UNMC/Nebraska Medicine’s First Contact with COVID-19

On February 7, 2020, UNMC/Nebraska Medicine answered the national call to support 57 Americans returning from Wuhan, China, in need of quarantine and care during the initial outbreak of COVID-19. Upon arrival at Eppley Airfield in Omaha, they were safely and securely transported to the Nebraska National Guard’s Camp Ashland location for a 14-day quarantine period as mandated by the Centers for Disease Control and Prevention (CDC). Only one person developed minor respiratory symptoms and was transported to the National Quarantine Unit on the UNMC/Nebraska Medicine campus. This person was returned to Camp Ashland after two negative coronavirus tests to complete the rest of their quarantine period. By February 20^th, all 57 patients were released.

The operation to return these Americans from China was a collaborative effort between UNMC/Nebraska Medicine, the U.S. Department of Health and Human Services, the CDC, Douglas County Health Department, Sarpy-Cass County Health Department, Lincoln-Lancaster Health Department, Nebraska Emergency Management Agency, Nebraska Department of Health and Human Services, Three Rivers Health Department, and the Nebraska National Guard.

National Institute of Health Clinical Trials

In February 2020, Andre Kalil, MD, MPH, led a team at Nebraska Medicine in enrolling some of the first COVID-19 patients in a National Institute of Health clinical trial to study remdesivir as a treatment for the disease. The study confirmed remdesivir as an effective treatment and was approved for emergency use in May 2020. The drug received full FDA approval in October 2020 and continues to be a form of treatment for patients with severe COVID-19 conditions.

Donning and Doffing COVID-19 PPE

Donning and doffing PPE in a specific order helps protect health care providers caring for patients with infectious diseases and helps prevent spread of pathogens. COVID-19 PPE is designed to protect the health care worker from exposure to the respiratory droplets that spread the virus. Click on the interactives below to explore more about donning and doffing protocols.

John-Martin Lowe, PhD, Director, Global Center for Health Security

Transcript

John-Martin Lowe: [I]n the COVID response and my initial roles and responsibilities, again, because I had been so involved in transport, got pulled into how do we do a lot of the local coordination and integration with federal organizations for receiving patients that are going to need to be provided medical care or monitored. So, a fair amount of liaising and pulling together those organizations here in Omaha that do all of the planning and do the piece to get people safely to the airport and from the airport to wherever they're going. Also very involved in kind of rewriting protocols. So, we have lots of protocols for viral hemorrhagic diseases. We had a variety of protocols for respiratory pathogens but, knowing what we knew and knowing what we didn't know in February of 2020, we really—it was a great opportunity to refine our protocols based off of the current body of information, or lack thereof, to kind of maximize safety. So, it was prepping for transport and doing a final deep dive on our safety protocols for the initial response where it was—we were so integrated and embedded with federal agencies, it was really just helping make sure that the federal agencies had the information that they needed and a lot of coordination on behalf of the biocontainment unit with different federal agencies that thought they might have somebody that would need to come to the biocontainment unit.

Mark Rupp, MD, Chief, Division of Infectious Diseases, College of Medicine

Transcript

Darby Kurtz: [W]hat is the role of an infectious disease professional when dealing with a pandemic?

Mark Rupp: The COVID pandemic has been incredible. It really was something that stressed the division and really the whole medical system to the breaking point, and our group and the Medical Center has responded so tremendously well and so heroically. It's really inspirational to have seen how people rallied and did what they needed to do. Sort of in comparison to the Ebola patients, that was incredibly stressful for a period of about three months. This has been incredibly stressful for going on starting our fourth year. It's been impactful not only for ID, but for all groups of clinicians. There's a lot of folks who are frayed at the edges and suffering a little bit.

James Lawler, MD, MPH, Associate Director, International Programs and Innovation, Global Center for Health Security

Transcript

James Lawler: I think we all essentially filled in whatever holes needed to be filled in at the time. And that's true not only at—I mentioned that kind of the Global Center team has from its inception been willing and able to wear multiple hats at any given time, doing what's necessary. I think that was true, certainly, across our entire institution here, the university and hospital, that people did what needed to be done and I think our team did that as well. So, some of it was dealing locally with things within the hospital and within the university that needed to be addressed. How do we create safe infection prevention control practices for managing patients? Advocating for airborne isolation for all the patients very early on, again, based on some of the information we were getting in some of what we saw in managing early patients. Helping response across the state and region, particularly in places that were seen to be especially vulnerable or, early on, had huge issues. So, meatpacking facilities obviously being one, right, where we put together teams and we went out to these facilities to see firsthand what was happening, where were vulnerabilities, how could we create interventions that would you know, reduce spreading and keep what is critical infrastructure running. Same thing for nursing homes and long-term care facilities, that was recognized very early on as a very vulnerable segment in society and, same thing, sent teams out and we went to these places, and you know, did training, assessed their procedures and physical layouts, and, again, did things to try and reduce risk. Schools, same thing. So, wherever we thought there was a need we would jump in.

Elizabeth Rupp

Transcript

Elizabeth Rupp: [I]t's so frustrating, if people knew—he has nothing to gain by advocating vaccines or face masks or—he has no personal gain and he's so careful about reading the studies and analyzing them and determining the validity of the findings. “Yes, that's a good study and it makes sense and you can trust those findings” or “no, they didn't do things right.” He has—no horse in the race, so to speak. It's just like, he's working hard for the betterment of everybody, but yet people think he's motivated by some sinister or personal gain. I don't know what it is. It's just—it's hard to see that happening it’s really—when he just has dedicated his life to vanquishing these kinds of things and educating people about them, but it's not appreciated and he's criticized because of it and called names and threatened. That's hard to watch. If they knew him and knew what he was doing and how he goes about his life, they would feel very differently. And I think the access to social media is just a very scary thing that anybody can say anything they want to say and people will believe them. It's just very disheartening when the facts are not held as closely as the fallacies.