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.’”

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.