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.

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.