ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2026
The toll of voting in a pandemic? Regional elections and the spread of COVID-19 in Bavaria.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study investigates whether the regional elections held in the German state of Bavaria on March 15 of 2020 - shortly after the WHO declared COVID-19 a global pandemic - contributed to the spread of COVID-19 cases and COVID-related deaths. Constructing synthetic controls for each of Bavaria's 96 districts based on non-Bavarian German districts, we find that over a third of the increase in positive test results cannot be explained by district-level demographic, economic, health or child care characteristics, nor by the distance to Ischgl - a proxy for skiing tourism associated with the first COVID-19 wave in Germany. Within Bavaria, districts with higher voter participation witnessed a steeper increase in COVID-19 cases and deaths after the election, while controlling for alternative drivers, such as the distance to Ischgl and the number of strong-beer festivals. Our results are highly robust and suggest that an unfortunate timing of elections contributed to the spreading of an infectious disease.
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