Why Nebraska?
Nebraska Biocontainment Unit team
The first patient treated in the Nebraska Biocontainment Unit, Rick Sacra, MD, and his wife, Debbie, celebrate his recovery from Ebola in 2014, surrounded by the NBU all-volunteer team, at a press conference held the day he was discharged. At table from left: Angela Hewlett, MD; Phillip Smith, MD; Rick Sacra, MD; and Debbie Sacra.

Why? Because of vision and an all-star, all-volunteer team

How did Omaha, Nebraska, an ambitious, but decidedly mid-sized Midwestern city, become a global epicenter for biopreparedness?

It started with a vision. And, with people.

Years before Ebola became a worldwide buzzword, the state’s academic medical center, UNMC, primary clinical partner Nebraska Medicine, and the Nebraska Department of Health and Human Services, came together to create the Nebraska Biocontainment Unit. One of only a select handful of such specialized units nationwide.

But without people, that’s merely expensive infrastructure. Nebraska’s difference is an all-star, all-volunteer team that dedicated itself to being ready for a crisis it did not yet know, at some future date that had not yet come.

Years went by. Nearly a decade. Save for a few false alarms, the unit sat empty. The team, driven by a vision, kept on.

“By the end of that nine years,” longtime Nebraska Biocontainment Unit medical director Dr. Phil Smith told Nebraska Educational Television, in an award-winning documentary, “we had the hard-core biocontainment geeks, if you want to put it that way.”

They were firefighters, forever drilling. But their call never came.

Some openly wondered, Would it ever?

Dr. Smith felt the rumbling: “I know there were times when the hospital was full, we had to divert people to other hospitals. They were saying, Why are we just letting this 10-bed unit sit there?”

But the vision held.

“Dr. Smith put his foot down about a hundred times,” said Dr. Daniel Johnson, who would later join the unit: " 'We need to keep this unit. We are going to need it. Trust me.’ ”

In Omaha, Nebraska, leadership agreed.

“To their credit,” Dr. Smith said, “they had the long vision. They could see the global trends. And the fact this was something that could be very useful if there were an outbreak down the line.”

And then the call came. In 2014, Ebola, one of the world’s deadliest special pathogens, was ravaging West Africa like a wildfire.

The State Department called. American medical missionaries had become infected. Was the Nebraska Biocontainment Unit ready?

Always ready.

And with that, an Ebola patient was in the air and on his way. To Nebraska.

“I tingled from head to foot,” Dr. Smith said.

It was real now. At long last.

“I remember saying that we’d trained 10 years for this moment,” said Shelly Schwedhelm, executive director of emergency management and biopreparedness at Nebraska Medicine. “And these are our fellow Americans. And if we weren't going to seize this, then everything that we have done has been for naught.”

“Dr. Smith and Shelly had told us that everything was going to be good,” said nurse Betsy Flood, “we had prepared for this. We knew what we were doing. And they had this kind of calm, that, it was like, Well, they say it’s going to be OK. It’ll be good. We know what we are doing. We’re smart. We’ve practiced. Let’s go.”

They did what first responders always do: They strode calmly and deliberately toward the crisis, not away from it.

The lessons learned were invaluable. Other aspects of the medical center became involved. Global partnerships were established. Papers were written. Nebraska protocols declared good as gold.

In Dallas, two nurses who hadn't had this specialized training became infected with Ebola (they were treated and cured). But in Omaha, the team conducted its work without incident, with flying colors.

The Nebraska Biocontainment Unit team was lauded with international headlines, earned praise from President Barack Obama.

A mid-sized Midwestern city had become a global epicenter for biopreparedness.

The team members seemed to echo a common theme: Yes, there was that element of adrenaline. You might even call it fear.

But once they saw the patient in person it all melted away. What they saw was someone who needed care. And that’s what they do. That’s why they drill.

That’s how the vision held strong for all those years.

As the first patient with Ebola rode in an ambulance on the way to the Nebraska Biocontainment Unit, Kate Boulter, a nurse, looked down into his eyes. She told him the team was ready. That he would receive the best care.

He was grateful.

“Welcome to Nebraska,” she said.