On coronavirus maps, her northeastern Wisconsin county was glowing bright red. Kristin Lyerly decided this was the moment to turn it politically blue.

The 50-year-old doctor had jumped into the race for state Assembly — her first-ever campaign — because she was appalled by the GOP-dominated legislature’s opposition to efforts to beat back the virus.

As the Republican incumbent campaigned with handshakes and a bare face, Lyerly donned a mask and kept her distance from voters while promising she would follow the science, wherever it led.

“My whole campaign was about ‘covid, covid, covid,’ ” said Lyerly, a Democrat who has a degree in public health. “And when I talked to people through their storm doors, they would say they wanted responsible covid management.”

But when the votes were counted, the citizens of Brown County had not only reelected the Republican, they had also flipped their state Senate seat to the GOP. The coronavirus red zone had unleashed a red wave.

It wasn’t just northeastern Wisconsin. Democrat Joe Biden may have won the presidency pledging a national mask mandate and a science-based approach to controlling the pandemic. But in the states where the virus is spiking highest — particularly in the Upper Midwest — Republicans made substantial gains down-ballot. Often they did so by railing against the very tool that scientists say could best help arrest the virus’s spread.

To many Republican voters, “masks have become a symbol of assaults on freedom,” said Aaron Weinschenk, chair of the political science department at the University of Wisconsin at Green Bay. “I’ve heard so many times, ‘You know what’s best for your family, so you should decide.’ ”

A number of governors, including Wisconsin Gov. Tony Evers (D), warned the public to take safety precautions as coronavirus cases surged across the nation. (Reuters)

The victories in state and local races have allowed GOP leaders to claim a mandate for their let-it-be approach to pandemic management, with pleas for “personal responsibility” substituting government intervention. As hospitals fill and deaths climb, it’s a philosophy that public health experts warn could have disastrous consequences this winter.

“In the weeks ahead, we will see hospitals overwhelmed,” Scott Gottlieb, a former Trump administration Food and Drug Administration commissioner, predicted at a recent forum.

Gottlieb is among the experts who have advocated for a national mask mandate if governors fail to act.

Yet the election results suggest there is no political penalty in many areas of the country for failing to heed the advice of public health authorities. There may, in fact, be a benefit in not doing so and in arguing that economic interests take precedence.

In Iowa, cases have grown by nearly 180 percent in two weeks, and the average daily death count is well above its springtime peak, according to state data.

Yet President Trump — who held mostly maskless rallies in Iowa — won the state by a large margin, as did Joni Ernst, the incumbent Republican U.S. senator. Democrats had been hoping to flip the state House, but it was the GOP that made gains.

At a news conference this month, Republican Gov. Kim Reynolds called the result “a validation of our balanced response to covid-19, one that is mindful of both public health and economic health.”

While Reynolds last week issued a limited mask mandate for large indoor gatherings and for certain businesses, such as hair salons, she has continued to resist the broader restrictions embraced by dozens of other governors.

Republicans in North Dakota were also rewarded by voters, with the party managing to deepen its dominance of state government even as coronavirus cases jumped tenfold in the three months before the election.

Among the state’s more than 700 covid-19 deaths was a Republican candidate for the state legislature who died in October. He easily won election anyway, as did nearly every other GOP legislator, as well as the governor, Doug Burgum.

Burgum has given teary-eyed news conferences to talk about the toll the virus is taking on his state. For months, he refused to implement a mask mandate or business restrictions, saying he prefers a “light touch” from government.

But in an indication of just how much pressure the state’s creaky health-care system is facing, Burgum abruptly shifted course late Friday, issuing a month-long mask mandate. He also decreed that bars and restaurants are required to limit occupancy to 50 percent and large-scale venues have to max out at 25 percent capacity.

Next door, in Montana, the current governor is Democrat Steve Bullock, who enacted a mask mandate in July. His lieutenant governor, Mike Cooney (D), ran to succeed him on a platform of toughening up the rules as the state experienced one of the nation’s worst coronavirus spikes.

“The economy will not recover if we don’t keep Montana healthy,” Cooney said repeatedly.

But voters chose his rival, Rep. Greg Gianforte (R-Mont.), who was photographed without a face covering and embracing maskless supporters while on the campaign trail.

Gianforte said he will consider rolling back the state’s restrictions in a bid to boost the economy.

“We can’t neglect the fact that the actions that have been taken have resulted in 150,000 Montanans losing their jobs,” he said during an October debate.

