In March 2020, the improbable suddenly became the unthinkable for Swedish Health Services, the largest nonprofit health care provider in the greater Seattle area, where two of us work as senior executives. An increasing number of Covid-19 patients from a local skilled nursing facility began to arrive at our Seattle hospitals in severe distress. We had been tracking the illness before the first U.S. Covid-19 patient was admitted on January 30 at a sister organization 30 miles north of our headquarters, and we knew how bad it might get — models projected that the region’s healthcare system could soon be overwhelmed.

      We, along with the rest of the medical world, faced many unknowns in how best to care for the surge of patients we expected. But we were better prepared than we might otherwise have been because of an unrelated experience that had just played out across our health system: in January 2020, just weeks before the coronavirus outbreak began in the U.S., nearly 75% of Swedish’s caregivers, some 7,800 people, went on a three-day strike.