On Wednesday, March 18, three days before Minnesota’s first COVID-19 death, Rick Huggins’ throat began to feel sore.
“I don’t feel good,” the 51-year-old Eden Prairie man told his wife, Patti.
They were in Youngstown, Ohio, the hometown they’d left barely a year before to move to Minnesota for Rick’s job. They saw the crescendo of headlines about a pandemic spreading in the U.S., so they decided to return to Minnesota early and not put Patti’s elderly parents at risk.
They spent that night on an air mattress in their daughter’s living room and awoke at 3 a.m. to make the 15-hour trek back to Minnesota. They figured that Rick, a cycling aficionado in prime health, was fine, and that they were being overly cautious. As they drove through Chicago at morning rush hour, the feeling was creepy. The highways were empty as the nation hesitantly entered a lockdown. Rick felt tired.
At that moment, he had no idea how these mundane little signs — empty highways, a sore throat, a nagging cough — would be harbingers of lives disrupted and cut short in the coming months around Minnesota, the nation and the globe.
In Wayzata, a longtime funeral home director would go from wondering whether reports of this global pandemic were exaggerations to being overwhelmed with dozens of COVID-19 deaths.
In south Minneapolis, a new mother’s joy would give way to fear for her infant’s life and anxiety about the world she would grow up in.
At a hospital in St. Paul, a young nurse, buoyed by professional duty, would volunteer to work at one of the nation’s first hospitals dedicated to patients with the worst cases of this new and terrifying disease.
On Minneapolis’ Eat Street, the tireless owner of a landmark Chinese restaurant would be forced to close her dining room, worried whether the family business could survive. Then, months into this pandemic, a new and more immediate tragedy would come to her door.
And a block from the State Capitol in St. Paul, Minnesota’s health commissioner would set aside her grief from a deeply personal loss. Perhaps the worst global pandemic in a century was looming on the horizon, and she had work to do.
Lives, on the line
It was a bitterly cold morning on Tuesday, Jan. 21, when Jan Malcolm returned to her fifth-floor office in the Freeman Building after a few weeks of leave. Post-it notes and files were scattered in an organized chaos that only Malcolm had the key to unlock. Determined to compartmentalize her own grief, she logged onto the computer at her standing desk, only three weeks into what had already been a long and painful new year.
For Minnesota’s health commissioner, 2020 was supposed to be a time to enjoy life. She was to turn 65 and, retired from her career in health care and government, would travel the world with her spouse, Kris Carlton. The two were soul mates: bred in the Twin Cities, savants of health care policy, lovers of nature who liked little more than to escape to their cabin in northwest Wisconsin and kayak around the lake.
But life had something else in store. The past year had been consumed with Carlton’s battle with pancreatic cancer. Malcolm had planned to retire at the end of Gov. Mark Dayton’s term, but when it became clear that the cancer would stop those travel plans, she committed to one more year leading the Department of Public Health under the new governor, Tim Walz. That’s what Carlton wanted her to do: keep working.
On Jan. 4, 2020, Carlton passed away with Malcolm at her side. Five days later, a 61-year-old man died in Wuhan, China, the first reported death from a mysterious, yet-to-be-named pneumonialike illness. When Malcolm returned to the office days after laying her spouse to rest, she and her colleagues pulled out their pandemic preparedness plans: a big white binder where you fill in specific details when a new pandemic emerges.
By the end of her first week back, Malcolm did her first news briefing on the coronavirus. She said the state had no confirmed infections, and there was a “health alert” issued for Minnesotans who’d recently traveled to Wuhan and showed respiratory symptoms, but she said Minnesotans were currently at “low immediate health risk.”
At this point, public health officials still hoped to keep the virus out of Minnesota.
The virus had other plans.
It had been 30 years since Mark Arnold had graduated from the University of Minnesota Medical School’s mortuary science program, and he thought he could handle whatever came his way.
The first family he made funeral arrangements for was a suicide; somehow, he held his emotions together. He has transported thousands of bodies to the funeral home or the crematory, and even the most horrific deaths had become second nature: gunshot wounds, car accidents, decomposed bodies. That was the job, and he was good at it.
And not just the mechanical part of the job. The part he cherished most about being a funeral director at the family-owned David Lee Funeral Home in Wayzata was shepherding people through their most difficult times. When he does his job well, a family’s pain is a little bit less.
Arnold is 57 years old, a thin and athletic father of three who loves to disappear for long, ruminative hikes on Minnesota’s North Shore. As he watched news reports in February of this deepening pandemic, he wondered whether he’d seen all this before. There was global panic about SARS in 2002 and 2003, but in the end, there were fewer than 800 known deaths — none in the U.S.
When Italy locked down towns in late February, though, Arnold realized this was bigger than SARS. But how much bigger? When the virus reached Minnesota in March, and when Walz declared a peacetime emergency and ordered all schools, bars and restaurants closed, Arnold again wondered: Are we overreacting? At that point, Minnesota hadn’t even had a single death from this virus.
So he texted a funeral director friend in Venice, Italy: Is this mysterious virus really as bad as it seems on the news?
Her reply jarred him.
“In Italy we have done a big error when the virus arrived: we underestimated it,” she replied. “But listen to me, really: stay at home. This is not like ‘a simple flu,’ absolutely. Don’t wait for the situation to get worse to take precautions.”
All of Italy was quarantined. Traditional funerals were outlawed. The father of Arnold’s Italian friend was infected and fighting for his life.
Alarmed, Arnold prepared for when, not if, he’d handle his first virus death. He put together a COVID-19 kit — an N95 respirator mask, a face shield, gloves, a full-length gown — and secured it in the hearse.
Less than two weeks later, Arnold’s phone buzzed. Even though he was expecting it, the text message still made his heart jump into his throat.
Lena Gardner had spent winter in new-mother bliss.
She named her daughter Winifred, which means “blessed joy and reconciliation.” Winnie was born on Thanksgiving. It had been an excruciating labor of three days and two nights, and that had been after three years of fertility treatment and swirling emotions. Gardner was a single mom by choice. The 37-year-old’s biological clock was ticking, so she looked at her eclectic circle of friends — from First Universalist Church of Minneapolis, from her time as a guide in the Boundary Waters, from her decade as a rugby player, from the Black Lives Matter movement she’d helped start in the Twin Cities — and decided she could do this on her own.