In states that still have Democratic governors, losses in the legislature erased any hopes that they would have an easier time implementing their virus-fighting strategies. Democrats in both Michigan and Pennsylvania had hoped legislative gains would help to break stalemates between the executive and the legislative branches that have hobbled their states’ virus responses, only to end up disappointed.

In Minnesota, Biden won comfortably. But Republicans dashed Democratic dreams of retaking the state Senate. Amid record-breaking virus numbers and predictions that the state could see as many as 100,000 new cases by Thanksgiving, Gov. Tim Walz (D) will continue to have to work with Republican legislators who have called for the state to be fully reopened while denouncing his restrictions on hours and occupancy for bars and restaurants as a threat to the economy.

During a special legislative session, Republicans ignored Walz’s request for them to publicly back some of the measures he has put into place, including a statewide mask mandate. Walz said such an endorsement would have helped in winning compliance from citizens who “don’t believe what I’m telling them about covid. They don’t believe that this is out there.”

Walz on Saturday blasted Republicans in the state Senate for not informing their Democratic colleagues of an outbreak within their caucus that affected multiple members and staff members before the Thursday special session. “If we know of a positive case, we have a moral obligation to share that with others so that they can protect themselves and their families,” Walz wrote.

Wisconsin’s Democratic governor, Tony Evers, has also voiced frustration as he has tangled with Republican legislators who have thwarted his attempts to try to bend the coronavirus curve.

When Evers enacted a stay-at-home order in the spring, Republicans successfully appealed to the state Supreme Court to have it thrown out. They and their allies have also challenged the state mask mandate and the governor’s restrictions on business hours and occupancy.

Those stands were what inspired Lyerly to enter the fray of politics for the first time. The OB/GYN had seen the toll of the coronavirus on her patients and couldn’t understand why politicians weren’t doing more to protect the public.

A former Republican, she ran on a platform of getting control of the virus through sound public health measures, such as mask mandates.

“We’re not listening to the experts, and that is the biggest travesty,” she said.

Her opponent, John Macco, opposes statewide mandates, and his Facebook page is full of mask-free photos from the campaign trail. He told the Green Bay Press-Gazette that he would prioritize jobs and the economy.

“Livelihoods are at stake and [voters] resent being classified ‘nonessential,’ ” said Macco, a small-business owner first elected in 2014 who did not respond to an interview request.

While Macco’s victory in the conservative Green Bay-area district was expected, Democrats were discouraged by their failure to make up ground statewide after a decade of Republican legislative dominance.

Ben Wikler, state Democratic Party chair, said a big part of the reason is that Republicans drew legislative maps to their own benefit. “If the districts weren’t gerrymandered, we would have a closely divided legislature,” he said.

But Wikler also allowed that Democrats may have been lulled into a sense that their positions on the coronavirus were more broadly supported than they actually were.

“The polling is very clear that voters support mask mandates and social distancing,” he said. “But a lot of voters turned out who aren’t answering polls.”

Evers this week pleaded with the state’s residents to stay home while acknowledging that, without legislative support, he lacked the authority to force them to do so.

Ashok Rai, president and chief executive of Prevea Health, said the governor’s appeal was unlikely to make a difference.

“We’ve asked for changes in behavior,” said Rai, whose company helps to operate two of Green Bay’s four hospitals. “We haven’t seen them.”

As a result, Rai’s hospitals have been operating for weeks at or near a crisis footing. Test positivity rates in the surrounding county were hovering at an astounding 40 percent, while the state was topping 2,000 hospitalized covid-19 patients for the first time.

“Every metric is going in the wrong direction,” Rai said.

Among them was the state’s death toll, which was above 2,600 as of Friday.

Benji Ramirez, 20, lost cousins to the virus. The Madison, Wis.-based community activist has been among those tracing dozens of chalk body outlines on the streets and sidewalks around the state Capitol in recent weeks, a reminder to legislators of the human cost of their decisions and rhetoric.

“What do we, as a people, do when the leadership is letting us die?” asked Ramirez, who called failure by Republican legislators to embrace public health measures “a bioweapon against people of color.”

Lyerly, meanwhile, has gone back to full-time medical practice after leaving the campaign trail. She is reminded of the toll every day. One of her partners has covid-19. Another has a spouse in the ICU.

“I am a fundamentally optimistic person. But I’m also realistic,” she said. “The trajectory that we’re on right now has me profoundly concerned. I don’t think that my friends and neighbors and patients have any idea what it’s going to be like in a month.”

Holly Bailey in Minneapolis contributed to this report.