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On a calm day in one of Minnesota’s busiest emergency rooms, Dr. John Hick stands next to a ventilator.

“During COVID, these things were getting an absolute workout because we had a lot of people in the emergency department on them,” Hick said. “We never ran out of such critical devices. I cringe thinking of potential future epidemics where that becomes an issue.”

In March 2020, while working at HCMC in Minneapolis, Hick, an emergency physician and medical director for emergency preparedness, began hearing reports of increasing COVID-19 cases in the Pacific Northwest, particularly in skilled nursing facilities. He realized it was only a matter of time before the virus reached his own hospital.

The emerging risk from exposure to COVID-19 led governors across the country to declare states of emergency. Gov. Tim Walz 

. Days later, he ordered schools, restaurants and bars to close.

At the same time, hospitals began to fill up with severely ill patients, many of whom were struggling to breathe.

When patients began arriving at HCMC, health care providers were ready. Hick said they also felt nervous due to the unpredictability surrounding a potential surge in cases.

“This was a disease that we did not have a lot of experience with. We did not have a vaccine for it or any antivirals at the time,” he said.

Hick led the state’s health care response alongside the health department and the Minnesota Hospital Association during the first several months of the pandemic.

There are inherent risks associated with practicing medicine in an emergency department, such as exposure to infectious diseases and injury caused by patients. But Hick said the pandemic intensified everything.

He added that it was difficult at times to transfer critically ill patients to available medical facilities quickly, distressing health care providers, especially in greater Minnesota.

Small hospitals across the state were overwhelmed with patients. To address this issue, health officials formed the 

statewide Medical Operations Coordination Center

, a bridge between private and public health care and state emergency management agencies.

“I see that as a big win, but it was a full-on effort, and I think we can do better in the future with that too,” Hick said.

Even with increased cooperation, the entire statewide health care system in the pandemic’s early years came under unprecedented strain. Many patients were intubated, which is a serious and invasive medical procedure involving the insertion of a tube into the trachea through the mouth or nose to maintain an open airway. The staff at HCMC were unsure about when, or if, these patients would be able to breathe independently again.

“We were taking care of patients who were needing to be on ventilators and were challenged with some pretty significant volumes of COVID patients,” Hick said. “I felt like I was just walking from one cube into the next with identical patients.”

took a toll on the mental and physical well-being of health care workers

increased levels of stress, anxiety, fatigue, and grief

 from constant exposure to patient deaths and the demands of the job.

A 2021 survey conducted by the Minnesota Department of Health explored how health care providers were affected by COVID-19. Many considered leaving their careers due to stressors associated with providing care during the pandemic. 

 that “respiratory therapists were four times more likely to say they were leaving due to burnout or dissatisfaction in 2021 compared to 2019.” Physician assistants and registered nurses said they were three times as likely to leave their careers within five years for the same reasons.

Although Hick was accustomed to witnessing and treating trauma, this experience was exceptionally difficult. Family members and friends outside of the medical field did not grasp what he was dealing with at work.

Hennepin Healthcare provided peer support and encouraged people to take care of themselves, Hick said.

“I would get home from the Emergency Operations Center, usually after dark,” he said, his voice breaking. “But I would make it a point to go down to the lake and look across Bde Maka Ska, see the lights reflecting and just take a few minutes to know it’s going to be okay.”

Hick is not the same person he was before the pandemic and is more aware of his vulnerability and mortality. However, he is not abandoning emergency medicine. Instead, he feels motivated to continue making health care safer for both the providers and the patients he serves.

“There is a lot of things that we became aware of post-pandemic about the fragility of ourselves and of our health care system,” Hick said. “But I think we also learned a lot about our resilience.”

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Dr. John Hick saw Minnesota’s busiest emergency department fill with patients, many struggled to breathe. Five years later, health care is still dealing with the pandemic’s aftermath.

Dr. John Hick saw Minnesota’s busiest emergency department fill with patients, many struggled to breathe. Five years later, health care is still dealing with the pandemic’s aftermath.

‘Identical patients’: A Minneapolis ER doc remembers the COVID-19 surge

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