During her third trimester, she had nightmares her baby would be stillborn. When Winnie came out with her umbilical cord wrapped around her neck, Gardner was amazed: “You’re alive? You’re breathing?” Winnie was. Gardner burst into tears.
As the frigid Minnesota winter passed, Gardner and Winnie mostly stayed home. Gardner made spreadsheets to schedule friends to help, and she made sure everyone washed hands around the baby. She was sleepless but blessed: Her job as the executive director of Black Lives of Unitarian Universalism granted her a year of maternity leave. It felt like Gardner had been born anew. Life made sense.
Then the pandemic hit. And her world collapsed.
As the virus spread in China and Europe, she stocked up on canned beans and dry goods. She had a will and trust drawn up just in case. But when the nation locked down in March, the support network that she’d so intentionally built crumbled. One good friend told her she couldn’t risk seeing Gardner anymore for health reasons. For weeks, it was mother and baby, isolated, staring at each other in their second-floor apartment on Powderhorn Park. She fell into a depression. She drew strength from quotes by a favorite author, Octavia Butler, pasted on her wall: “God is change.” “Love quiets fear.” “Kindness eases change.”
In a new mom’s world, danger appears at every turn. In Winnie’s first weeks, Gardner put her hand on her sleeping baby’s chest to feel it rise and fall, ensuring she was breathing. This invisible virus introduced even more fear.
“It was like, ‘Oh my God — I actually can’t keep you safe from this,’ ” Gardner said. “There was a certain element of surrender. Of course I’m going to do everything in my power to minimize our exposure and our risk. And then at the end of the day, I have to surrender to the fact that I cannot keep you safe from this. It’s humbling, and it’s heartbreaking.”
In the weeks of isolation, Winnie’s nursing struggles became more pronounced. Winnie wasn’t latching properly and started losing weight. A lactation consultant diagnosed the problem: Winnie needed tongue- and lip-tie surgery.
But nonemergency procedures were canceled. Gardner called four pediatric dentists until one agreed to do the surgery.
In a parking lot, Gardner handed off her baby. The nurse took Winnie inside. Gardner paced. When a nurse brought Winnie back out, her mouth was scarred from where lasers separated her skin. She screamed like Gardner had never heard before.
Rick Huggins was sitting in the passenger seat while Patti drove through the eerie, empty Chicago rush hour. He snapped a picture. Zero traffic in Chicago on a weekday morning. How strange.
Surely this tickle in his throat wasn’t this terrifying virus. Rick is tall and wiry with a salt-and-pepper beard. Some years he has logged more than 5,000 miles on his bicycle. Maybe this was bronchitis, or allergies he gets when seasons change.
On Friday, Rick worked a half day. That’s when the fever started. Patti made him sleep in a separate room. On Saturday, his fever spiked to 105, but Patti didn’t take him to a hospital; she heard this virus had overrun hospitals, and she thought they would get turned away. On Monday, Patti took a shivering Rick to a clinic. The doctor sent him home with a steroid. For days, his fever didn’t break: coughing fits, handfuls of Tylenol that brought down his fever for only an hour at a time, ice packs on his groin and neck, uncontrollable shaking when hot spells shifted to chills.
“I’m doing better,” Rick lied to his wife.
“I’m taking you to the hospital,” she told him on Thursday, March 26, his fever still boiling.
She took him to M Health Fairview Southdale Hospital in Edina. He tested positive for COVID-19.
From his hospital bed, Rick texted his wife of nearly 30 years. He was being intubated — a tube inserted down his throat to help him breathe — and couldn’t talk for a few days. “Stay safe. I love you,” he texted.
“And that’s the last I heard from him,” Patti said.
An ambulance took him to M Health Fairview Bethesda Hospital in St. Paul. Rick was the second patient admitted since it had opened that day as one of the nation’s first hospitals dedicated solely to COVID-19 patients.
For more than a month, Rick lived in a fuzzy seam between life and death. Patti would call the hospital multiple times a day, holding onto any bit of good news that doctors or nurses could give.
The news was never good.
When Patrick Stith was in college at UW-Madison, he watched “Contagion” in the theater. It was terrifying: A virus spread through respiratory droplets turned into a global pandemic, and social order broke down.
That’s what he was thinking about when he drove to Bethesda Hospital for his first shift. He always knew that as a health care worker, he might be in the midst of a global health calamity, but he never imagined it would happen less than two years after becoming a registered nurse and two days before his 29th birthday. “This is it,” he told himself as he walked in.
“It is crazy how fast they converted the hospital,” Stith wrote in his journal. “I only volunteered yesterday and they immediately called me at 8:00 am.”
Journalism that matters.
Stith’s decision to work with COVID-19 patients was not a hard one. His mother has been a nurse for decades. As a teen Patrick volunteered at St. Joseph’s and Bethesda, and he continued volunteering at hospitals while getting his biochemistry degree in Madison.
Stith believes nursing is about relationships. When a patient has been in the ICU for weeks, Patrick will wash their greasy, matted hair. He wants to know them as human beings, not just patients. He imagines himself in their shoes: What if that were his husband, Tommy, connected to oxygen tubes?
He was young and healthy. He was scared of the suffering he would witness and of this new virus potentially infecting him and his family. But this was his duty.
“I am very concerned with what is yet to come,” Stith wrote after his first shift. These cases were unlike anything he’d seen before: “These patients,” he wrote, “are sick when they’re sick.”
Public health is marked by uncertainty. Even when experts are right, it may not seem like it, because it’s almost impossible to prove how many deaths were prevented by draconian-seeming measures such as pausing an entire economy.
But even given that uncertainty, Malcolm became almost in awe of this ever-evolving situation: how quickly this virus invaded a person’s body and how quickly it spread in a population. Sometimes the virus was detectable; sometimes infected people were completely asymptomatic, stealth spreaders of a deadly disease.
She also knew that such an impossible-to-manage global pandemic was the ultimate raison d’être for the field of public health, which has mesmerized her for more than four decades.
Malcolm grew up in Bloomington and Minnetonka, her dad a high school football coach and her mother a model. Her younger sister modeled, too. Malcolm’s path was propelled by something quite different.
The first tumor was discovered in her leg when she was eight. It was benign. Five years later, at 13, the tumor returned. This time it was malignant: fibrosarcoma. Doctors again sliced it out. The scars from the surgery were both physical and mental: “You’ll never be Miss America,” the surgeon told her, “but you still have your leg.” Later, when she worked as a lifeguard, kids asked about the scar. “A bear bit me,” she told them.
