WOODBURY, Minn. A year after the promise of COVID-19 vaccines led to hopes the pandemic could be extinguished, case counts and hospitalizations are surging again in Minnesota, and exhausted front-line health care workers are fighting the virus and misinformation about how to treat and prevent it.

“We went from being heroes right in the beginning to pariahs now when we confront people — this remnant group of members of our community that have chosen not to get vaccinated,” said Dr. Craig Matticks, an emergency physician with nearly 30 years experience who works at North Memorial Health and the Urgency Room.

“We can’t remember a time where people have doubted our advice quite like this. And it's more than doubt — it’s anger,” said Dr. Bryan Williams, who delivers critical care, and serves as the chief well-being officer for M Health Fairview’s 34,000 employees.

Another physician who works in M Health Fairview hospitals, Dr. Will Nicholson, has also seen a backlash from patients.

“There are people who feel like the recommendations we have are an assault on their freedom,” Nicholson said. “Nobody in health care wants to take away anyone’s freedom. We want to use our freedom to help people live better lives, to not pass this stupid virus to somebody else.”

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One of the biggest frustrations for these front-line physicians is resistance among the public to the COVID-19 vaccines.

“I just was caring for somebody who had been in the hospital for a month who contracted COVID, and I asked why he didn’t get vaccinated,” Williams said. “And he said he wished he would have, and he felt misled. He pointed directly at a TV station I won’t mention, and he said, ‘That’s why I didn’t get a vaccine.’”

Fox News host Tucker Carlson in particular has amplified vaccine misinformation.

Williams said some other patients stand their ground in opposition to vaccination.

“They often have multiple stages of denial and anger,” he said. “We have had some challenges with patients and families that were demanding nonevidence-based care. And we've worked really hard to describe why we do what we do and that we believe some of these cares might actually be more harmful than good. And it has been a challenge to do that respectfully because to be honest, not everybody's been respectful to us in return.”

Health care workers who are leaving the profession present a further challenge to those who remain in the field.

“We are worried that we see a lot of people not just retiring early but some changing their careers early on,” Williams said. “There are empty beds right behind us, but our hospitals are full because there's no point in being in a bed if there's nobody to care for you.”

The staff shortages are sounding “alarm bells” about the quality of care, Matticks said.

“We're short-staffed, so we show up to a shift in the emergency department and we can't open as many beds as we normally would have open to take care of patients because there aren't nurses to staff those beds,” Matticks said. “Or if it's not in the emergency department, it's on the hospital floors. We don't have nurses to staff beds, we can't put people in the ER into those beds or people.”

It's difficult to quantify exactly how many health care workers have left because of COVID-19, but a survey in September from Morning Consult found 1 in 5 have left the profession since February with a majority saying they quit because of the pandemic.

A lot of researchers have been looking into the problem of health care worker burnout in hopes of finding ways to improve conditions in the profession. Among them is a team from the University of Minnesota, which includes School of Nursing professor Jayne Fulkerson.

“Health care workers, you know, they are front line. They are working extremely hard and have been for quite a while,” Fulkerson said. “I think we need to protect them and help them with their stress levels, with their well-being. And if we don't, we're going to have a crisis in health care.”

The doctors we talked to said the burnout issue won’t be resolved until the country gets ahead of the COVID-19 pandemic.

For now, Matticks said emergency rooms are so busy it’s best for people who aren’t seriously ill to avoid them if possible.

“Because what that care setting really needs to focus on is identifying the people who require admission to the hospital and getting their care started,” Matticks said. “And if their throughput is gummed up with patients of lower acuity, they can't get to the people who really need the care.”

The main message these doctors want to send is simple: Get vaccinated against COVID-19. They say it's the best way — and the only way — to save people's lives, reduce the strain on the health care system, and finally get the pandemic behind us.

“The one thing I would ask of Minnesotans is be a little bit more like us in health care,” Nicholson said. “If everyone is a little bit more compassionate; if everyone is a little bit more caring and a little bit less judgmental, we will go from 70% vaccinated to 100% vaccinated. That's what's going to solve this problem.”