The first COVID-19-related death in the United States was announced on February 29, 2020, the day of the South Carolina primary. International news about the early spread of the coronavirus and the initial reaction from American public health professionals to its quick spread in this country made it clear that the presidential election was facing an existential threat. Election officials who held primaries in early- and mid-March found themselves increasingly making public health decisions to guard both their voters and their staff. The larger societal challenges quickly overwhelmed the ability of states to hold primaries at all, leading to hastily canceled and postponed elections. The one early primary that was not postponed, Wisconsin, provided cautionary tales in the form of closed polling places, poll worker shortages, and massive transitions to mail balloting.