Malcolm wanted to be a doctor. Plenty of people in the 1960s and 1970s corrected her: “Oh, you mean a nurse?” No, she meant a primary-care doctor. When she studied premed at Dartmouth, she became fascinated with health policy and biomedical ethics. Instead of medical school, she focused on making the whole system work better.
As the coronavirus spread worldwide in February, Malcolm reassured legislative leaders that the system is set up to manage outbreaks. At first, she hoped this could be contained like the H1N1 “swine flu” pandemic, the department’s most recent large-scale public health event. It lasted 1½ years in 2009 and 2010 and is estimated to have killed more than a quarter million worldwide, but only 61 in Minnesota.
By late February, Malcolm conceded that keeping the virus out of Minnesota was unlikely. In news briefings, she and other state health officials sounded like overprotective parents: Stock up on supplies, wash your hands, cover your cough, stay home if you’re sick. In early March, Malcolm announced the state was able to screen for the disease locally. That meant a more rapid response to positive tests. But at that point, the state only had 400 testing kits.
After she’d returned to the office, her days blended together. Tension, worry and fear slowly built. In early March, Vice President Mike Pence visited 3M, maker of now-vital N95 respirator masks, and she gave him an elbow bump instead of shaking his hand. The next day brought Minnesota’s first case. “This is cause for concern but not panic,” she told the media, the governor standing behind her. “It’s certainly not unexpected.” She emphasized that while most Minnesotans were at low risk, it was our responsibility to protect those at high risk.
If she had to pinpoint one moment where this turned from an urgent but recognizable public health emergency into a once-in-a-lifetime pandemic — the moment she realized this time the sky actually might be falling — it was Thursday, March 19, the same day Rick and Patti Huggins were driving back from Ohio. At that point, Minnesota had fewer than 300 confirmed cases. Minnesota’s first death would not come for two more days. Fewer than 200 had died nationwide.
That day, President Donald Trump spoke at the daily briefing of the coronavirus task force.
“The federal government is not supposed to be out there buying vast amounts of items and then shipping,” Trump told reporters. “We’re not a shipping clerk.”
The message she heard: You’re on your own.
What went through Malcolm’s mind was this: “How absurd that was from a public health perspective, to think you can have anything close to a realistic and successful strategy between all 50 states. That’s what flipped my mind. We could walk this clever Minnesota line as a state. And it wouldn’t matter from the standpoint of what would really happen with the disease, because of the interdependence of the whole world.”
At Rainbow Restaurant, the landmark Minneapolis Chinese restaurant on Nicollet Avenue, Tammy Wong is perpetually in motion: Greeting customers, pouring drinks, disappearing into the kitchen, feeding the koi in the fish tank.
By late March, the health calamity had become an economic one, too. The governor’s “stay at home” order shut down thousands of businesses. State and national unemployment rates began skyrocketing to levels not seen since the Great Depression.
Wong, who has operated her restaurant for 33 years, had little choice but to let go of two-thirds of her staff, going from about 30 employees to fewer than 10. Right away, she started doing curbside service. Meat shortages meant ingredient prices increased, but she ate that cost. She drove around in her old Saab, personally delivering meals to customers.
COVID cripples job security
Economic ramifications from the pandemic have been deep in Minnesota, including a loss of more than 350,000 jobs in April.
Each week, she heard of more restaurants permanently closing. But Wong needed her restaurant to survive.
“It’s my life — it’s our life,” Wong said. “We’ve been doing this for so long, it’s more like a home for so many people.”
She was still a teenager in Cholon, the Chinese neighborhood of Saigon, as the Vietnam War was ending. Her childhood was colored by chaotic scenes of war on her television; it felt like it was happening far away, even though it wasn’t. She remembers her roof littered with bullet casings as Communists took over in 1975.
Her family came to the U.S. as refugees in 1979, first to New York City’s Chinatown, where Wong took English classes and sewed garments. They moved to California, and then, in 1983, to Minneapolis. Her family opened the restaurant; Wong was the oldest daughter of the nine kids, cooking all her life, so she was put in charge.
The restaurant flourished as an early entrant on Eat Street, Minneapolis’ ethnic restaurant corridor filled with Asian businesses. She bought a house nearby. She sold egg rolls at the Minneapolis Farmer Market. She tended to two plots at a community garden.
This place was home, and this restaurant, where her sons grew from toddlers into men, was her American dream.
It also helped carry her through her lowest moments. Five years ago, Wong’s son Euyon died by suicide. At first, she couldn’t leave home. But a restaurant had to be run.
“I had to go up and get to work,” Wong said. “This restaurant saved my life.”
“Gloria Hays just died.”
The text message popped into funeral director Mark Arnold’s phone as he left for work on Thursday, March 26. It stopped him in his tracks.
Here it was, Minnesota’s second COVID-19 death and now, his responsibility.
Gloria was 89, a mother of four with seven grandchildren and six great-grandchildren. Arnold knew she had COVID-19. The family had previously arranged for Arnold to handle her services. Arnold knew this time would come inevitably, but when it did, he still didn’t feel quite prepared.
He drove the hearse to Parks’ Place Memory Care in Plymouth. Standing in the parking lot, he put the protective equipment over his suit — something he’d never done in three decades as a funeral director — and walked inside.
“I’m going to wait out here,” a nurse said when they arrived at Gloria’s room.
Arnold’s heart raced. He imagined this invisible virus everywhere: On the walls, in the bedding, in the air. Gloria lay face up, arms crossed, her face anguished. He could tell it wasn’t a peaceful death. As he slid her body onto a cot, he whispered to her: “I’m so sorry you had to go through this alone.”
Outside, wheeling the cot to the hearse, Arnold noticed a woman watching him.
“Are you her daughter?” She was. “This must be hard, since you can’t be with your mom.”
She took a step back, fearful of virus exposure. Arnold wished he could offer solace, or at least a chance for the woman to touch her mom.
“Why don’t you follow me behind the hearse,” he told her, “this nice, honorable procession from care facility to funeral home?”
Relief washed over her. It was a two-vehicle, 4-mile funeral procession, the only dignified ritual Arnold could offer.
