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.”

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