SALT LAKE CITY — As a cancer survivor, Dr. Catherine Troisi worries how she’ll vote this November — not her decision, but the actual act of casting a ballot.

“From an epidemiologic standpoint, we would all be voting by mail because there’s really no risk,” Troisi, an infectious disease epidemiologist at UTHealth School of Public Health in Houston, said. “But we don’t live in an ideal world, do we?”

She’s not alone. In the buildup to a contentious presidential election, the mechanics of voting have become a source of friction. Headlines portray a clean partisan divide over mail-in voting — with Democrats arguing that the practice should be easier during the coronavirus pandemic, and Republicans claiming it allows for voter fraud — but exceptions abound. President Donald Trump, for example, is a mail-in voter.

Troisi does not intend to join him. “I am 67 years old, I’ll be 68 by election day,” she said. “I’m in a high-risk group. But I am going to the polls in person. It’s important to me to have my vote counted, so I’m not taking a chance on vote by mail.”

Other voters find the alternative to voting in person to be just as daunting. Utah is one of several states with universal mail-in voting; elsewhere, applying for a mail-in ballot can be complex or challenging. That was one reason behind the NBA’s push, following player protests last month, to make arenas available as spacious polling places conducive to social distancing.

Individuals are left to weigh competing variables to decide how, or whether, to vote this November: personal safety, trust in experts’ advice and confidence in various institutions. How dangerous is it to vote in person? Will that uncertainty shape the election?

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Are polling places risky?

COVID-19 exposes certain flaws baked into humans’ decision-making processes. Dr. Melanie Bell, a biostatistics professor at the University of Arizona, says that negotiating a pandemic — deciding what activities are worth what dangers — has a lot to do with assessing an individual’s risk. “The problem is,” she says, “that most people are really bad at risk assessment.”

That has played out this summer as parties, weddings and festivals across the country have become super-spreader events. But a former health adviser for the Barack Obama administration thinks voting is far more benign.

Dr. Zeke Emmanuel told The Atlantic that casting an in-person ballot was similar to shopping for groceries — an activity many Americans have accepted as worth the minimal risk, especially given the prevalence of masks. Months earlier, Emmanuel categorized shopping as a “low/medium” risk activity, given the relative prevalence of enclosed space, duration of interaction, crowd density and forceful exhalation.

Like grocery shopping, voting lends itself to straightforward safety measures. Voters stand in lines, where they can easily keep their distance. Touch-screen voting kiosks carry no more risk than credit card machines at stores, and can be sanitized just as often. Emmanuel told The Atlantic that no major outbreaks have yet been tied to polling places.

Still, as experts acknowledge that in-person voting is unlikely to trigger mass spreading of the virus, they argue that avoiding even a lower level of risk can be crucial for some people.

Troisi points to a number of factors that would give her pause in recommending voting in person. “Age is certainly an issue,” she said, “people with diabetes and heart disease and lung disease and cancer.”

CDC studies have found that, in 75- to 84-year-olds, the risk of dying of the coronavirus is 220 times higher than that of 18- to 29-year-olds. Among people older than 85, the number jumps to 630 times higher. If someone has three or more risk factors — asthma, hypertension, obesity, diabetes or chronic kidney disease — they are five times as likely to be hospitalized by COVID-19 as people with none.

Institutions are taking steps to mitigate those risks for voters. In August, the Brennan Center and the Infections Diseases Society of America issued guidelines for polling locations, calling for precautions such as Q-tips and finger coverings, and more room — shifting where possible to more spacious locations.

NBA arenas are nearly ideal polling places during a pandemic. Voters will have ample room to line up and any airborne contaminant can diffuse quickly. The floor of the Vivint Smart Home Arena is a far cry from an elementary school.

Still, maintaining safe social distancing procedures will be no easy feat. In November, people may well want to get out of the cold sooner at the expense of maintaining a well-separated line outside. Certain states, such as Texas, do not have mask mandates, and many voters may refuse to wear them. “If mask rules are implemented, that’s great,” Bell said, “but it’s pretty easy for all those things to break down, too.”

How will it affect the election?

Health concerns coincide with scrutiny over alternatives to in-person voting. President Trump continues to question the legitimacy of voting by mail. And amid a civil rights uprising, many people of color have expressed a similar distrust of mail-in ballots. The question of how to vote, then, could shape who will vote.

The New York Times, in June, reported that the pandemic had substantially weakened many voter-registration drives, potentially reducing the numbers of young people who can participate in November.

As election day nears and worries abound — over touching a touch-screen, or the usefulness of mailing in a ballot — politicians, officials and experts predict procedural anxiety could affect outcomes. “We’ve had to constantly reiterate that this (voting by mail) is normal in Utah,” said Justin Lee, Utah’s director of elections. “We’ll be doing outreach like we did for the primary, encouraging people to vote by mail, talking to the media and getting the message out there.”

“I think people that don’t take the virus seriously — that think it’s a hoax or no more serious than the flu — they are more likely to vote in person,” Bell said. Such a trend could have a substantial effect. Studies show that Republicans take the pandemic less seriously than Democrats.

Weighing a voting preference against a desire for personal safety is the sort of decision everyone has become more accustomed to making over the past few months, but that doesn’t necessarily make it easier. Troisi sees a flaw in Emmanuel’s grocery-store analogy. “Grocery shopping is not a civic right and duty,” she said. “And I think it is incumbent upon our leaders to make exercising that right and duty as safe as possible.”