For 15 years, the University of Nebraska Medical Center and Nebraska Medicine prepared for this moment.

They trained their physicians, nurses and staff to wear personal protective equipment — the heavy hazmat-style layers that protect against dangerous pathogens — perfected medical procedures under the weight of those layers and ran drills on providing care in areas of deadly contamination.

In the wake of 9/11, as the country scrambled to respond to a new, devastating threat, hospitals, universities and state governments were called on to prepare. For what was unclear. The veiled, recondite threat of terrorism meant unknown dangers, including the possibility of biological warfare, thrown into sharp relief by the series of anthrax attacks that followed the World Trade Center’s fall. 

Few responded to the call with the diligence of UNMC and Nebraska Medicine. Immediately, their leadership began drawing up plans for a biocontainment unit: a 10-bed facility, the largest of its kind at the time, fitted with negative air flow, a pressurized entrance and decontamination autoclaves, which would provide a safe environment to deal with the world’s worst pathogens.

“We took it seriously,” said Ken Bayles, Ph.D., executive director of basic science research for UNMC’s Global Center for Health Security. “Not only did we stand it up and invest in and build this structure, but we prepared year after year.”

The Nebraska Biocontainment Unit officially opened in 2005. Then it sat empty, as the world waited and attention drifted to other things. But it was never unused. UNMC and Nebraska Medicine continued to prepare — training staff, running drills, learning and getting better.

Then, in 2014, Ebola hit West Africa, and U.S. physicians and a journalist who had been exposed to the deadly virus were flown to the place best equipped to treat them: Nebraska.

Two patients were treated and discharged; one, whose disease was advanced by the time he arrived, didn’t make it home. It was a defining experience for the team. It gave them practical knowledge that advanced their understanding of pathogens and how to treat and contain them. It also led to further federal partnerships and the establishment of the National Ebola Training and Education Center (NETEC), which trains health professionals nationwide to prepare for catastrophic diseases.

“One thing we learned from taking care of the Ebola patients,” said Cheryl Rand, clinical operations lead of the Nebraska Biocontainment Unit, “is no one got sick. The disease didn’t spread anywhere from here. So we knew we could do that again.”

They continued to prepare. NETEC grew; it has now reached more than 120 hospitals nationwide, and NETEC staff has trained more than 8,000 health professionals on deadly pathogen preparedness.

“I would say the majority of hospitals in the country in one way or another have benefited from NETEC training,” said James Lawler, M.D., executive director of international programs and innovation at the global center.

Few could have predicted how necessary that training would prove to be — the devastating scale of what was to come as COVID-19 began to ravage communities around the world.

But UNMC and Nebraska Medicine’s preparedness and expertise have helped not just Nebraska or even just the U.S. but the whole world battle the pandemic. They treated some of the U.S.’s first COVID-19 patients. They conducted some of the earliest virus tests and clinical treatment trials. Their leadership ran models of the virus’s spread and was critical in informing state and federal policy.

Fifteen years of gathering expertise, running drills over and over and preparing for every scenario put UNMC and Nebraska Medicine in a position to make a substantial difference in one of the world’s most deadly and dramatic crises. They were front and center in the global fight — right here in Nebraska.

Luis Olivas knows the contours of Grand Central Apple Market well.

He’s learned who the quickest baggers are and who will point out active markdowns.

Rolling through checkout with 45 TV dinners or enough produce to comfortably feed a residence hall typically elicits a second glance, a probing question or two.

Olivas has grown accustomed to the attention. One of his responsibilities as diversity coordinator in the Office of Student Diversity and Inclusion at the University of Nebraska at Kearney is to keep the Big Blue Cupboard stocked. So as the coronavirus emptied businesses throughout the country, Olivas was still making biweekly speed-runs through the grocery store, filling his cart with peculiar quantities of food.

Hundreds of students rely on the Big Blue Cupboard — and, in turn, Olivas — whether learning is remote or not. To keep the cupboard operational during the spring, Olivas alternated shifts with Juan Guzman, director of the Office of Student Diversity and Inclusion.

