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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

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