UNMC’s Global Center mitigates emerging threats

The Global Center for Health Security was recently featured as part of the University of Nebraska System’s NU for NE campaign, which shares stories of outstanding faculty, staff and student work across the campuses

Chris Kratochvil, MD, UNMC’s Global Center for Health Security chair, knows UNMC is a leader in its field. And with the nation and the world in the throes of a pandemic that has been going on for two years, we can expect even greater things from UNMC and its Global Center for Health Security.

"Since the Ebola outbreak of 2014 and the COVID-19 pandemic of 2020, the federal government has put its faith — and significant funding — in the University of Nebraska Medical Center’s biopreparedness efforts and expertise," he said. "They see us as a tremendous national resource."

With the world in the throes of the COVID-19 pandemic, managing and treating highly infectious disease safely is a top priority for health care providers across the nation.

Leading the world — from the heart of the Midwest

Why would a globally-renowned infectious disease center — led by experts in biopreparedness and high-consequence infections research, education and clinical care — be located in Nebraska? It started with a vision and an all-star, all-volunteer team that dedicated itself to being ready for any biocontainment crisis at any time.

Years before Ebola and COVID became worldwide buzzwords, the Nebraska Biocontainment Unit was one of only a select handful of specialized units nationwide. It was staffed by a team dedicated 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 — and save for a few false alarms, the unit sat empty.

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

The team in Nebraska 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. Scientific papers were written. Nebraska protocols were declared good as gold. The Nebraska Biocontainment Unit team was lauded with international headlines; a mid-sized Midwestern city had become a global epicenter for biopreparedness.

Containing infectious disease in a safe space

The Ebola outbreak of 2014 was only the beginning. A series of partnerships also began during that time. In 2016, the U.S. Department of Health and Human Services awarded nearly $20 million to UNMC and Nebraska Medicine to develop a national Training, Simulation and Quarantine Center (TSQC) with state-of-the-art quarantine facilities. 

Research coordinator Vicki Herrera works in the Global Center for Health Security-home to the nation's only federal quarantine center and one of the nation's largest biocontainment units.

Experiential learning at the TSQC takes place in arguably the most sophisticated patient biocontainment training unit in the nation. Combined with experienced instructors, students and trainees enjoy unmatched learning opportunities.

Individuals learn by training in six fully-simulated patient rooms, each with its own high-fidelity mannequin and adjacent briefing room for pre- and post-simulation instructional review. All six rooms are viewable and operated from a central control room with full audiovisual capability for instructors.

The center also contains a fully functioning simulated biocontainment laboratory and an emergency operation center for simulating exercises in managing a large-scale response to a biological event.

In 2017, UNMC and Nebraska Medicine established the Global Center for Health Security as the umbrella entity to oversee the entirety of its biopreparedness efforts. In 2019, the Davis Global Center, a facility which houses the TSQC, the National Quarantine Unit, clinical simulation infrastructure and a training lab, opened.

Elizabeth Beam, PhD, works in a fully-simulated patient room. Each room has its own high-fidelity mannequin and adjacent briefing room for pre- and post-simulation.

The National Quarantine Unit is the only federally funded resource of its kind; it is specifically designed to provide first-class quarantine care to people exposed to highly hazardous, communicable diseases. Its 20 rooms employ individual negative air pressure systems. They are single occupancy with ensuite bathroom facilities and contain exercise equipment and Wi-Fi for patients requiring longer stays.

Stepping up during a global pandemic

In 2020, the National Quarantine Unit and the Nebraska Biocontainment Unit were activated during the COVID-19 outbreak. They worked closely with federal partners to provide quarantine services for American citizens being evacuated from Wuhan, China — the original epicenter of the COVID-19 pandemic. Only a few weeks later, the U.S. government turned to Nebraska again to receive and care for American passengers rescued from the Diamond Princess cruise ship. The last of the passengers were released just as UNMC began to receive local cases in earnest. 

Over the course of the following years, UNMC stepped up again and again — developing new treatments, testing new ways to use personal protective equipment and providing important research on how the virus spreads. Dr. Kratochvil says the medical center’s foundation of experience and expertise played a key role. 

Jana Broadhurst, MD, PhD, director of the Nebraska Biocontainment Unit Clinical Laboratory, pipettes a blood sample.

"When the pandemic hit, we had a team that we’d developed. We had resources that we’d developed. We had the National Quarantine Center. We had further refined our procedures, policies, resources and trainings with the bio-containment unit," Dr. Kratochvil said. "Because we had that preparedness, we were able to quickly step up, leverage our partnerships, leverage our team and respond to the national need."

Infectious disease experts also have been a tremendous source of support for local and statewide businesses during the pandemic. UNMC has developed guidelines and provided technical assistance to numerous industries and community partners — such as meatpacking plants, correctional facilities and homeless shelters — since the early days of the pandemic. And UNMC continues to help Nebraskans in many ways.

What the future holds

As 2021 closed amid the largest global pandemic since the early 1900s, the Global Center for Health Security and its partners have played a vital role in our community, our state, our nation — and even across the globe. Providing assistance with quarantine and isolation care, convening an ethics committee to promptly address rising concerns and rapidly conducting ground-breaking research are just several of the accomplishments that continue to make the GCHS a world leader in public health emergencies.

"The med center and the GCHS are global leaders in biopreparedness," UNMC Chancellor Jeffrey P. Gold, MD, said. "The dedication to our mission ensures our nation will always receive an immediate response to critical needs. We are fortunate to have such a highly-respected resource and national treasure right here in Nebraskans’ own backyard."

"Nebraskans lean forward," Dr. Kratochvil said. "And I think that leaning forward is really what makes us unique. We're willing to step up and do what it takes."