Both were first-generation, Latino college students who earned associate degrees at Central Community College before attending and serving UNK.

“We have many immigrant and international students as well as refugee and asylum-seeking students,” Olivas said. “Thus, it’s super important for them to be able to see somebody that has been in their shoes to not only create empathy but also to be able to relate on a personal level.”

Hui Ru Ng might not have boarded a flight to Nebraska if not for Tommy Lee.

Ru (as her friends call her) was raised in Malaysia and dreamed of traveling to the U.S. to enroll at a college that was equally affordable and reputable. She also dreamed of seeing the sun-swept landscape exhibited in the since-canceled TV show “Tommy Lee Goes to College,” which chronicled the former Mötley Crüe drummer’s uninspired attempt to assimilate at Nebraska’s land grant institution.

Ru ultimately chose the University of Nebraska at Omaha and boarded an airplane for the first time.

“Back home, it’s summer all year,” she said. “When I got to the airport, I was like, ‘Oh, this isn’t what I thought.’ But I grew to love this place because of the people. I will never forget how Nebraskans supported me.”

After completing her undergraduate degree, Ru applied to be a graduate assistant at the Nebraska Business Development Center located at UNO. Oluwaseun Olaore (Seun, as his friends call him) applied around the same time.

A project director back home in Nigeria, Olaore foresaw a professional ceiling unless he had an advanced degree.

Ru and Seun’s two years with the NBDC coincided with a 100-year flood and a COVID-19 pandemic. Suddenly the vulnerabilities of the Midwestern economy were tested like never before.

“This whole experience actually made me realize that I want to start a small business,” said Ru after having experienced a frightening two-part course on the financial realities of small-business ownership in times of crisis. “You get inspired by clients, see their innovation and passion.”

Seun too came away from this experience reaffirmed in his commitment to the industry. 

“I’ve been able to help business owners figure out a way around these problems,” he said. “This hasn’t scared me away. It has strengthened me.”

It starts with an email notification.

An interesting opportunity. Care to hop on a conference call to discuss?

The three University of Nebraska at Omaha students are intrigued.

 On the phone, the pitch goes like this:

Would you like to build a groundbreaking mobile application with considerable value as a public health tool? It’ll involve collaborating with two teams.

The first is the University of Nebraska Medical Center’s Global Center for Health Security, which is rapidly working to quell an unprecedented global health crisis and is also home to the nation’s only federal quarantine unit. The other is Apple Inc.

With the COVID-19 pandemic having recently arrived in Nebraska, spring break has come early.

No need to juggle coursework.

The students quickly agree.

Work begins immediately. Prototyping and wireframing and coding. Analysis and dialogue and refinement. Daily meetings stretch into the pre-dawn hours as each team navigates hunger — the UNMC team subsisted on takeout curry — exhaustion and multiple time zones.

As news segments turn some of their peers infamous during imprudent trips to warmer regions, Keegan Brown, Grayson Stanton and Carly Cameron spend their spring break tucked away in a design studio, maintaining 6 feet of separation and working in conjunction with experts in the fields of medicine and technology.

Less than three weeks later, 1-Check COVID was available in the Apple App Store and was downloaded more than 10,000 times in the first 10 days. The app is now also available on Google Play for Android phone users.

1-Check COVID is a risk-assessment tool that asks the user a series of questions ranging from biographical to geographical before inquiring about symptoms. All are computed in an effort to assess the likelihood of someone having contracted COVID-19. Once the questions are completed, users learn their risk levels: low, urgent or emergent. From there, they are guided toward subsequent steps, whether to continue to monitor their symptoms or contact the public health department. If users agree, they can share their risk profiles with health care professionals, employers and family members, among others.

“This will hopefully be lifesaving,” UNO and UNMC Chancellor Jeffrey P. Gold, M.D., said in a news release, which names the three Scott Scholars, who are all Nebraska natives, computer science majors and underclassmen. Cameron, the oldest of the trio, was 2 years old when the SARS outbreak occurred. She doesn’t remember it.