From the journal of Patrick Stith during his first five weeks at Bethesda:
Stith’s fourth shift as a COVID-19 nurse: “Watching the 5:30 pm national news was horrifying. 500 a day are dying in New York and they are reportedly only days away from capacity. I’m glad it isn’t that bad here, yet I have no idea what’s to come … When I got to work a woman … had passed … This marks the second death on the unit so far.”
His sixth shift: “Today I was watching the CBS local news and they had a story about a Minnesota man who passed away from COVID-19 … Instantly, a wave of emotion came over me and I started crying. I had not expected to see the stories of patients I had taken care of on the local news.”
His 12th shift: “(My patient) really isn’t getting better at all … I fear that after 3 weeks he is not going to make it. Overall, many of the patients aren’t doing well. We have reached the point when we start to have discussions about comfort measures (with family) after no improvement.”
His 13th shift: “There are over 38,000 deaths in the US now as the death rate continues to soar. One bit of good news is that it looks like NYC is coming down from their peak — but there are still over 500 deaths a day there. Yesterday, 800 people protested outside the governor’s mansion demanding immediate reopening. Things in Minnesota are still quite good with only 120 total deaths, but I’m concerned it is still too soon to reopen.”
His 14th shift: “It was a very emotional night in many ways … A (man) … needed to be intubated. I can’t get the image out of my mind of him … crying asking me to keep his Bible close when we intubate and sedate him. All I was left to do was take his hand and promise him I’d take care of him.”
His 18th shift: “When I arrived on the unit some of the nurses were opening a package that came in the mail. It was filled with pictures drawn by a bunch of daycare kids for all of us at Bethesda … I was almost brought to tears. The messages of thanks were just what I needed and so heartfelt. One 4-year-old boy thanked us for our care saying, ‘My mom gets to see doctors a lot because of her cancer and it makes me happy you can help her to feel better even though it makes her sick.’ The way people trust us humbles me every day.”
His 20th shift: “We still haven’t opened our third ICU, but our patients are all dying too fast for us to increase numbers in our ICU. At least it seems that way. It’s encouraging that there is still no surge in Minnesota.”
That day, the U.S. surpassed 1 million coronavirus cases, with more than 58,000 dead.
“Can I come get my mom?”
The voice on Mark Arnold’s phone was of Ava McKnight, one of Gloria Hays’ four daughters. He was relieved to hear her words. He could sense the family’s frustration at this arrested stage of grief.
It was April 7, less than two weeks after her mother’s death and only two days after McKnight — herself diagnosed with COVID-19 — was released from quarantine. She pulled her Honda CR-V into the parking lot and opened the trunk. McKnight motioned to a simple wooden box where her mother used to store playing cards: her urn.
Arnold took the urn into the funeral home. He placed Hays’ ashes inside, then placed the box in a velvet bag. He delicately laid it in the trunk.
McKnight drove to her sister’s office and showed her the urn. Together, they cried. The family did not know when they could have a memorial service.
In the days after Winnie’s surgery, her mother reached into her wounds three times a day, moving the tissue so it didn’t reattach. Gardner watched YouTube videos to make sure she did it right. The surgery worked. Winnie gained weight.
But soon, Winnie’s temperature spiked to 103.7. Gardner panicked. Was this normal, just a baby teething? Or could this four-month-old have the virus? Gardner’s parents had passed away years before, so she didn’t have them to call on for advice. She was alone with her baby, and scared.
She gave Winnie Tylenol and waited to see whether her fever would break.
All 40 ICU beds at Bethesda quickly filled with COVID-19 patients. The nearby St. Joseph’s Hospital — built in 1853 to respond to a cholera outbreak — would soon open for COVID-19 patients. Every day, Patrick Stith watched the news in horror. The first week in April saw nearly 10,000 COVID-19 deaths nationally. The next week saw more than 15,000.
Being surrounded by death was taking a toll. Stith was eating poorly. After another 60-hour workweek, Stith felt as tired as he’d ever felt. He’d end a night shift, sleep until 5 p.m., eat something, mindlessly watch television, and then sleep again from 8 p.m. until 6 a.m. He spent many nights at a hotel for COVID-19 health care workers. Being away from his husband while witnessing so much pain was isolating. For the first time in his life, Stith wondered whether he might be clinically depressed.
Some moments stayed seared in his mind: When a young woman tore out her own breathing tube. When a patient’s ICU delirium caused him to think he was being held prisoner in a foreign country. When families had multiple family members hospitalized with COVID-19 — including a patient who came out of sedation to learn their spouse had passed away.
As the pandemic wore on, it could have become easy to look at his patients as unanimated bodies, paralyzed and connected to machines. No movement, no eye contact. The only sound was the ventilator. Stith would come armored in personal protective equipment. During nighttime lulls, he’d wash their hair. It felt like that brought some life back.
Amid indescribable sadness, though, came moments of humanity.
In late April, it became clear that one COVID-19 patient would soon die. Previously, she had requested to be surrounded by flowers when she passed.
But live flowers are not allowed in the ICU, since they pose an infection risk.
Bethesda nurses sprang into action. One took a framed painting of flowers from a hallway and brought it to the woman’s room. Others commandeered fake plants from offices. Another nurse cut paper flowers, and since Stith was the tallest, he tacked them to the ceiling, in the woman’s sight lines.
Stith joined the bedside nurse and respiratory therapist in the room, and the three of them held vigil together for almost an hour. It’s something they had done before, and something they would do again, never wanting someone to die alone. Origami flowers hung from the ceiling by paper clips. Stith tuned out monitors measuring her heart beat and blood pressure. He cleared his mind and just tried to be a presence for the family.
In the morning, the woman passed away.
During the first weeks of the shutdown, Tammy Wong’s mother, nearly 80 years old and in the early stages of Alzheimer’s, would come into Rainbow Restaurant, confused. Why is the dining room empty? she asked.
Wong had to do something to combat her mother’s isolation and confusion. So she loaded her mother into the old Saab with Minnesota license plates reading “EGGROLL.” Together, they made deliveries. They dropped orders to customers they’ve had for decades, to families who’ve celebrated birthdays at the restaurant, to new patrons they’d never met. The brown paper bags were filled with chicken fried rice or moo shu crêpes or jai mai fun.
For her mother, the drives soothed her in a disorienting time. For Wong, it was survival; business was half of what it was a year ago.
