The last days of the 2020 campaign have become anxious moments for some Democrats. They believe that signs point to a victory for former vice president Joe Biden, but that’s never quite enough when it comes to dealing with President Trump. The hangover from 2016 remains palpable.

Strategists agree that were it not for what happened in 2016, it would be easier to predict the outcome in 2020 with confidence. But 2016 did happen, and the country has lived with the results for four years. As in the closing days four years ago, Trump still appears to have another path to victory, perhaps against great odds. Also there is disagreement over whether the country faces a long and fractious week of vote counting or will have a clear and decisive outcome relatively quickly.

The president hasn’t changed in four years, and his campaign rallies offer fresh testimony. He is trying to replicate that closing rush that shocked the world. Along the way, he has sought to divide, to inflame, to distract. At a time of record numbers of new cases of novel coronavirus infections, his closing message continues to be a claim that the country has rounded the corner in containing the coronavirus’s spread. Truth has never been Trump’s calling card.

While campaigning Friday, he asserted falsely that doctors have dishonestly recorded deaths linked to other causes — cancer or other diseases — as being caused by the coronavirus because they make more money doing so. What the president said was both callous and outrageous. Doctors and other health-care workers have been on the front lines all year; some have given their lives in service to others. It matters not to the president. It should matter to voters.

His final rally speeches are often laden with grievances, charges that his rival is a corrupt politician, and more evidence-free allegations of coming voter fraud, irregularities and rigged elections. His attacks on Biden are delivered with extravagant rhetoric — his rival would destroy the suburbs and empty the 401(k) of every American.

Such rhetoric is fodder for the audiences at Trump rallies and more broadly for the voters who believe in him. Trump is defying health guidelines because he knows that he must squeeze every last vote out of the enthusiasm his followers have for him. He and they feed on the energy produced by those rallies, and he must depend on that to produce huge turnout on Tuesday by those who haven’t cast early ballots and a decent split on those who have.

The president will lose the cities and most of the suburbs to Biden, perhaps by bigger margins than in 2016, which means the small towns and rural areas must turn out in even bigger numbers than before. These areas were crucial to his victory over Hillary Clinton and will be again if he is to win. Trump’s most loyal followers believe the ingredients could be there for this to happen.

In the first year of Trump’s presidency, I spent time off and on in counties along the Mississippi River in the Upper Midwest, places that had flipped to Trump after backing Democrats in multiple elections. Recent phone conversations with some of the Republicans and Democrats I met then produced a uniform view: The enthusiasm for Trump in these areas is as great as or greater than it was then.

They report that county Republican offices have seen higher demand for yard signs and other Trump paraphernalia and report that there are new registrants who are voting for the president. “In 2016 a lot of the people who supported Trump were quiet about it, meek and mild,” said Dan Smicker, the Clinton County Republican chair. “Not anymore. They’re becoming almost too aggressive.”

“Trump signs have never not been up,” said Brian Bruening, the Clayton County Democratic chair. “It’s an expression of who you see yourself as a person. Supporting Trump is more than supporting a candidate. It’s a big middle finger to the Democrats and multicultural things. … There are a lot of folks around here who used to fly Confederate flags. Those flags have come down, and now it’s all Trump flags.”

But Bruening said Democrats are fighting back in these rural areas. “We had Biden-Harris signs printed in the middle of August before the campaign had them,” he said. “Those were gone in three days. People were desperate for signs. We did another printing. They were gone in three days.”

Iowa, a state that Trump won by nine points four years ago, is now considered competitive, and first-term Republican Sen. Joni Ernst is fighting for survival in her reelection campaign. Biden campaigned there Friday. Vice President Pence was there Thursday.

That Iowa is competitive — as it often used to be — and that other states Trump won comfortably also are in play gives Democrats hope that Biden truly does have more ways to get to 270 electoral votes than does the president. Still, they worry and wonder about whether Biden somehow will let the advantages slip away.

Biden has been battling the doubters from the day he announced his candidacy. Too old. Too moderate for a party moving left. Too given to gaffes and mistakes. Too long a record that opponents could pick apart. Some Democrats who knew and liked him hoped he would not run, fearing that he could be humiliated if he sought the nomination, that the last race of his career would stain the record of four decades of public service.

But he and his team thought they understood the mood of the electorate and charted a path based on what they saw. When other Democrats running for president said, “This is not about Donald Trump,” Biden said just the opposite, that it was an election first and last about the president. His announcement video made that clear.

A recent conversation with a northern Illinois state legislator, Republican Andrew Chesney, reinforced Biden’s view of what the election has always been about. “This conversation [here] is not about policies of Biden versus Trump. This is Trump versus Trump,” he said. “Before it was a compare and contrast of two candidates. Now it’s President Trump’s record that is on the ballot.”

Biden campaigned in the early primaries with lackluster energy and was repaid with losses in Iowa and New Hampshire that seemingly put his campaign on the edge of extinction. He and his team held firm and were rewarded with what became one of the swiftest conclusions to a nominating contest in memory.

Trump and Republicans have tried to make an issue of the contrast between a president racing from state to state, holding multiple rallies a day, and a challenger going at a far slower, more deliberate pace — albeit one that is calculated to heed the advice of medical experts about the risks to supporters and the candidate during a pandemic.

Nate Silver’s FiveThirtyEight site gives the president little more than a 1 in 10 chance of winning the election — poorer odds by far than at this point four years ago. Still, Democrats worry, unable to shake the memories. They worry that mail ballots will not all arrive on time, or that Republican challenges will result in those ballots not all being counted or that Trump will manage to thread the needle once again.

Privately, Republicans are gloomy about the president’s chances but don’t rule out victory. They are just as worried about losing control of the Senate. Meanwhile, Biden has set his course and tries to screen out the noise. In days, the country should have a clearer picture of whether the doubts about him were justified or whether Biden was right all along.