A Wisconsin medical examiner fought to prepare her county for the virus. Then it struck.

The pandemic was a faraway nightmare — a catastrophe on the coasts — when Patty Schachtner, the medical examiner in St. Croix County, Wisconsin, began preparing.

In March, she counted up all of her county's hospitals, ventilators and nursing homes, including the one where her beloved 88-year-old father lived. If the coronavirus reached this mostly rural place on Wisconsin's western edge, full of dairy farms and snowmobile trails, would residents be ready? She had spent 31 years working in public health — the last nine as the county's chief medical examiner — but she could not be sure. So she kept going.

She delivered masks to funeral homes, hoping they would help protect the staff from the virus and slow its spread. She installed showers in an unused warehouse for sheriff's deputies and other front-line workers who might need to clean off before heading home to their families.

And in the grim chance that the virus did come and that there were more deaths than the county could handle, she dropped off body bags at nursing homes. Part of the warehouse was turned into a morgue.

Even this might not be enough, she knew — not with a team of five death investigators to cover a county of more than 700 square miles. So she did what few other medical examiners were doing and rented a refrigerated truck to store even more bodies.

"I pray that I never have to use it," Schachtner, who also is a state senator, said in March. "But this COVID can get out of control really quick."

To some people, the preparations might have seemed like a bit much, especially in a county that had seen five virus cases by the end of March. But to Schachtner, it was her job as medical examiner to worry about worst-case scenarios, to take care of the unpleasant, pragmatic details that other people would rather not think about or see.

Schachtner, a motorcycle enthusiast who canceled a trip to Sturgis, South Dakota, this summer because of the pandemic, is unfussy, practical and plain-spoken. She is also a hugger, a grandmother and a careful thinker about respect, death and its attendant rituals. Once she gave a TEDx Talk on the subject.

And all summer long, the coronavirus barely rose above a trickle in St. Croix County. Then came fall.

Now dozens of her neighbors in St. Croix County are contracting the virus each day. The local health department has abandoned efforts to contain the spread with contact tracing, saying it is too busy simply notifying all the people who test positive. The nightmare scenario unfolded not just for the county, but for Schachtner. In October, her sister-in-law got it — then, in quick succession, her brother-in-law and her sister.

And then, two weeks ago, her father.

'No end in sight'

The outbreak in Wisconsin spiraled beyond control weeks ago, with rates of new cases that are consistently among the country's worst. Tests are often scarce, the governor has begged people to stay home, and all but one of Wisconsin's 72 counties faced "critically high" case activity Thursday, the state's highest level of concern.

Week after week, the state shatters records for cases, hospitalizations and deaths, said Dr. Ben Weston, director of medical services for the Milwaukee County Office of Emergency Management. Desperate pleas from officials, even as the United States surpassed 250,000 deaths from the virus, do little to stop the spread.

"Wisconsin is in a tough place right now," Weston said. "Despite much talk, we are not turning the corner, nor are we flattening the curve. In fact, our curve is steepening, with no end in sight."

Schachtner, whose family has lived, farmed, camped and hunted in St. Croix County for generations, has seen public health from more than one angle. She was a longtime emergency medical technician, a job that sent her out on an ambulance and racing urgently into people's most difficult moments. When she began as a death investigator in 2003, she was struck by parallels in the work.

"When the bad stuff happens, people are going to expect you to have all the answers," she said. "You have to be prepared for that. Collectively, they're all saying, 'What didn't you do for my person?' You try to make sure you have done everything."

When the pandemic took hold in the United States in March, Schachtner already had a wide network of connections in public health — people who were thinking the same thing she was: What can we do to protect the community?

But in St. Croix County, a mostly conservative area that President Donald Trump won decisively in 2016 and 2020, Schachtner endured some criticism about the refrigerated truck, which mostly stood empty. Schachtner's role as appointed medical examiner is nonpartisan, but she won her seat in the state Senate as a Democrat in a low-turnout special election in 2018. "Oh, I got it from both sides," she said of the refrigerated truck. "I mean, some people thought it was overreacting, and other people were very grateful."

There was public resistance to masks, social distancing and a stay-at-home order from Gov. Tony Evers, a Democrat, from the beginning.

Ann Hall, who owns a bistro in New Richmond, Wisconsin, closed the dining room of her restaurant early in the pandemic. She still serves takeout through a drive-up window but has yet to reopen inside service.

Her regular customers are respectful. But others saunter inside without masks, she said, despite the three signs warning that they are required. And she has heard complaints about her decision to keep the dining room closed.

"They believe it's within their rights to force me to be open," she said. "It's been astonishing. It puts me between a rock and a hard place."

Paulette Anderson of Hammond, Wisconsin, a member of the St. Croix County board of supervisors, said that tensions over the pandemic response have been mounting in the county, especially in recent months. This week, the board considered an ordinance that would have tightened restrictions on businesses and made masks mandatory in indoor public places. It was rejected, 9 votes to 10.

"It's really become divisive," Anderson said. "I believe in mask-wearing and social distancing. I believe that you shouldn't go into a business without masks. But lots of people don't feel that way, and those folks don't want to be told what to do."

A surge at home

As more people in St. Croix County became sick from the coronavirus this fall, Schachtner was struggling with the demands on her staff. The five death investigators now work 12-hour shifts four days a week and spend 36 hours a week on backup. One staff member had to quarantine because of a spouse who was sick with the coronavirus.

Her own state Senate reelection bid was coming up in November, but Schachtner did not hold campaign events or knock on doors, worried that it was not a safe practice; her Republican opponent won easily.

Last week, Schachtner sent a memo to local funeral homes, some of which were at capacity, telling them they could use the refrigerated truck for their dead. The number of infections and virus deaths in the county was rapidly turning bleak.

"It was like a snowball," she said. "Just all of a sudden, the reality of what everyone said was going to happen was happening. And I feel like it was almost like people were like, 'I never thought this was going to happen, and this is actually happening.' "

Then the virus reached her own family.

Schachtner's sister-in-law, about to have surgery, took a routine coronavirus test that came back positive. In the following weeks, more family followed: a brother-in-law, a sister and a niece who was an aide in the nursing home where her father, Richard Rivard, lived.

Two weeks ago, her father tested positive. "It was really our biggest fear," she said.

In his final days, the family showed up outside his window, as they have faithfully done throughout the pandemic. Their mother, in a mask and gloves, was allowed inside to say goodbye to her husband, an Air Force veteran, farmer and outdoorsman who had Alzheimer's disease at the end of his life but never forgot the faces of his family.

Last Saturday, the morning he died, Schachtner huddled with her siblings in the cold, peering at their father one last time through the glass. "He was not supposed to die from COVID," she said. "He was supposed to die from something else."

"COVID robbed us of time with our dad, and with my mom, her husband," she said. "There's so many families that are going through the same thing we are. And it's hard now. It's hard not to be angry."