Still, Wong felt pulled to do more than just ensure her restaurant would stay afloat. She wanted to give back to this place that’s become home. So, after the restaurant closed for the evening, she would drive the half mile home and descend to her basement. She ordered fabric and elastic bands and fasteners. And she sat at her old sewing machine and made masks. She got efficient enough that each mask took only 10 minutes. It reminded her of four decades ago, new to the U.S. and sewing in a Chinatown sweatshop.
She washed and ironed the masks and gave them away. At first, she gave them to employees and family. Then friends and neighbors. Then longtime customers. She thought of each as a little note of thanks.
Patrick Stith went into work the evening of Tuesday, May 5, knowing the next day would be National Nurses Day. It normally passed with little notice, but this year felt special.
Around 5:30 a.m., a nurse down the hall in a medical-surgical unit stopped by. A patient Stith had cared for for more than a month — adjusting his ventilator, giving him medication, shaving his face around the tubes — was awake and alert. Stith had thought this man was going to die. Now, he was heading to a rehab center.
Stith and another nurse introduced themselves as ICU nurses. They had been bedside when he was near death. Stith apologized for the patchy shave job he’d given the man. He told him how nice it was to see his full face and smile.
The man had no idea who they were.
“Thank you for saving my life,” the man said. The man’s voice lacked the Minnesota accent Stith had imagined. Instead, he carried the nasal intonations of the Rust Belt. Stith shook the man’s hand and cried.
“Sometimes us in critical care know we are the forgotten ones by our patients,” he later wrote. “They will never remember the weeks I was bathing and shaving and turning them. But now I hope he will remember me (as that set of tearful hazel eyes behind the mask and shield and gown) as one of the ones who cared for him.”
That man was Rick Huggins.
His month in the ICU had passed like a long, hallucinatory dream. He had heard muffled voices, but he couldn’t make out words. He has one foggy memory of trying to communicate something to nurses — maybe that he had to go to the bathroom? — but he couldn’t get words out. Nurses handed him a whiteboard. He held the marker in the wrong hand and couldn’t write.
As her husband had teetered on the brink of death, Patti Huggins would only see him as a barely living face on her iPad, a sedated pile of ventilator tubes and hospital linens. Any small piece of data from doctors could be seen as a glimmer of hope: Improvements in his respiratory pressure, or in his oxygen numbers, or in his white blood cell count.
“We were running out of ways to tell her that he wasn’t any better or that he was getting worse,” Stith wrote in his journal. “I could feel her pain.”
Rick had nine blood transfusions. He had kidney dialysis three times. Nurses proned him, meaning they flipped him on his stomach to encourage breathing. His body went through a cytokine storm, where the immune system attacks itself. Patti was prescribed anxiety medication. She had an excruciating talk with their two children that their father may die.
But then, for whatever reason, things turned. Patti could hear it in nurses’ voices when she called at 6:30 a.m.: “He had a really good night last night!” Later, Rick and Patti would wonder at the capricious nature of life: Why such a healthy man could be brought to the brink of death, and why a man about to die could suddenly rise again.
Rick’s first memory was the doctor removing the breathing tube. He was groggy. But he was alive. He’d lost 35 pounds. He had to relearn how to walk. When doctors and nurses moved Rick from the ICU to an adjacent unit for less severe cases, they held a miniature parade for him; Rick FaceTimed Patti and held up his phone, but she could only see a flurry of fist bumps against the backdrop of a ceiling. The night before he was transferred to Fairview Acute Rehabilitation Center, he took his first proper shower in nearly two months. It felt like a dividing point: Rinsing away the past, starting his recovery.
On Friday, May 15, 50 days after she had dropped him off at the hospital, Patti and their daughter, Emily, waited outside the rehab center. A nurse wheeled him out. Patti rushed up to him, her first time seeing him in seven weeks. She clasped his hands; he cradled her face. He stood and embraced his wife and daughter. Behind Patti’s blue surgical mask, the tears made her makeup run.
The files piled up on Mark Arnold’s desk — a backlog of funerals that for now could not be had.
After transporting Gloria Hays’ body in late March, he hadn’t had another COVID-19 death for a couple of weeks. Cases were rising in Minnesota, and there were a handful of deaths a day, but this wasn’t the same calamity as New York City.
Then came late April, and a surge in COVID-19 deaths that he handled — 40% more deaths at the funeral home than a typical April. It continued into May. The number of COVID-19 deaths in Minnesota tripled that month, as did the number of cases. “We started getting death calls: ‘This is a COVID death, this is a COVID death, this is a COVID death,’ ” he said. By late May — as the national death toll crossed 100,000 — Minnesota deaths would spike: 32 on May 21, 33 on May 22, primed to pass 1,000 by the end of the month.
Arnold would wake up in the middle of the night, wondering when he’d see his parents again, wondering when he’d hold his grandkids again. He had recurring nightmares about junior high, the most awkward and anxiety-filled time of his life. Sometimes it felt like panic attacks, gasping for air. After a rough day at work, he’d have a couple more drinks than he’d usually have. By May 22, Arnold had handled 20 COVID-19 deaths. Over the next few weeks he’d have six more.
The worst part, though, wasn’t the sheer numbers. It was that he couldn’t help families. Whether their loved one had died from the virus or not, the funeral would not be what they had envisioned.
“I’ve done more soul-searching these last months than I’ve done my entire 30 years as a funeral director,” Arnold said. “A good funeral is a celebration about a story that everyone can hear. And these families can’t do that now. Everything with this pandemic is in a holding pattern. That’s frustrating for us. It’s where we find our value as morticians, helping families find positivity in death, helping them find hope during their grief.”
Working from home — a newly lonely place since her spouse’s death — was not good for Jan Malcolm’s mental health.
All spring, she got very little exercise, even with the waters of Bde Maka Ska a block away. Days no longer seemed to have endings; when she couldn’t send any more e-mails, she went to bed. Her sweet tooth led her to stress eating, especially doughnuts. She missed seeing people. Grief would come in five-minute bursts, then she’d get back to work.
She worried about outbreaks at Upper Midwest meatpacking plants, and she worried about Trump ordering them to quickly reopen. She worried about outbreaks at nursing homes, which would account for about three-quarters of Minnesota COVID-19 deaths by July; she learned how dangerous the asymptomatic transmission of this virus could be, and emphasized the importance of testing everyone in a congregate-care facility where even one case was detected. She worried whether testing could ramp up quickly enough.
