), and visual reminders to remain at least 6 feet apart (84%). Only 45% of respondents reported separate doors for entry and exit. Few respondents reported physical barriers (e.g., plexiglass) at registration desks (5%) and between voting booths (7%). Most respondents reported that hand sanitizer was available for poll workers (94%) and voters (82%), as were masks (88% and 70%, respectively). Eighty percent of respondents reported receiving COVID-19 training, and 92% answered all three COVID-19 survey questions correctly. The majority of respondents (72%) reported contact (within 6 feet) with more than 100 voters, while 27% reported close contact (within 6 feet for 15 minutes or more) with more than 100 voters. Nearly all respondents reported mask use by most (80-100%) poll workers and voters; 73% reported never or rarely witnessing incorrect mask use by poll workers, while 54% reported the same for voters.

Study Strengths

Survey questions addressed not just knowledge and attitudes, but also directly observed behaviors among voters and poll workers, along with physical characteristics of polling locations.

Limitations

Respondents may differ from all Delaware poll workers in meaningful ways; for example, if respondents worked at a subset of polling locations with more extensive SARS-CoV-2 transmission control protocols, results could overestimate the statewide adoption of these protocols. Similarly, only poll workers with valid email addresses were included, who may be different from those without email addresses. Poll workers may have had investment in the success of transmission control measures and their answers may have been subject to social desirability bias, which would result in an overestimate of the uptake of distancing, mask-wearing, etc. Alternatively, poll workers who were upset with non-adherence to control measures may have been more likely to respond.

Value added

This is the first study to focus on measures to reduce SARS-CoV-2 transmission in voting locations during a U.S. election, and it may be relevant to planning for upcoming elections.

This review was posted on: 19 November 2020