Record-setting levels of US coronavirus cases are coming at the worst possible time politically for Donald Trump.

The president, who has spent months attacking mail-in voting, needs a dramatic turnout on Election Day to have any hope of overcoming his sagging poll numbers and the advantage Democrats have with mail-in voting. But the spiking cases numbers and rising hospitalizations in key battleground states could deter some Republicans from voting, even though the party insists that Trump's supporters remain fiercely motivated to show up.

The surge in cases also puts Trump on the defensive and keeps the focus at the end of the race on his handling of the pandemic, which Democrat Joe Biden has made a central part of his campaign, with the president spending the past eight months downplaying the virus and insisting it would go away.

"To a certain extent, it's going to cost him some votes," said Ed Rollins, a Republican strategist who's chairman of the pro-Trump Great America political action committee. "Our vote will hopefully turn out, but I'd much rather have them in the box than waiting for them to come."

The Covid spikes will make it more difficult for Republicans to execute their voter turnout plans, especially with polls showing Trump trailing Biden, said Kevin Madden, a Republican strategist and senior adviser to Mitt Romney's 2012 presidential campaign.

The concern for Trump isn't just turnout but also the economic anxiety the pandemic has spawned, how it has affected older voters who are an important constituency for the president as well as working-class and rural voters who backed him in 2016 and may "have a bit of buyers' remorse," Madden said.

"If a voter walks into the polling place thinking about the coronavirus pandemic, they'll leave having cast a ballot for Joe Biden," said Ben Wikler, chairman of the Democratic Party of Wisconsin, a state recording record highs in hospitalizations and cases.

At the same time, there are risks for Biden too. Black voters, some of Biden's strongest supporters, also have been hard-hit by Covid cases in the weeks leading up to the election in the key swing state of North Carolina. Experts say that could depress turnout. But that state is an outlier: Nationwide, the largest Black communities have never had fewer virus cases relative to other counties.

Rising cases also could cause a shortage of poll workers that reduces the number of polling locations in urban areas, disproportionately affecting Democratic voters. And there are concerns that large numbers of mail-in ballots being cast by Democrats in response to the pandemic could be rejected because of delays in US Postal Service delivery or on technical grounds.

Any political impact of the coronavirus is already baked into the race after eight months, so a spike now isn't likely to make much of a difference, said Republican strategist Bryan Lanza, deputy communications director for Trump's 2016 campaign. While the heavy Democratic early voting is a concern if they're new voters and wouldn't have voted anyway on Election Day, Trump's supporters will be there for him, Lanza said.

"His voters are going to show up on Election Day irrespective of what's happening in the world," Lanza said. "Whatever the fears are of Covid, I don't think it's going to be enough to scare his voters away."

Another factor is that a record number of Americans have voted early. More than 69 million Americans have cast mail-in or in-person ballots -- far exceeding the early vote total from 2016 and accounting for more than half of the total vote count in 2016, according to the US Elections Project.

Of the more than 33 million votes cast so far in states that report party registration data, Democrats account for 48% of the total and Republicans 29%, according to the same data.

At the same time, the virus statistics are worsening each day. The US reported 73,096 new Covid-19 cases Tuesday, bringing the seven-day average to a record 71,532, according to the Covid Tracking Project. More than 226,000 people have died, Johns Hopkins University data show.

Despite Trump blaming rising cases on increased testing, current hospitalizations with Covid-19 have climbed 36% to 44,212 in the past three weeks, after months of decline and a brief plateau. About 6% of America's inpatient beds are now occupied by Covid-19 patients, according to data from the US Department of Health and Human Services.

The coronavirus spike is being driven by sharp increases in the Midwest and adjacent states, including in Wisconsin, Michigan and Pennsylvania -- three states that Trump won by a combined 77,744 votes in 2016 and he needs to carry this year to win re-election.

Wisconsin now has the third-worst number of per-capita cases in the US in the past week, and it's getting worse, with the seven-day average rising 23% in the past week. Weekly cases per capita jumped 25% in Michigan and 33% in Pennsylvania in the past seven days, and current hospitalizations rose 27% in Pennsylvania, 10th-most in the US.

Photo: Bloomberg

No swing state has been immune as cases and hospitalizations have been rising in most states, including Florida and Arizona. The pandemic is now hitting rural areas and white voters -- key for Trump's re-election -- harder relative to other groups, and the record Covid-19 surge that started with young Americans is increasingly reaching the older communities at elevated risk of severe outcomes.

Even after a first outbreak hit Trump and White House staffers, a second outbreak came to light over the weekend when the chief of staff and other members of the inner circle for Vice President Mike Pence -- who leads the coronavirus task force that has been largely marginalized in recent months -- contracted the virus. That hasn't stopped Trump from saying the US is "rounding the turn" on the pandemic and that the surge is part of a "fake news media conspiracy."

"You turn on MSDNC, you turn on this network, it's COVID, COVID, COVID, COVID," Trump said at a rally Friday in Florida. "They want to scare you to try to make you vote for Biden."

While Biden has held limited events without big crowds to contrast his response to the pandemic to Trump's, the president has continued to hold boisterous rallies with supporters packed together and few wearing masks -- despite Trump being only weeks removed from his own battle with the virus. Health experts fear the rallies could be super-spreader events.

"The bottom line is Donald Trump is the worst possible president, the worst possible person to try to lead us through this pandemic," Biden said during a campaign event Monday in Pennsylvania.

There are challenges with Covid that other countries are also facing, but Trump's approach will soon defeat the virus, Jared Kushner, Trump's son-in-law and senior adviser, said on "Fox & Friends" on Monday. Politically, Trump's campaign is designed to turn out the vote, and state directors feel more confident about where they are now than in 2016, he said.

Still, some analysts say Trump is pursuing a risky strategy depending on a strong Election Day vote to overcome Democrats' advantage with early voting -- especially if some voters stay home and any uncommitted voters want to hold him responsible for an unchecked coronavirus.

In Wisconsin, Trump's handling of the coronavirus has gone from 51% approval in March to 56% disapproval in early October in the Marquette Law School poll -- even as a majority still support him on the economy. If the virus surge does impact the race, it probably affects Trump more because more Republicans plan to vote on Election Day, said Charles Franklin, the poll's director.

"I really think it's an issue," David Axelrod, the former chief strategist for President Barack Obama, said on his "Hacks on Tap" podcast on Friday. "The virus has defined this election, and it may define Election Day."

Disclaimer: This opinion first appeared on Bloomberg, and is published by special syndication arrangement.