Monday, June 7, 2021

Adding injury to insult: the negative public health implications of Republican-sponsored voter-suppression laws

There are all sorts of reasons being offered for opposing the GOP-sponsored restrictive voting legislation being enacted around the country in states like Georgia and Texas. Most of them have to do with the fact that these measures, contrary to the claims of their authors, are intended to limit access to the polls by eligible voters, in particular by voters of color. The anti-democratic intent of these laws is clear; they are little more than a sour-grapes expression by Republicans for having lost the 2020 elections fair and square and a desperate attempt to not do so again.

But little is being said about another important reason to stand against these new voting measures that aim to thwart mail-in voting, either by making getting a absentee ballots harder to get or by reducing the number of drop boxes to which to return them, or by limiting early-voting options which distribute the otherwise large pulse of election-day voters over an extended period of time. That reason is that these voter suppression laws will also put public health at greater risk.

As much as we'd like to believe that the COVID-19 pandemic is a one-off event, hopefully one we will be able place behind us soon, the fact of the matter is that it will more than likely mark the first in a series of pandemics that we will have to confront this century. This is due in part to the fact that habitat loss, either as a result of encroachment by expanding urban areas or environmental degradation, will bring wild animal populations in closer proximity to humans. The chances of the occurrence of zoonotic disease, an infection that jumps from an animal to a human, becomes more and probable. And the increasingly connected global transportation system ensures that any such spillover will spread as far and as quickly as possible.

We dodged the other coronavirus bullets of SARS in 2003 and MERS in 2012 which had originated in non-human animals. And, even if it turns out that COVID-19's intrusion into the human population resulted from a laboratory accident and not direct animal to human transmission, we should in no way breathe a sigh of relief. These pathogens are coming for us. When they do, they may take the form of a more virulent version of the common cold, as has COVID-19, or a more deadly strain of the seasonal flu. In this regard, an H5N1 variant of influenza, the so-called avian flu, has been on our pandemic radar for years. It really is only a matter of time.

The emergence of a novel coronavirus in China in late 2019 and its rapid spread to other parts of the world served to remind us that these kind of pandemics can arise unexpectedly. In the case of COVID-19, its U.S. debut coincided with the run-up to the 2020 primary election season. It is useful to remember that, in a time before the virus became a political hot potato, election officials began taking steps to reduce the infection risk to voters in their respective jurisdictions. These steps were viewed as prudent public health measures plain and simple.

Notably, Republican Georgia Secretary of State Brad Raffensperger took quick action to distribute absentee (a.k.a mail-in) ballot applications to all registered voters and wisely deferred primary election dates to better get a handle on how to operate in-person voting in the midst of a pandemic. Raffensperger, in spite of the fact that he had always been aligned with elements of the state's GOP-dominated government in their efforts to limit access to voting, recognized that the grave responsibility of reducing the impact of COVID-19 on Georgians going to the polls was in his hands.

And Secretary Raffensperger was not alone in this recognition; his counterparts in both red and blue states implemented similar measures, such as allowing for no-excuse absentee ballots and increasing the number and geographical distribution of drop-boxes where they could be returned. To the extent possible, especially given the short notice, these actions reduced the health risks to voters around the country who wanted to do their civic duty by participating in all phases of the 2020 election cycle. As dozens of legal challenges would reveal later that year, these voting changes were made without degrading the integrity electoral process one iota.

So, when all was said and done, as the last of the 2020 elections trickled into early 2021 with the Georgia runoffs for U.S. Senate, many states had accomplished the unexpected: they had made voting both more accessible and safer from a public health standpoint. It will be a head-scratcher for future historians who will ponder why such significant electoral achievements were dismantled almost immediately after their unalloyed success had been widely demonstrated.

Well, I guess they won't be scratching their heads about what motivated the Republican Party to turn back expansion of voter access. Due to cultural and demographic shifts in the electorate, the survival of that party has come to depend on anti-democratic measures like political gerrymandering and creating obstacles to voting by people of color. So there won't be much puzzle to the upside the GOP saw in rescinding pandemic voting procedures to renew established efforts at voter suppression.

What future historians will find puzzling is that the public health advantages that resulted from expanded absentee- and early-voting were so soon abandoned, especially since there would be a scramble to reimplement them when the next pandemic - and there would be a next pandemic - coincided with an election cycle. At a time when state officials and legislatures should have been working to refine and standardize approaches to voting that takes public health into account, they were instead preoccupied with dismantling the small advances they had made in this regard.

If you think that we reap benefits from socially-distanced approaches to voting only in the midst of a pandemic, you may want to think again. Although the Founding Fathers may have been visionary in many regards, ignorant of the germ theory of disease, they could not have contemplated that gathering large numbers of people to vote in enclosed spaces for an extended period of time in early November was a very bad idea from a public health perspective. It is the height of flu season, a reality that will likely stay with us for years until a universal influenza vaccine is fielded and widely administered.

The seasonal flu is responsible for 10,000 - 60,000 deaths in this country every year, not to mention many tens of thousands of more cases of serious illness and the hospitalizations that result from them. Its most vulnerable target is seniors, who turn out to be not only a segment of the population who vote in disproportionately large numbers but who also traditionally provide the lion's share of the army of volunteers that make in-person voting possible. Socially distanced voting measures will not only reduce the disease burden shouldered by the elderly but also by other vulnerable populations.

Admittedly, given the numerous state party primaries and runoffs, elections in the country are held at a variety of times of year well outside of flu season. But, as the COVID-19 pandemic has illustrated, you don't need cold weather to encourage the spread airborne diseases. Indeed, the prevalence of respiratory illnesses in the fall and winter have less to do with the temperature itself and more to do with the fact that cold weather tends to drive people indoors. Why give these diseases a foothold anytime of the year by forcing vulnerable people into polling places unnecessarily?

Yes, it should be enough to retain or even extend expanded mail-in and early voting options as a matter of increasing participation in our elections at all levels and all times of the year. In spite of a small number of isolated incidents of voter fraud, as dozens of legal challenges have indicated, the 2020 elections have been the most secure and the most transparent in this country's history.

The bottom line is that recently enacted voter suppression legislation is the wrong way to go. Rolling back the very measures that made voting safer during the 2020 COVID pandemic is ill-advised according to public health considerations. It is these regressive laws that should themselves be rescinded to ensure that our electoral process is not only fair but also healthy.

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