Sign-On Letter for Public Health Experts on COVID-19 and the US Elections
This letter is to members of Congress, local and state election officials asking for the establishment of nationwide by-mail voting in time for the November 2020 elections as well as other measures to ensure the integrity of the electoral process in the midst of a pandemic. Links to all pertinent facts will be included in final version of the letter.

April 26, 2020

To Members of the United States Senate and House of Representatives:

Wisconsin’s primary election on April 7th of this year was an expression of the democratic spirit in a crisis, as thousands lined up to fulfill their civic duty. The right to vote is an essential element of our democracy and Americans should not have to choose between their rights of citizenship and their own health.

For epidemiologists and public health experts, Wisconsin’s election took on other meanings, alarming many of us who have devoted ourselves to combating infectious diseases for all of our professional lives. Despite the Wisconsin Governor’s plan to delay the election until June because of the COVID-19 pandemic, the state legislature and the state supreme court refused to allow this postponement. Thus, many of us in public health looked on with horror as thousands of people in Wisconsin were forced to choose between exercising their right to vote and staying home to protect themselves from exposure to the new coronavirus SARS-CoV-2, or imperil their own lives by voting in person that day. Though there were new cases of COVID-19 among those who voted in person that day and those who worked at the polls in Wisconsin, the impact of the decision to go ahead with the primary on April 7th on the spread of the disease may never be known. However, as Dr. Ben Weston, the Medical Director for the Milwaukee County Office of Emergency Management, has said: "While we continue to monitor cases of Covid-19 linked to election activity, we know that gatherings such as (the election) are detrimental to the efforts to slow the spread of this pandemic."

Americans should never again be asked to choose between performing one of the most hallowed obligations and privileges of citizenship—voting for our representatives at the local, state and federal levels—and our health. This November 2020, we have a Presidential election before us. We also have the prospect of a resurgence of the coronavirus, SARS-CoV-2, which to date has killed over 50,000 Americans and infected close to one million people in the United States. Both the Director of the Centers for Disease Control and Prevention, Dr. Robert Redfield, the Director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, along with many other scientists, have warned about the possibility of a resurgence of SARS-CoV2 this fall. Furthermore, until an effective vaccine is developed and widely administered in the US, intermittent outbreaks of COVID-19 may reoccur at least until 2022. The potential for reoccurrences of SARS-CoV-2 will require new rounds of social distancing to keep each outbreak in check.

In order to ensure the integrity of the electoral process and protect the public health at the same time, it is incumbent on our leaders to prepare for a Presidential election by mail, in which ballots are sent to all registered voters, to allow them to vote from home and ensure their health and safety in the event of a new outbreak of SARS-CoV-2. Several states already conduct most elections by mail, and many states are preparing for by-mail voting in the fall. However, states will need resources to rapidly prepare to ensure that a vote-by-mail option is available to all voters. The costs of this effort—for ballot printing, postage costs, dropboxes for absentee ballots and appropriate security, secure electronic absentee ballot request technology, ballot tracking, improvements to absentee ballot processing, including additional facilities and staffing—are estimated to total $4 billion and will require a Congressional appropriation to support this work. In addition, while we hope most Americans will have the opportunity to vote by mail, maintaining the safety of in-person voting will also be required for November 2020, as well as subsequent elections as long as SARS-CoV-2 circulates in the US. These additional measures, including those that ensure polling facilities that meet public health standards, will entail an additional $271.4 million in federal funds.

Members of Congress must ensure funding for the rapid scale-up of by-mail voting nationwide in time for the 2020 Presidential election, and our local and state election officials must do all they can to support American citizens’ right to vote, while protecting them from SARS-CoV-2 infection, from spreading the virus during a pandemic. The right to vote should not have to be sacrificed or compromised to ensure our health and safety. If you act now, we can all vote without fear of acquiring or spreading COVID-19 as we send in our ballots in November 2020.

Respectfully yours,
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