With concern over novel coronavirus shutting down much of public life in the United States, states holding upcoming primaries face a dilemma. The Centers for Disease Control and the Trump administration have recommended postponing gatherings of people over a certain capacity, while many schools, libraries and other places that often double as polling centers have shuttered their daily operations as a precaution.

A growing number of states have gone ahead and postponed their primaries, raising questions about how the 2020 presidential race will move forward in a time of public crisis.

On Monday, Ohio Gov. Mike DeWine recommended that polling stations for Tuesday’s contest be closed in response to the health concerns. When a county judge denied that request, the Ohio Department of Health Director signed an order declaring a health emergency to close the polls.

Now, despite the court ruling, Ohio is planning to move forward with postponing the primary day until June 2; the secretary of state has also extended absentee mail voting through June 1, according to a directive issued by Secretary of State Frank LaRose.

“If any piece of that [process] gets interrupted, the Democrats have to figure out how to finish the primary.”

Three states are pushing forward with voting on Tuesday: Illinois, Arizona and Florida.

Looking further ahead, Kentucky’s secretary of state also recommended moving the state’s elections, initially set for May 19, to June 23. These changes come after Georgia postponed its primary from March 24 to May 19, and Louisiana postponed from April 4 to June 20. Maryland will also move its primary, originally scheduled for April 28, to June 2.

On the campaign trail, former Vice President Joe Biden and Vermont Sen. Bernie Sanders have instructed staff to work from home and cancelled rallies in favor of virtual events. Sunday’s Democratic presidential debate was moved from its original location in Phoenix, Arizona, to Washington, D.C., where former Biden and Sanders addressed moderators without a live audience.

The uncertainty threatens to derail bigger events (like the national conventions) that are integral to the party nomination process.

“If any piece of that [process] gets interrupted, the Democrats have to figure out how to finish the primary,” said Democratic strategist Simon Rosenberg.

Worries about staying open

As local officials in Illinois, Arizona and Florida scrambled to prepare for an unprecedented crisis, voters, poll workers and public health experts had questions and concerns in the days leading up to the primaries.

The experience of voting in person presents a cross section of factors that could be particularly problematic during a viral outbreak. Hoards of people gather in close proximity, touching the same doors, pens and voting machines, which could lead to exposure if a person carrying the virus has touched the same surface.

“We all know what these polling places look like, so it is a concern,” said Ellen Carlin, an assistant professor with the Center for Global Health Science and Security at Georgetown University. In such a crisis, “we do want to do everything we can to prevent a high density of people.”

That worry is particularly high for poll workers, the majority of whom are between 60 and 80 years old, according to multiple local officials from different states. People older than 60 and those with underlying health conditions are most vulnerable to COVID-19, the disease caused by the novel coronavirus, according to the World Health Organization.

In the days leading up to Tuesday’s primaries, county officials around the country experienced a flood of calls from anxious poll workers who had either decided not to come, or were worried about their safety.

“The poll workers themselves are an at-risk community, demographically,” said Peter MacKenzie, a longtime poll worker from Worthington, Ohio, who spoke with PBS NewsHour a couple days before his state announced the poll closings. “We’re being told that additional sanitation supplies will be provided to our polling location. But have I been trained? No.”

MacKenzie, 52, said he understands standard hygiene practices, but believes a viral outbreak requires additional support.

In Illinois, Kay Nolan, 72, was also apprehensive about working her polling place; she ultimately called in to say she would not show up on Tuesday. “The governor of Illinois just said, ‘Everyone who can stay home should stay home.’ But, by not cancelling the primary as Ohio has done, he is asking hundreds of thousands, perhaps a million, people to leave their homes to vote.”

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Nolan said she isn’t just worried about her own health, but also that of her husband, who is 74 and has battled heart disease.

State and local officials in Illinois, Arizona and Florida tried to alleviate these fears for voters and poll workers. Hundreds of polling places across these states were moved from locations that have a higher concentration of vulnerable residents. States said would also be providing hand sanitizer, disposable gloves, disinfectant spray and access to bathrooms with soap and water.

Early voting and mail-in ballots have also become a big focus. Several early voters noted small groups at polling locations ahead of Tuesday’s March 17 primary contests, but some also said they didn’t see many precautions taken at their location. “They didn’t hand us wipes or anything for the machines, and no one was wiping them down. That made me a little more nervous,” said Katrina Gibson, 46, who voted early in Darke County, Ohio.

“I think the idea of postponement might be a bit idealistic because we don’t really know how long the need for this distancing is going to go on.”

Over the last several years, mail-in ballots and early voting have grown in popularity in states around the country. This primary, Franklin County in Ohio saw about 25,000 ballots cast in early voting compared to about 14,000 early votes in 2016, said Aaron Sellers, a spokesperson for Franklin County. As of late last week, Miami-Dade County said around 140,000 voters had either voted by mail or voted early. But residents who aren’t aware of the deadlines for these options could miss out.

In Arizona’s Maricopa County, an attempt by county recorder Adrian Fontes to mail out the remaining ballots to eligible voters was blocked by a state judge. Fontes said about 75 percent of voters already received their mail in ballots, but he wanted to help the remaining voters amid the increased fears over coronavirus.

Maricopa County had to close about 80 polling locations due in part to insufficient sanitization supplies, Fontes said, but he felt confident the county was prepared to move forward with the primary.

“People should come out to vote and they should understand we are doing everything we possibly can to make their environment safe for them,” Fontes said.

Long-term fallout?

The current public health crisis has the capability to dramatically shape the Democratic presidential nomination process. At Sunday’s debate, Sanders and Biden, who are each in their late 70s, greeted each other by bumping elbows. The debate also largely centered on how each candidate would deal with the health and economic implications of COVID-19 in the U.S.

Biden called for expanding novel coronavirus testing and hospital capacity, as well as providing interest-free loans to small businesses. Sanders spoke to the need for his “Medicare for All” plan and questioned whether hospitals have adequate supplies and personnel to address the outbreak.

On Monday, President Donald Trump — who previously downplayed the seriousness of the outbreak — delivered a more severe message, saying the crisis could extend to July or August. Such an outcome could mean the disruption of more primaries and even the national conventions used to pick the party nominee. The Democratic National Convention team said in a statement that it “will continue to monitor” the outbreak and will remain in contact with officials. So far, plans to move forward with the party’s convention in Milwaukee, Wisconsin, remain on track.

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Health experts recognize that state and local officials face a difficult decision as they weigh whether to postpone primary voting.

“This is a really tough one. I don’t think that there’s a clear ‘we should absolutely not [postpone], versus we should absolutely do it’ answer. … The election is obviously very important and consequential,” said Swapna Reddy, a clinical assistant professor with the College of Health Solutions at Arizona State University.

Reddy recommends that states consider moving away from traditional voting processes in order to make it easier to participate without physically going to a polling site. Carlin from Georgetown University favors options like mail-in ballots, scheduling appointments for voting, or having small groups vote in batches.

“I think the idea of postponement might be a bit idealistic because we don’t really know how long the need for this distancing is going to go on,” Carlin said.

Strategist Rosenberg agrees. He noted one possibility being recent legislation introduced by Sen. Ron Wyden, D-Ore., that would provide funding to help states set up emergency vote-by-mail systems.

At this point we don’t know what the fallout will be long-term, so it’s best to get ready now, Rosenberg said.

“This is something that should be within our power to do, if we get on it and move now,” Rosenberg said. “I think that will go a long way to making sure that we’re protecting and preserving the general election in a way that allows everybody to participate.”