DEAR DR. ROACH: I have worked at the election polls in a school gym for years and know that presidential elections bring out close to 2,000 voters in my precinct. Most of my fellow workers are 70 and older. I am the youngest at 60. Is it safe for us to work over 15 hours while exposed to so many people even if we get masks and gloves? I’m torn between my patriotic duty and my health and those of fellow workers.

Is it safe for 30-year-olds to work? My son says he could take my place if I don’t work, but he is currently living at home. Wouldn’t he need to quarantine for two weeks after working? There is so much confusing information about exposure, so guidance would be greatly appreciated. — M.D.

ANSWER: I honor your commitment.

The risk of getting COVID-19 depends on three major factors: the concentration of virus; how close you are to a source; and the amount of time you spend there. In nearly all areas of the country, you are likely to be exposed if you see 2,000 people, and in some areas of the country at the time I write this, you could be expected to be exposed many times. Polling places have always been indoors, making the concentration of virus potentially high, and 15+ hours is certainly a long time of potential exposure.

Poll workers can dramatically reduce their risk by using personal protective equipment. Everyone can get some protection by having ALL voters REQUIRED to wear masks and by ensuring as much distance as possible during the voting interactions between voters and poll workers.

Health care workers taking care of people with known COVID-19 wear multiple layers of personal protective equipment, including N95 masks, gowns and face shields. Gloves are changed after every interaction and then hand hygiene is performed. This combination is very effective (though sadly not perfectly), but the best PPE can be hard to find. I would obtain PPE now if you plan to work. Multilayer cloth masks provide protection and are easy to obtain.

A 30-year-old and a 60-year-old have about the same risk of acquiring COVID-19, but a 30-year-old has much lower chance of having a severe complication.

The question of quarantine is one of local guidelines, and my advice to you or your son would depend entirely on the local prevalence in your area.

While health care workers go into the field understanding that there may be some risk to themselves from taking care of sick and potentially contagious patients, poll workers (like retail workers and many others) should not have to. Hence, I support vigorous efforts to minimize the need for in-person voting.

DR. ROACH WRITES: A recent column on abdominal migraine inspired many readers to write in with possible alternative diagnoses. Blocked arteries to the small intestine, meat allergy from Lone Star tick bite, intestinal angioedema and celiac disease all were mentioned by several readers. I am always impressed with the knowledge of readers.

As a student, my surgery professor would ask only one question for his oral exam: “Give me 50 causes of right upper quadrant abdominal pain,” which sounds intimidating, but it is not hard to generate a long list for a common problem. I never have enough room to go over all the diagnostic possibilities, so I have to choose one to go over in greater detail.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.

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