In a time of crisis, both UNMC and Apple have bet on youth. And youth has delivered.

“What these students did is nothing short of extraordinary,” said Harnoor Singh, director of student development for the Walter Scott, Jr. Scholarship Program (Scott Scholars), which was launched in 1997, thanks to the generous support of the Suzanne & Walter Scott Foundation. The program challenges high-achieving engineering and information science and technology students to develop their technical, creative and leadership skills.

“These are the students we’ve been waiting for,” Singh added.

In 2019, researchers and the media began sounding alarm bells about a “loneliness epidemic” — a rise in people reporting feelings of isolation that could become a health crisis, leading to increases in heart disease or even shorter life spans.

And that was before COVID-19. Before the world shut itself indoors and government leaders mandated, and pleaded, for everyone to stay at least 6 feet apart.

Isolation and social distancing are terms the world is all too familiar with now.

“I have, for years, been trying to come up with ways to make people more aware,” said Todd Richardson, Ph.D., an associate professor in the University of Nebraska at Omaha Goodrich Scholarship Program who is researching loneliness. “And then this comes around and does it for me.”

What researchers like Richardson have warned of — fraying social connections and the ways people arrange their lives to perpetuate isolation — rocketed to the world’s collective consciousness as COVID-19 spread rapidly across the globe. As cities, states and countries shut down, everyone felt the pain of isolation. People kept friends and family members at bay. They missed play dates, barbecues, birthday parties and graduation ceremonies. They missed the rush and roar of live music, the shared excitement of home runs and 3-pointers. They wondered if the “sea of red” would ever wash over Memorial Stadium in quite the same way.

And everyone felt those things, together.

“It’s ironic that the experience of loneliness unites us, but I think it can in this moment,” said Richardson. “We’re all under threat from something that doesn’t discriminate between human beings. This is an extra-human threat. So we can bond as humans and realize we’re working together in order to resist this. And I think there’s something really, really beautiful in that.”

But there’s a flip side to that potential beauty. The longer people stay apart, the harder it becomes to return to one another.

“There is a period where you acknowledge the loss in your life, and you lament it, and you try and fill it in whatever way you can,” Richardson said. “But the longer you’re away from other people, the less trust you have for other people, so the harder it gets to break out and to reach out. And at that point, loneliness starts feeding in on itself. It becomes a self-perpetuating kind of cycle.”

Richardson said social interaction influences people in ways they’re not even aware of. Seeing another person express emotions, such as joy and pain, sparks a mirror response in the brain.

“The mere fact of making eye contact with them, or being in the same physical space as them, connects us to them in important ways,” he said. “It makes us acknowledge them as people, as fellow humans, as entities worthy of respect and autonomy.”

Fundamentally, Richardson said, it teaches people empathy.

“The longer we retreat from one another,” he said, “the longer we don’t share that physical space, the less empathetic we get, and the less we care about other people.”

There is also risk in social interaction, and humans are inherently risk-averse, Richardson said. People may want to avoid not just the risk of disease, but the risk of shame, embarrassment or rejection that comes with putting themselves out there in the world. The longer people stay protected, the more comfortable they may become.

“I think that when this abates, we’re going to have a lot of work ahead of us reacclimating and coming to terms with the fact that we need one another,” he said, “and that is worth the risks that we take.”

University of Nebraska–Lincoln alumna Willa Cather was not only a famous writer, she also survived a pandemic. The so-called Spanish flu ripped across the globe from 1918 to 1920, its spread accelerated by the troop movements and combat conditions of World War I. At that time, Cather was in her 40s and living in New York City, having left teaching and magazine editing behind to be a full-time writer.