She imagined Minnesota’s peak: Would the state be overwhelmed in early July with 5,000 hospitalized cases at the same time, or would the burn be slower, with 2,000 hospitalized cases weeks later?
Throughout May, as cases and deaths steadily grew in Minnesota, she worried about June 1, which she saw as the biggest step of Walz’s phased reopening of the state’s economy.
It felt like there were no good decisions that she or the governor could make — only less-bad decisions.
“It’s a lot of stress, an enormous amount of professional pressure and anxiety,” she said. “Because there’s too much uncertainty, and the data is imperfect, and the stakes too high. There’s terrible trade-offs to every decision. All these roaring debates of are we overreacting with all the stay-at-home orders and business closures and restrictions on social distancing — well, those are the best ways to slow down an epidemic. But they come at enormous costs to people’s jobs and quality of life. You can’t afford to keep everything locked down. Literally. And we know there are negative health consequences to an economic downturn.”
She was angry at the virus, angrier than she’d felt during any sustained period of her life. She frequently found herself wanting to hang up in the middle of video meetings. She tried to never let her frustration show.
“There’s no such thing as a perfect decision,” she said. “It feels maddeningly impossible. There’s no good way to balance those things that are at cross-purposes. We’ve been trying to make the point that the economic costs are horrific, but you can’t successfully reopen the economy without those public health protections.”
As she spoke from her living room, the lilacs out back were in full bloom. An entire season was passing her by.
And then, shortly before sunset on Memorial Day, a Minneapolis police officer killed George Floyd.
The pandemic had felt slow-moving and interminable, then Floyd’s killing hit the Twin Cities like a brick. The region erupted, a tragedy wrapped within a tragedy, each impossible to disentangle from the other. The pandemic made us bottle up everything — our anger, our sadness, our very sense of human connection — and Floyd’s killing lit that tinder box on fire.
Black Americans were watching their community die at disproportionately higher rates than whites. Underlying medical conditions that increase the risk of COVID-19 are among the most prevalent in the Black community.
As Floyd begged police not to kill him, he told them, “I just had COVID, I don’t want to go back to that.” Floyd’s death laid bare the systemic inequalities.
From the fifth-floor window of Bethesda Hospital, Patrick Stith saw a glowing horizon to the west: Fires burning 10 miles away in Minneapolis, soon to spread to St. Paul. As protests spread nationwide, Stith thought about inequality among his COVID-19 patients, disproportionately people of color. “This is not the only unfair disease,” he said. “This is just showing the world the kind of racial and economic disparities we see every day in medicine.” When Jan Malcolm saw the video of Floyd’s killing, she was outraged. The protests, she thought, were an understandable reaction not just to police violence but to weakened social cohesion as well as health inequities that have built up over centuries. She feared mass protests could act as superspreader events and undo the months of sacrifice to stem the spread of the virus. She felt silly asking people to wear masks and social distance during protests. But she did so anyway.
From her second-floor apartment off Powderhorn Park, Lena Gardner watched the uprising on Unicorn Riot. Normally, she’d be in the thick of it, but her role was to protect Winnie. She closed her windows, turned off her lights and lay low. As she thought of the nation’s worsening inequities, the uprising seemed to tap into the vulnerability and rage of being Black in America. Even though she didn’t agree with militance as a strategy, she understood it. “You can only push people so far,” she said, “before people feel like they have no other recourse.”
Plenty of reports showed these stark inequities. Data on nearly 1.5 million coronavirus cases in the U.S. revealed that among whites, there are 23 coronavirus cases per 10,000 people. Among Blacks, it increases to 62 cases per 10,000 people.
In Hennepin County, the racial and ethnic disparities are even more pronounced: 27 coronavirus cases per 10,000 white people, but 146 coronavirus cases per 10,000 Black people.
“Nobody needs a report to tell us that,” Gardner said.
On Thursday afternoon, May 28, Tammy Wong stood outside her restaurant on Eat Street. COVID-19 was no longer top of mind, even though this day saw Minnesota’s record-high daily report of virus deaths, 35. Friends nailed thick sheets of wood to the restaurant’s windows. Scenes of fires and violence and rage brought flashbacks to her childhood during the Vietnam War. She worried what that night could bring.
For the next few nights, Wong barely slept. She felt sick to her stomach when buildings on Lake Street, just two blocks from her restaurant, burned: The post office, the bank. Customers called and offered to stand guard at night.
Somehow, Wong’s restaurant escaped damage, as did most of Eat Street.
But now her worries stretched even further into the future, beyond whether people would ever feel safe eating in her intimate dining areas. Would customers venture to an area associated with one of the most fear-filled moments in recent Minnesota memory? Two weeks after Floyd’s death, a friend in Texas called Wong. “Is it actually safe to walk on the street?” the friend asked.
“For many years, people would feel intimidated and not come to this neighborhood: Lake Street, Chicago, Nicollet,” Wong said. “We turned a corner. People want to come now. When you see what happened that weekend, it makes me think, ‘Wow — will this turn another corner, back to what it used to be?’ ”
She believes in the righteousness of protesters’ goals. But even after she took the boards off her windows and reopened, she wondered what her future would hold. The pandemic would rage all summer, surpassing 1 million worldwide deaths in September. After Floyd’s killing, business slipped even more; 14 tickets one night, 20 tickets another. A typical summer night would be double that.
One night, an employee shouted out, “Miss Tammy! Delivery!” She scooped up bags of food and walked past a chalkboard advertising a special drink for Chinese New Year. “Year of the Rat,” the sign read. Chinese New Year was January 25. Life seemed paused in the past.
As she drove around her city, she contemplated her future. She saw nothing but a foggy uncertainty. She had no idea whether her restaurant would still exist a year from now, or what Eat Street would look like, or how her country would weather this pandemic.
Hours after the Third Precinct went up in flames, Gardner awoke to smoke pouring into her apartment.
It was 5 a.m., the Friday after Floyd’s death, and East Lake Street smoldered a few blocks away. When Gardner opened her bedroom door, she thought her apartment was on fire. It wasn’t; she had accidentally left a window cracked, and noxious smoke billowed in. Winnie, five months old, was coughing. Her April fever had been a false alarm — just a teething baby — but this was the real thing. They had to leave.
They packed a bag and drove to a friend’s house. That night, she heard about white supremacists stoking the violence. That made her scared. They went to another friend’s house in northeast Minneapolis the next night; that friend was armed. As the friend, who is white, patrolled the nighttime streets, Gardner and Winnie hid in the basement.
