ANNVILLE, PENNSYLVANIA (NYTIMES) - Entering Ted's Bar and Grill on Monday (Oct 5), Mr Tim Girvin briefly slid on a Trump 2020 face mask, before whisking it off to join friends at a table for lunch.

He said those few seconds were the only time he wore a mask all day.

"I have my own business and I don't have anybody wear a mask in my business," said Mr Girvin, a used-car dealer.

"I don't buy into it. When you look at the facts, with how many people die of influenza every year. Obesity kills more people than the Wuhan virus does."

On the day that President Donald Trump defiantly left the hospital where he was being treated for a coronavirus infection and returned to a White House that appears to be one of Washington's most contagious hot spots, backers of the President in rural Pennsylvania showed no signs of questioning their own defiance of experts' advice on how to limit the virus's spread.

In the Lebanon Valley east of Harrisburg, where support for Mr Trump remains particularly strong, the President's failure to protect his family and inner circle from the virus was not seen as a reflection on his inability to protect Americans, as the death toll passed 210,000.

On the contrary, Trump loyalists echoed misinformation that the President has spread for much of the year, as he has sought to minimise the threat of the virus to aid his re-election.

Voters who support the President falsely claimed that data from the Centres for Disease Control and Prevention on deaths and cases were wrong, that getting the virus was no worse than getting the flu, and that it was introduced and kept in the spotlight only by Mr Trump's Democratic opponents.

"Who do you think brought this into the country?" said Mr Girvin, who has shared posts on Facebook that independent fact checkers have labelled misinformation.

"Joe Biden has enough nerve to say Donald Trump's killing people? No. The far-left liberals are causing this. The Pelosis, the Soroses and all these people, that's who caused it. And I wish them all the worst."

As interviews with Mr Girvin and others make clear, Mr Trump has managed to politicise science during a public health crisis, something that historians will likely look back on as a defining aspect of the coronavirus pandemic.

Scoffing at masks, social distancing and crowd avoidance - all measures recommended by health experts, including in the Trump administration - has become a test of loyalty for fervent supporters of the President, who mocked Mr Biden's masks during their debate last week and, on returning to the White House on Monday from the hospital, ripped his off, despite being highly contagious.

Mr Brad Dechert, a Trump supporter who visited a Walmart here Monday without a mask, said, "I like my freedom" on leaving the store, and pronounced Covid-19 as "nothing more than a flu, really".

Pennsylvania requires face coverings indoors in all locations open to the public, and most businesses, including Walmart, post notices warning patrons not to enter without one.

But a store greeter identified by her vest as a health ambassador said she had no power to stop the 10 per cent of shoppers who refuse to cover up.

"Younger people's more safe," said Mr Dechert, 31.

"Older people have an issue. Nobody batted an eye for the flu. Now all of a sudden, it's an election year - Covid."

Mr Dechert, a volunteer firefighter who served overseas with the National Guard, said he thought the CDC's count of 209,000 deaths from Covid-19 as of Monday was grossly inflated.

"Say I have it and I get tested five times, that's five new cases," he said. "I know for sure, through EMTs, they count it separately." (This misconception, spread on social media, has been rebutted; the CDC reports total cases and total tests separately.)

His wife, Ms Jennifer Schickram, 33, a homemaker, said with equal conviction that health providers exaggerate cases to collect higher payments.

"They want the extra benefits that are going to come out of listing people as Covid," she said.

"We all die at some point," Mr Dechert added. "So, hey, I grew up in this America where you could have freedom, go out about your own business. Cool. Hey, if I get it and I die, awesome."

In a Reuters/Ipsos poll released on Monday, four of 10 likely voters in Pennsylvania said Mr Trump would be better at handling the coronavirus outbreak, while five in 10 said Mr Biden would be better.

The partisan divide mirrored the overall race, with Mr Biden leading Mr Trump in the state by 50 per cent to 45 per cent.

Mr Trump had an edge with voters on managing the economy. Other recent polls of the state have given Mr Biden an edge of 4 to 11 percentage points.

In a Quinnipiac University national poll last month, four out of five likely voters said they believed masks to be effective at slowing the spread of the virus.

Dr Robert Redfield, director of the CDC, told Congress that wide use of face masks would bring the pandemic under control and might offer more protection than a vaccine.

Outside a Giant food store in Hershey, Ms Joanne Clark, who said she worked part time in a hospital, added that she, too, did not trust CDC statistics.

Doubts about the CDC figures trace back at least to August, when Mr Trump retweeted a post by a follower of the QAnon conspiracy.

