Photograph: Courtney Pedroza/Reuters

For days, as coronavirus cases climbed across the state, Arizona’s Republican governor blocked local lawmakers from being able to mandate that residents wear masks.

The mayors of Arizona’s largest cities went on national television and radio shows, pressing the governor, Doug Ducey, to give them the power to require mask-wearing in their cities if he was unwilling to mandate it statewide.

Hundreds of Arizona medical professionals sent Ducey an open letter this week, outlining the evidence that masks save lives and asking him to require citizens to wear them.

Partially bowing to pressure, Ducey announced on Wednesday that he would allow local governments to set their own mask-wearing regulations.

He confirmed in a press conference that Arizona was headed in a dangerous direction, with nearly 2,400 new coronavirus cases announced on Tuesday and another 1,800 announced on Wednesday, and hospitals reporting that intensive care units are already at more than 80% capacity.

But just a week before Donald Trump is expected to come to Arizona for a major campaign rally, the Republican governor is continuing to resist calls to make mask-wearing required in public places statewide.

Masks have become a charged partisan issue in Arizona, one of the key swing states in the 2020 presidential election. As thousands of people watched Ducey’s press conference live on Facebook, many commenters demanded, “Make masks mandatory!” but others pushed back: “Breathing is not aggression. Fear is not a virtue,” one posted.

The chairwoman of Arizona’s Republican party shared a local Fox News reporters’ Twitter poll asking users whether it was appropriate to “force” people to wear masks, or whether the best option was “No force. Free choice.”

Arizona, once a conservative stronghold, is now one of a handful of states that is being fiercely contested in November’s election. Trump is expected to hold a campaign rally in Phoenix, with an unconfirmed date of 23 June.

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Ducey’s Democratic critics have accused him of repeatedly making coronavirus policy choices in response to Trump’s visits to Arizona, rather than in response to public health data.

“I just hope that it’s not tied to Trump’s visit, the unwillingness to make the call for mandatory face masks in Arizona,” said Regina Romero, the Democratic mayor of Tucson, who has publicly pushed Ducey to make mask-wearing mandatory. “But it seems to all tie together.”

“These are people’s lives,” she added.

In May, just one day before Trump’s visit to a mask production plant in Arizona, Ducey had suddenly announced he was accelerating plans for reopening barbershops, salons, and dine-in services at coffee shops and restaurants.

The timing of the announcement was “suspicious,” and obviously not coincidental, an Arizona Republic opinion columnist argued at the time, although likely shaped by a rebellion among Republican state lawmakers against public health measures, as well as the president’s visit.

Now, just over a month since Arizona’s full reopening on 15 May, coronavirus cases are spiking, the death toll has risen to more than 1,200 people, service workers are speaking out on social media about being required to keep working at restaurants that remain open even as their coworkers are diagnosed with coronavirus, and the president is once again planning a trip to Arizona.

Ducey defended plans for Trump to hold a large rally in the state next week.

“There are voluntary events,” he said. “We are going to protect peoples’ right to assemble in an election year.”

Romero, the Tucson mayor, called Ducey’s announcement to “untie the hands” of local mayors a “positive step” and said that Tucson would be putting a mask requirement into place on Thursday.

Related: Fauci says US ‘still in the first wave’ as six states see record Covid-19 cases

Arizona’s former public health director Will Humble, who served under a previous Republican governor, has been arguing publicly that requiring masks, at least in indoor spaces like grocery stores, is an essential step to flatten the curve and keep Arizona hospitals from being overwhelmed.

Without any change in the state’s public health policies, the latest model from researchers at Arizona State University projected that Arizona hospitals could run out of hospital beds in late June or early July and have to shift into “surge status”, Humble said on Wednesday morning.

“You should be honest with people: that comes with a different standard of care,” Humble said.

While he did not mandate masks statewide, Ducey said that wearing a face mask was “an issue of personal responsibility” and that “every Arizonan” should wear one.

Rebecca McHood, a Democrat who lives in a Gilbert, a wealthy, deeply conservative area outside Phoenix, said that voluntary mask-wearing in her neighborhood had been very mixed, with almost everyone at her local Walmart wearing a mask on a recent day, and at the nearby Target, almost no one wearing masks.

As a longtime resident of “a pretty libertarian state”, McHood said that the most she could hope for was that Ducey would consistently message and model good mask-wearing behavior.

“The Arizona GOP seems to just want to lick Trump’s boots and do whatever Trump does,” said McHood, who said she had been a registered Republican until Trump was elected.

Following reports that Arizona’s bars, nightclubs, and casinos have been crowded over the past month, Ducey also said businesses needed to observe social distancing and capacity guidelines.

“If they don’t, there will be enforcement and they will be held accountable,” he said.

A nurse checks vitals from a woman complaining of virus symptoms in the Navajo Nation town of Monument Valley in Arizona, in May. Photograph: Mark Ralston/AFP/Getty Images

Jonathan Nez, the president of the Navajo Nation, which has seen one of the worst coronavirus outbreaks in the US, announced new weekend lockdowns on Tuesday, citing concerns about troubling numbers in Arizona.

The Navajo Nation, unlike the state of Arizona, has already required residents to wear masks.

“I truly believe wearing masks helps slow down the spread of Covid-19,” Nez told a local news outlet. “And in the state of Arizona there’s no public health order that mandates citizens to wear masks, and maybe that is a factor in this real big spike.”

The Associated Press contributed to this report



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