Cather’s letters describe some things that sound familiar today. She wrote to her mother that she needed to spend some time in the hospital, but her doctors suggested waiting until the flu had died down (Letter No. 2414). In the same letter, she added that her friend Ethel Litchfield was exhausted from caring for her sick children, so Cather had her over for a respite, complete with a good meal and a little time to rest by the fire. In a note to her Aunt Frances Smith Cather in November 1919, Cather said that she couldn’t write too much, as she had so many letters of condolence to write “to friends who have been bereaved by this terrible scourge of Influenza” (Letter No. 440).

Cather knew how brutal the flu could be — she caught it herself in September 1919 and had a bad time of it. She wrote to a friend, “I have been in bed with Influenza for two weeks, and it has ended in a stubborn bronchitis which refuses to quit me and keeps hovering on the edge of pneumonia. … I am simply unable to make any plans at present — I’ve had to call off ever so many engagements on account of this stupid illness” (Letter No. 474).

In an odd twist of literary fate, Cather’s bout with the flu ended up strongly influencing the novel she was writing at the time, the story of a Nebraska farm boy serving in what was then called the Great War. The doctor who treated her during her illness had previously been a physician on a troop transport ship that was struck with influenza. Cather borrowed the doctor’s journal and used it extensively when writing her novel.

That novel, “One of Ours,” won the Pulitzer Prize in 1923.

Please visit the Willa Cather Archive at cather.unl.edu to explore more of Cather’s life and letters.  Thanks to the support of donors and UNL’s Center for Digital Research in the Humanities and University Libraries, this free online archive shares a vast collection of Cather material with the world. The collection includes not only Cather’s writing but also photos, letters, interviews and biographies.

Eric Weaver, Ph.D., Scientist

Most researchers love to see their work impact the real world. They are thrilled when their theories are tested or their papers widely read.

Özgür Araz, Ph.D., is not so thrilled. He is a business professor at the University of Nebraska–Lincoln, and he studies pandemics, applying the science of data and supply chain management to difficult questions like school closings and the availability of ventilators. While he is glad his research is useful, he never wanted to see it in action.

Araz’s background is in industrial engineering. However, he said he “finds the social side of technical problems very interesting,” an interest which led him to supply chain management. He first studied pandemics as a dissertation topic for his Ph.D. and taught complex systems thinking at the University of Nebraska Medical Center’s College of Public Health before being recruited to UNL’s College of Business to teach supply chain management and analytics.

Supply chain management education is a strength at the university, with programs at UNL, UNK and UNO. Supply Chain Management and Analytics is the newest department in the UNL College of Business. Araz describes the ultimate goal of SCM as creating systems which produce “the right quantity of items, in the right place, at the right time.” Students study logistics, production, procurement and distribution, leading to jobs in fields as diverse as manufacturing, health care, global sourcing and inventory control. Currently, around 140 students major or minor in SCM at UNL, in addition to about 45 graduate students in the department’s online master’s degree in business analytics.

The battle against COVID-19 rages on many fronts: hospitals, labs and even private homes as people carefully wash their hands and practice social distancing. But Araz argues that, in many ways, fighting the virus is fundamentally a supply chain and capacity management problem. Are there enough masks, ventilators, test kits, hospital beds and other supplies? Are there sufficient health care personnel? SCM is also about timing. It’s not only a question of whether the needed ventilators are available; they are needed at a certain time and in a certain place. Next week may mean they are too late to save lives. If they are in a warehouse three states away, that’s not much good either.

Araz’s most recent article, published in Decision Sciences in November, studies capacity optimization under resource shortages. Previously, he looked at the challenges of stockpiling ventilators for influenza pandemics and school closure policies for cost-effective pandemic decision-making.

A pandemic is also a living math problem, and Araz is a numbers guy. How many people does one infected person generally infect? How quickly does the disease spread? What are the fatality rates? Araz explained that economic impacts are taken into consideration when modeling effective decision-making.

“We want to answer whether school closings and social distancing policies are cost-effective,” Araz said. “Both questions, of when to close schools and when to reopen, are equally important. We take information about how fast the virus is spreading, using a basic reproductive number, and estimate the number of secondary cases generated in a completely susceptible population. In the case of the coronavirus, it’s spreading fast.”