An Associated Press analysis reveals that in 376 counties with the highest number of new cases per capita, the overwhelming majority — 93% of those counties — went for Trump, a rate above other less severely hit areas.

Most were rural counties in Montana, the Dakotas, Nebraska, Kansas, Iowa and Wisconsin — the kinds of areas that often have lower rates of adherence to social distancing, mask-wearing and other public health measures, and have been a focal point for much of the latest surge in cases.

Taking note of the contrast, state health officials are pausing for a moment of introspection. Even as they worry about rising numbers of hospitalizations and deaths, they hope to reframe their messages and aim for a reset on public sentiment now that the election is over.

“Public health officials need to step back, listen to and understand the people who aren’t taking the same stance” on mask-wearing and other control measures, said Dr. Marcus Plescia of the Association of State and Territorial Health Officials.