Gardner was torn. She had spent years as a Black Lives Matter leader. Part of her wanted to be out there marching. But a bigger part of her thought it was someone else’s turn.
The violence disturbed her. So many of the destroyed businesses were minority-owned; that only hurts the community. And she believes deeply in nonviolence to force change. She has long been convinced that the most effective way to bring structural change is through mass nonviolent protest. In her friend’s basement, though, she wondered whether it was time for a new strategy. After all, many racial disparities have increased since Martin Luther King enshrined nonviolence as a core belief of the civil rights movement.
When the protests calmed, Gardner and Winnie returned to their apartment a couple of weeks later. But the neighborhood had changed. Powderhorn Park, where she’d walked Winnie several times a day in spring, became a homeless encampment. She saw people shooting up drugs and leaving needles strewn about. People had sex in the alley. She and Winnie escaped in July to YMCA Camp Northern Lights near the Boundary Waters; they got a scholarship to go. But one afternoon after returning home, there was a carjacking outside her window. She posted on Facebook about bursting into tears while she drove around town trying to get Winnie to sleep. It was inspiring how many friends reached out to offer a place to live.
She moved into a friend’s basement near Longfellow Park. It was still near East Lake Street and barely a mile from the Third Precinct, but it felt safe. As Gardner’s chaotic summer turned to fall, the friend told her to stay as long as she wanted.
At his home in Eden Prairie, Rick Huggins is improving every day.
In the first month after his discharge, he’d put on 11 pounds. When he sleeps, Patti touches his chest to make sure he’s breathing, like a newborn. He and Patti started going on walks in parks; at first he felt like an old man, struggling to breathe and looking for a bench to rest. By June he could walk a couple miles on the trail at Purgatory Creek Park. In mid-June, he went on his first bike ride. He kept his heart rate below 144 beats per minute, and he only went 2½ miles, but it felt good. He kept building his stamina all summer. Just before Labor Day weekend, he went on a nearly 60-mile ride. The halfway point was Bethesda Hospital. Dozens of doctors and nurses gathered outside to greet him. The group included a masked Patrick Stith. Rick biked slower than he would have a year ago, and it took an hour for his heart rate to settle down after his hardest ride since getting sick. He was glad to be able to thank the health care workers for saving his life.
Rick is still flummoxed why he, someone in perfect health, with no pre-existing conditions, was hit so hard by the disease. His only answers seem lacking: That men get hit harder than women, and that his Type A blood put him at a greater risk of severe symptoms — an early report that was later refuted. Rick persuaded Patti to get the antibody test for COVID-19. She tested positive, meaning she too had had the virus. Patti cried, guilty she’d experienced no symptoms from the virus that nearly killed Rick.
When Rick was in the ICU, Patti took to calling him Turtle, for his slow but steady improvement. Friends sent Patti turtle memorabilia: stuffed animals, photographs, statues, necklaces. She put the turtle gear in their spare bedroom and hung a photograph of Rick cradling Patti’s face from the first time they saw each other after Rick got out of the rehab center.
He loves to go into the spare bedroom, stare at the photograph, and contemplate how lucky he is.
“It reminds me how close I was to losing everything — and then getting it back,” he said. “I owe my life to somebody. Why me? Why did I make it through and so many other people didn’t? The medical staff, they never gave up on me. I could have easily died. They had very low expectations. But they never gave up.”
At Bethesda Hospital in St. Paul, Patrick Stith continued to bear witness to the most painful suffering he can imagine, but in summer the numbers of patients and deaths dropped. Stith was heartened that so far Minnesota has avoided the worst of the pandemic.
He still worried what fall and winter could bring with a potential second surge, but he had to keep on living. He bought a new bicycle, and he pedaled across the Stone Arch Bridge with Tommy. They took their two dogs on long walks. They postponed their fall honeymoon to France. Instead, they’ll hike at national parks in North Dakota and Wyoming.
After four months as a COVID-19 nurse, Stith started a new job that had been on hold, as a critical care nurse between three ICUs at the University of Minnesota Medical Center. As he went into his final shift at Bethesda in mid-July, he felt strangely sentimental about his time there. He looked at cases increasing in other states — Texas, Florida, California — and assumed there’s a good chance he’ll be back. If there is virus surge in fall, he will do whatever he’s called upon to do. In the meantime, he is volunteering to do free flu shots and COVID-19 tests for underserved communities.
The experience has changed him: How he thinks about human suffering, and how he thinks about fate.
“People like to have all the answers,” he said. “This is a terrible disease, and it affects people so differently, in a way that makes no sense at all. It’s wiping out entire families, and at the same time people are going to bars asymptomatic. You have to be OK with not being in control. We live in such a magic-little-pill culture. We invest so much in the magic cure and fix, but it doesn’t work that way. People think we’re in control. But we’re completely not.”
At her Rainbow Restaurant on Eat Street, Tammy Wong still doesn’t know whether her business will survive. Her space is not amenable for outdoor dining, nor does she feel comfortable opening the dining room until there is a vaccine. Takeout and delivery remain her only options. It was her slowest summer ever, but she hopes business picks up in fall. She brainstormed ways to make her food cheaper, like having a more limited menu, or cooking up giant batches of curry, or doing box lunches of teriyaki chicken. She thinks the restaurant can survive as is through the end of the year, maybe longer. She will keep going, even if she is the only one left in the kitchen.
“It’s terrifying,” she said of the possibility of losing the restaurant. “We really have no idea. We’ll do whatever’s necessary to get through this. It’s a lot on my head, trying to figure out what to do so we can survive. Sleep? I can’t sleep. But it’s my responsibility that I need to stay healthy. I need to take care of myself so I can take care of the restaurant. I’m going to make sure I can stay on as long as I can.”
About a decade ago, a longtime customer passed away at age 100. Wong wanted to do something in his honor, so she planted a pear tree in her backyard. When her son died five years ago, Wong thought back to how as a boy he loved staring out the window at an apple tree. In her son’s honor, she planted two pine trees. She looks at them every day.
Earlier this year, just before a big rain, Wong dug two holes, one on each side of her restaurant, and planted two skinny redbud trees. She wanted to mark this crazy season of her life, and honor those who died of this unpredictable virus. Redbud trees are sensitive, and she doesn’t know whether they will survive their first Minnesota winter. She hopes to see their bright pink flowers bloom in spring.
