The Supreme Court’s order Monday that South Carolinians must have a witness sign their mail ballots this fall sparked voter confusion in the state and fears among voting rights advocates that the requirement could impede people from casting their ballots.

The high court said in a brief order that mail-in ballots must contain the signature of one witness, siding with state Republicans and reversing a lower court’s recent decision to waive that long-standing requirement in response to concerns about exposure to the coronavirus.

With tens of thousands of ballots already mailed out across South Carolina, voters and election officials said they were worried that what has been a series of rapidly reversing court rulings in recent weeks would potentially lead to rejected ballots.

“That flip-flop is really setting things back. They’re making it more difficult for people to vote,” said James Smeal, 69, a bakery owner who voted early on Tuesday in North Charleston.

The Supreme Court decision only confirmed his plan to vote early in person to avoid any potential problems, Smeal said: “This whole election has me so nervous and worried — I really don’t know that it’s going to be fair. ... I never thought this would happen in the United States.”

The high court’s decision, just a month before Election Day, is one of a number of legal fights still playing out across the country that will determine rules around voting this fall.

South Carolina has seen a dramatic increase in the number of voters who want to cast their ballots by mail for the general election, mirroring trends nationwide. In Charleston County, the state’s third-most populous, 53,000 mail ballots have been sent out so far, officials said. In 2016, just 16,000 people voted by mail.

In its order Monday, the Supreme Court said that any ballots cast before the court’s action “and received within two days of this order may not be rejected for failing to comply with the witness requirement.”

On Tuesday, the South Carolina Democratic Party, one of the plaintiffs that challenged the signature rule, called the Supreme Court’s decision “extremely discouraging.”

“This new ruling will confuse voters, as just one week ago they received information that witness signatures were no longer required,” Shaundra Young Scott, the state party’s voter protection director, said in a statement. “Voters who have sent in ballots under the previous waiver are concerned that their ballots may not be counted.”

Meanwhile, South Carolina GOP Chairman Drew McKissick said Democrats had sought “to hijack a pandemic and use it to meddle with our election laws.”

“It’s a great day for those who care about the security and integrity of our elections,” he said in a statement.

Although the state has required a witness for mail-in ballots since 1953, the surge in mail-in ballot requests this year means many new voters may be unfamiliar with that requirement, election officials said. Others who have not been following the case closely could be uncertain of what is now required, they added.

“It is confusing to voters because it has gone back and forth multiple times,” said Joe Debney, Charleston County director of elections.

As the fight has wound its way through the courts, state and local election officials alike have urged voters to obtain the signature of a witness just in case the requirement was reinstated.

Still, voting rights groups said they were worried that the Supreme Court decision would lead to greater health risks for voters who are turning to mail ballots for health reasons.

“The idea behind offering greater access to mail ballots during the pandemic is to allow people to have the choice to vote in a way that minimizes their risk of contracting covid,” said John Marion, executive director of Common Cause Rhode Island, a voter-advocacy group that recently prevailed in its efforts to suspend a requirement for voters to obtain signatures from two witnesses or a notary for mail ballots in that state.

Last month, several South Carolina voters and state and national Democratic groups sued state elections officials to block the witness requirement for the general election, noting that the requirement had been waived for the state’s primary election in June because of the pandemic.

U.S. District Court Judge J. Michelle Childs, an appointee of President Barack Obama, agreed and granted a preliminary injunction, which was upheld by the U.S. Court of Appeals for the 4th Circuit on Sept. 30.

State elections officials and South Carolina Republicans then asked the Supreme Court to weigh in, arguing that the one-witness requirement imposes a minimal burden on voters and is an important tool in deterring voter fraud.

That prompted advocacy groups to raise alarms that the signature requirement could pose health risks for voters, particularly for the elderly and others at high risk of contracting the coronavirus.

AARP had urged the Supreme Court to uphold a lower court’s decision to waive the requirement for a witness’s signature in South Carolina, saying it “needlessly puts at risk the health of medically vulnerable individuals.”

“The state law at issue poses grave risks to all older voters and to persons with serious medical conditions and/or disabilities — disproportionately older adults — who must leave social isolation to secure a witness to their absentee ballot,” the senior citizen group argued in its court filing.

In response to the Supreme Court order, Charleston County on Tuesday began a voter education campaign raising awareness about the requirement and how to rectify any problems with signatures before Election Day.

In York County, S.C., officials had just mailed out ballots on Monday and had not yet received any back by mail as of Tuesday morning. The elections office there had also been urging voters to send their ballots back with a witness signature just in case the requirement was reinstated.

“We are concerned about confusion at all times. These back-and-forth things can make the process more confusing,” said Alan Helms, deputy director for the York County elections office.

The county has received 29,000 requests for mail-in ballots so far, a significant increase from previous years, Helms said. The county has just under 200,000 registered voters.

The Supreme Court’s decision could drive more South Carolinians to cast their ballots early and in person — a method that has already seen signs of record turnout.

On the first day of early voting in Charleston on Monday, 1,294 voters cast their ballots at one of the county’s four locations — exceeding the 1,063 voters who cast their ballots during the first full week of early voting in 2016, Debney said.

On Tuesday, a steady stream of residents visited the North Charleston Coliseum polling place, though Monday’s long lines had dissipated.

Among those voting was Stephanie White, 39, an assembly worker who works the night shift. The news about the reinstated witness requirement made her worry about a fair election, she said: “Will those early mail-in ballots now not matter?”

Cheri Knight, 53, who owns a cleaning company in Charleston, had never voted early before, but said she decided to do so this year because she was determined to vote for former vice president Joe Biden.

“It’s unnecessary,” Knight said of the signature requirement, “just one more step to prevent people from voting with ease.”

Alejandro Gonzalez, 58, who is married to Smeal, said the witness signature requirement “creates more problems for people who want to vote, more restrictions. That’s the reason we came to vote early.” He said he canceled his mail-in ballot request to vote in person and avoid confusion over the signature rule.

Gonzalez, who became a U.S. citizen two years ago, wore his first-ever “I Voted” sticker as he left the polling location Tuesday.

“It felt great! I’m very excited because this is such an important election,” he said.

Hunt reported from North Charleston, S.C.