Twitter later removed the President's retweet for violating its rules about sharing disinformation.

The false claim arose because doubters of the CDC argued that deaths in people with underlying health problems, such as diabetes or heart disease, were not deaths from Covid-19 - whereas experts said they were.

The view that government data is untrustworthy persists among many of Mr Trump's supporters, along with other falsehoods about the virus and mask wearing.

Although Ms Clark, 62, wore a mask as she entered the supermarket, she questioned a reporter standing outside who was masked: "I think you're hurting yourself being outdoors wearing a mask. You're breathing your own carbon dioxide. It just makes no sense to me."

(Health experts have debunked claims about masks and carbon dioxide as a myth.)

Pennsylvania's mask order - which also requires people to wear masks outdoors when it is not possible to maintain 1.8m of distance from others - was signed by the state secretary of health, Dr Rachel Levine, and endorsed by Governor Tom Wolf, a Democrat.

Both officials are deeply unpopular in many rural regions of Pennsylvania. A state representative for part of Lebanon County, Mr Russ Diamond, mocked face masks at a rally in Harrisburg to reopen the state in May.

Lebanon County, a region where farms and a large Bell & Evans chicken processing plant meet the suburbs, was the last county in the state permitted to move to the final, "green phase" of reopening, which Dr Levine said at the time was because data showed a high level of community spread by the virus, in part because local officials had defied the governor's timeline for reopening businesses.

Republican leaders in the county in turn accused the governor of playing politics with reopening, and wrote he "deserves only to be ignored".

As of Tuesday, Lebanon County ranked 14th among Pennsylvania's 67 counties in new cases per capita in the past seven days, according to a New York Times data tracker. There were 117 new cases overall in the period.

On Monday evening, Dr Anthony Fauci, the nation's top infectious disease expert, said that the United States was "stuck" at around 40,000 new cases daily, with data foretelling a surge with the arrival of cold weather.

He renewed his call for universal mask wearing, social distancing, avoiding crowds and hand washing.

"If as a country we actually did it," he said, without naming the President, "we wouldn't be in the position we're in right now."

Ms Margaret Scholl, a resident of Annville, had Covid-19 in April.

"I did not wear a mask at first," she said, as she came to the door of her home, where she had been helping a granddaughter attend school online. "And then I finally started putting a mask on because people were getting it."

Her brother and sister-in-law were hospitalised with Covid-19.

Annville, a quaint, Republican-leaning community along busy Route 422, featured exuberant displays of Trump signage and Trump flags.

Ms Scholl, a retired employee of the Hershey Co (its original chocolate factory is just up the road), said she planned to vote for Mr Biden, whose signs are more visible than those for Mrs Hillary Clinton were four years ago, when Mr Trump scratched out a narrow victory in Pennsylvania, though he carried Lebanon County by more than two-to-one.

"I know a lot more people who don't have signs up are voting for him," she said of the former vice-president.

Ms Maureen O'Toole-Goldman is a nurse who is married to an infectious disease doctor at a medical centre in Harrisburg; she and her husband moved to the area about 25 years ago.

She said many voters in central Pennsylvania felt left behind economically, and to them, Mr Trump has become "a sort of demigod".

"They believe everything he says," she said, offering an explanation of why so many embrace the President's rejection of advice from the nation's top doctors and scientists.

"When the med centre came, there was a lot of distrust of the educated elite versus, you know, regular folk," said Ms O'Toole-Goldman, 57.

"They feel like people look down on them. Trump comes out and is sort of speaking their language."

Outside the Giant market, Ms Sue Jones, a retiree, entered with a face shield adorned with sequins.

She said Mr Trump's case of Covid-19 never gave her pause about his ability to protect Americans.

On the contrary, she believed he has been a model of how to respond.

"I was just telling her, it's peace through strength," Ms Jones said, referring to her young niece who accompanied her. "He has given us strength."

Ms Jones said she recently sold a child care business because so many parents were working from home that demand for her services plummeted.

The President "had one of the greatest economies going before it happened and the liberal left does not like that", she said.

"They couldn't impeach him. They couldn't do anything about the Russia collusion. So then they were colluding with China, they bring in the virus."

Asked where she got her news, she said, again gesturing to her young niece: "I was just telling her, don't go to the news sources. Go to different podcasts."

She mentioned podcasts by the conservative commentators Ben Shapiro and Dennis Prager.

In April, Mr Prager called coronavirus lockdowns "the greatest mistake in the history of humanity".