Updated at 3:33 p.m. CT
Wisconsin’s presidential primary election held last month in the face of the coronavirus pandemic drew concern from doctors, voters, poll workers and politicians who warned that having thousands of people leave their homes to cast ballots would further spread the highly contagious virus.
Now well beyond the 14-day incubation period for COVID-19, and with a Tuesday special congressional election in northern Wisconsin looming, it remains largely unknown just how many people contracted the virus at the polls on April 7.
“We lack the scientific tools and infrastructure to really measure the impact reliably,” said Kristen Malecki, an epidemiologist at the University of Wisconsin School of Medicine and Public Health. “If we were able to test everybody, then we would absolutely be able to say whether [there was a surge] or not.”
A team of epidemiologists and public health experts who examined the potential impact of the election on the spread of COVID-19 in Milwaukee released a study Wednesday that drew no conclusions, in large part because of the lack of widespread testing and contact tracing.
Nearly 411,000 people showed up statewide to vote, some waiting in lines for hours in Milwaukee, many of them wearing masks and voicing anger at Republicans in the Legislature who refused to delay the election. Assembly Speaker Robin Vos, who worked the polls in a mask, gloves and protective gown, was widely derided for reassuring voters that it was “incredibly safe to go out.”
It will likely never be known just how safe, or not, it was to vote, public health leaders said.
Malecki and other health experts said it's nearly impossible to quantify the impact COVID-19 had on those who showed up at the polls because of a lack of testing and contact tracing, the work of determining who an infected person has been around. In addition, some people are infected but have no symptoms and therefore don't get tested at all.
Sixty-one people who tested positive for COVID-19 since April 7 reported that they had been at the polls, but state health officials have warned against assuming that's how they became infected since many of them had also been other places where they could have been exposed.
The state intends to stop asking people who tested positive after Thursday whether they were at the polls because the 14-day incubation period of the virus has long since passed. They are also not counting anyone who was at the polls but who didn't show symptoms until after April 21.
“It’s safe to say [the election] didn’t help,” said Dr. Nasia Safdar, medical director of infection control and prevention at UW Health, the University of Wisconsin-Madison’s medical arm. “But whether it actively hurt people, it’s very likely but not possible to really prove it.”
For example, a voter or poll worker may have contracted the virus on the bus or while grocery shopping before the election, she said.
Five National Guard members who worked the polls reported having symptoms consistent with COVID-19, but only one was tested. That test came back negative. Doctors would not give the other four tests.
The number of infections linked to the election pales in comparison to the outbreaks seen at meatpacking plants in Wisconsin. More than 500 cases have been tied to plants in and around Green Bay.
University of Wisconsin researchers who are using cellphone data to track the mobility of Americans in the middle of the pandemic said the data show people moved around more on the April 7 election day than they did in the days leading up to the vote. That bolsters concerns raised before the election that holding the vote would lead more people to be out than otherwise would have been. As it was on April 7, Wisconsin remains under a stay-at-home order designed to limit movement and the chances of the virus spreading.
While more than 1.1 million people voted absentee, nearly 411,000 voters cast ballots in person. Many complained that they were forced to do so after their requests for absentee ballots went unfulfilled.
Wisconsin stood alone last month in carrying out its election as the coronavirus was spreading. While Alaska, Wyoming, Hawaii and Louisiana were all pushing back their elections or shifting to mail-only, Wisconsin's Republican-controlled Legislature — with the help of the conservative-controlled state Supreme Court — resisted Democratic Gov. Tony Evers' request to do the same.
Only five polling places out of nearly 200 opened in Milwaukee due to a shortage of people willing to work at the polls. Evers called out the National Guard to help.
Wisconsin is about to hold more in-person voting next week, to fill a vacant congressional seat in the northern part of the state. Evers has made no attempt to stop it, in part because of the more rural population and lower infection rates. Nebraska is also holding a statewide election Tuesday with in-person voting.
Evers has also been working to increase testing and contact tracing as part of his plan to reopen the state.
Ramping up contact tracing will help in identifying future cases but not tell the story of what happened during the election, said Brian Yandell, interim director of the American Family Insurance Data Science Institute.
In the absence of greater testing and tracking now, Yandell said, "we largely are flying blind.”