Corey Ingram, a resident of Spring Grove, Pennsylvania, felt good about voting for Donald Trump in 2016 — but the president’s handling of the coronavirus pandemic has already made his choice in November clear.

“How he’s doing with this doesn’t give me any confidence,” Ingram, 42, an inspector at a military equipment manufacturer, told NBC News. “The rejection of science, the constant disagreeing with his experts.”

“After this,” he added, “anyone but Trump.”

Like many voters across the United States, Ingram, a political independent who twice cast a ballot for Barack Obama, has seen the pandemic emerge as a main concern as the country slides quietly into a general election campaign eclipsed by the ongoing public health crisis.

How Trump has responded to the outbreak — from a public health and an economic standpoint, as well as a crisis management challenge — will pave a path to victory (or defeat) that largely goes through battleground states. And nowhere are his challenges clearer than in the swing state of Pennsylvania.

As of Wednesday night, the state had the fifth-most confirmed cases of COVID-19 and the fifth-most deaths from the virus in the U.S.

The economic toll has been even more striking. Since March 14, about 1.3 million Pennsylvanians (or nearly 1 in 5 workers in the state) have lost their jobs — the second-highest number during that period in the country, behind only California.

In interviews, voters, former lawmakers, political strategists and union leaders all said the political fallout for Trump in Pennsylvania is already significant — and is likely to remain stark unless the public health and economic situations improve dramatically before Nov. 3. But that doesn’t mean former Vice President Joe Biden is sure to capitalize, they said, due to his struggle to stay visible and break through during the so-called “virtual campaign” that he and Trump have been forced to engage in during the pandemic.

Trump’s challenge: maintain his margin of victory against economic headwinds
Even before the health crisis, Pennsylvania — with its 20 electoral votes — was shaping up to be one of the most critical battlegrounds in the 2020 race. Trump edged Hillary Clinton in the state in 2016 by just over 44,00 votes, turning it red for the first time since 1988. Doubling down on his criticism of free trade deals and exploiting broad dislike for Clinton, Trump dominated in the largely rural and industrial central, south and western parts of the state, while also turning, or nearly turning, red counties containing the smaller cities of Wilkes-Barre, Scranton and Erie, all of which went blue in 2012.

Trump’s challenge, sources said, will be to keep his razor-thin margin of victory alive amid a once-in-a-century public health disaster.

“Trump won here in 2016 because he ran as a disruptor. But in a crisis like this, even if he were performing strongly, people are going to want a stabilizer in the White House,” Phil English, a former Republican congressman from Erie, said.

“The stakes have changed,” added English, whose hometown of Erie County went to Trump in 2016 by just 1,957 votes. “Pennsylvania has been put into a much more challenging position, or at least demands a totally different strategy, for the president to keep it in his column.”