In her south Minneapolis home, Jan Malcolm is weary. During spring and into summer, she frequently visited her mother in the Minnetonka house where she grew up. They’d sit in the backyard and listen to the birds. Sometimes they’d hear an owl. But as summer waned, her mother’s health deteriorated. Malcolm moved in with her. Hospice workers came. A COVID test came up negative, but she was declining quickly. In late September — the same week Minnesota new cases reached a record high, and shortly after her 90th birthday — Malcolm’s mother passed away.
“My year from hell continues,” Malcolm said this week. “Losing your mom is hard at any time, but it seems like it just magnifies all my other losses.”
For Malcolm, and for many of us, this year feels like it has lasted five years. If she could go back in time and send a message to her January self, she would tell herself that this new virus would not fall into the familiar patterns of past epidemics: “This is going to sound really weird, but I wish I had been a little more freaked out a little faster in hindsight. It wasn’t complacency. I just didn’t have my mind around it.”
And she’d warn herself about just how politicized this pandemic would become — not just with wearing masks but with something deeper, almost the politicization of public health as a field. “Things that one would hope would be viewed as common-sense ways to protect ourselves and each other have become this battle over what you believe and who you believe and why you believe it,” Malcolm said. “It’s just our inability to have a common set of facts. We may disagree on what to do, but if we don’t even agree that there’s a problem, it can be really difficult to deal with effectively. I wish I had been more prepared for understanding the context all this is happening under.”
From spring through fall, the state’s daily case count has been a roller coaster. The accelerating part of the COVID-19 curve in May had leveled out by June and into July before rising to a new high, passing 1,000 new daily cases for the first time on Sept. 3. The number of daily deaths didn’t reach the peaks of late spring — there’s only been 14 days since July 4 when Minnesota’s daily death count reached double digits — but the state total death count shot past 2,000 by the end of September as the nation surpassed 200,000 deaths. Then, just before midnight on Oct. 1, President Trump announced that he and the first lady had tested positive for the virus. The relentless 2020 continued.
Malcolm says annual flu shots have never been more important as this year, and she believes it vital to assure people of the safety, efficacy and importance of an eventual COVID vaccine.
Her biggest fear is people will act as if this battle is over. She believes plenty has contributed to fall’s surge in cases in Minnesota: Tired of public health measures, people have let their guard down and returned to a semblance of life as they knew it. Since spring, Malcolm has worried about a second wave in winter. This surge in cases just as the weather gets colder and people migrate indoors feels like a terrible combination.
“We had hoped that the respite we saw in the summer would last longer,” she said. “It’s not so much of a simmer anymore. It’s more of a medium boil now. We’re just trying to keep the pot from overflowing. People keep asking, ‘What inning do you think we’re in?’ And it’s very hard to answer that with any certainty. But we know we’re not nearly done with it.”
At the friend’s house near Longfellow Park, Lena Gardner and her daughter have made a cozy new home. Toys are strewn about. Winnie is 10 months old, a babbling bundle of joy who loves hard-boiled eggs and blueberries. She’s taking her first steps.
Gardner is rereading Martin Luther King Jr.’s book, “Where Do We Go From Here: Chaos or Community?” She has thought deeply about the intersection of the pandemic and the uprising, and how both illuminate structural problems in America. Both of her grandfathers were Black and Indigenous, and two generations ago, both of her white grandmothers’ families largely disowned them for marrying a Black man. One generation ago, her father’s childhood home in St. Paul’s historically Black Rondo neighborhood was demolished to build an interstate. Now, Gardner looks at her daughter, and she wonders whether these same issues — of power and privilege and race, of inequities in everything from jobs to housing to health care to education — will change in Winnie’s lifetime.
Gardner doesn’t know how these twin tragedies will change Minnesotans. But she knows her daughter’s infancy happening amid this chaos has changed her. She’s trying to practice gratitude for little things and big things, like celebrating when her organization bought eight lots in north Minneapolis to build 30 units of affordable housing. She’s prioritizing her own well-being instead of running ragged for the movement. She wants 2020 to spur positive change, though generations of inequities make her pessimistic.
“We make meaning out of something like this,” Gardner said. “I think there is sort of a peeling back a layer, an unveiling that’s happening. I’m not going to tell George Floyd’s family that his death needed to happen. But it’s just like we make meaning out of this pandemic. Are we going to face the structural problems that created these health inequities? Are we going to do Medicare for All? Are people’s memories going to be that long in 2021? Because anything that happens, it can also be an opportunity.”
After months on edge, Mark Arnold needed a break from the funeral home. One Friday afternoon, he took off from work and drove north: Past Duluth and along Lake Superior before checking in at Grand Superior Lodge. He went to his favorite hiking trail, Bean and Bear Lake Loop. He climbed more than 1,000 feet in elevation, and before sunset, he settled on top of a granite rock above two teardrop-shaped lakes.
He took photographs. He listened to leaves rustle. He watched eagles soar as the sun dipped.
He reflected on life. He thought about Gloria Hays, and the others who’d died alone. He thought about George Floyd and the seismic shifts happening in our society. He thought about how grateful he was to finally be able to conduct funerals again after months where they were on pause. He thought about a family whose 2-year-old son had drowned a couple of years ago, a family he’d helped during their grieving process. He mentally noted that he should check in with them.
Weeks later, Arnold’s own father would die at age 90 from prostate cancer. Arnold had attended thousands of funerals, but this would be his first for a close family member. He’d make sure it was perfect.
As he sat atop the rock, Arnold thought about how 2020 has changed him — has changed all of us.
Life has slowed down. When he goes on walks with his wife, instead of just plowing ahead, they stop and talk to strangers. Perhaps we will look back at these anxious days as a time that was good for the whole of humanity.
“You could say this is something fate, or God, has put upon us, that you just need to slow down all your lives,” Arnold later pondered. “You’re living selfishly, with no purpose, with unattainable goals. Just slow down and appreciate each other. Our lives have really been put on the pause button. That could be that silver lining we could all experience.”
The orange of the sunset glowed on the lakes. He sat entranced as, after twilight, the sky entered the blue hour. Soon, it was pitch black. Arnold had a moment of panic. He was the only hiker out here, and had a 90-minute hike back to his car. He didn’t really know where he was going. Nobody could help if he got in trouble.
He turned on his headlamp, and he hiked down into the darkness.