Unlike previous lethal viruses, this one will define a major election

From a single case in Snohomish County, Wash., on Jan. 21, the coronavirus has mushroomed in less than 10 months to a widening scourge currently infecting nearly 100,000 Americans a day. As Election Day voters prepared to cast their ballots Tuesday, the medical examiner in El Paso was adding a fourth refrigerated “mobile morgue,” and hospitals in northwest Wisconsin were canceling elective procedures to save beds for patients with covid-19, the disease caused by the virus.

Two-thirds of the public now personally know one of the 9.25 million people who have tested positive for the virus — a new high — polls show. And even more think the worst of the pandemic is yet to come.

“We’ve never had an Election Day in the fog of a pandemic like this,” said Howard Markel, a medical historian at the University of Michigan. “It will, perhaps, be called the pandemic election.”

How those factors affect turnout and results won’t be known until evening, and perhaps not for days or weeks to come. But it is already clear that Tuesday will mark a singular modern-day confluence of a U.S. public health crisis and the election of a president.

“To my knowledge, it’s unprecedented,” said Harvey V. Fineberg, president of the Gordon and Betty Moore Foundation and co-author of “The Epidemic That Never Was,” an analysis of the federal swine flu immunization program in 1976. “Which means one has no basis for comparison.”

In the 1920 presidential election, voters faced a waning threat from the pandemic flu, there was no flu vaccine, and public health was seen as a local issue that did not merit intervention by the president. The Centers for Disease Control and Prevention did not exist. Even during the 1918 off-year election, the pathogen that would eventually kill 675,000 Americans was not a major subject of debate, Markel said.

Periodic flu outbreaks during ensuing decades did not move the political needle much either.

The worst polio outbreaks, in the 1940s and early 1950s, tended to wane as the weather cooled, and the virus was eventually quelled by successful testing of a vaccine in 1955.

Even HIV, which drove activists into the streets, had little impact at election time, at least during the epidemic’s first decade. President Ronald Reagan, who took office in 1981, the year the virus was first recognized, famously would not utter the word “AIDS” until 1987.

Tuesday will be much different.

“I have no idea what it will do in terms of turnout,” said Tom Inglesby, director of the Center for Health Security at the Bloomberg School of Public Health.

“What I’m hoping is that people are not afraid to vote in person if they haven’t voted yet,” he added. “Because I do think it’s possible to vote in a way where you can control your risk so that it wouldn’t be too different from going to the grocery store or going to the pharmacy.”

That includes voting in the late morning or early afternoon, when crowds are

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