There are 22 hospital beds capable of treating patients infected by the deadly Ebola virus in the United States.
Designed to completely isolate a patient and prevent further spread of a disease, they are located in places like Emory University Hospital in Atlanta, or the National Institutes of Health in Bethesda, Maryland, or the Rocky Mountain Laboratory in Montana.
Ten of them are in the Nebraska Biocontainment Patient Care unit in Omaha.
The Omaha center for treating infectious diseases entered “de facto standby” late last week after officials from the U.S. Department of State toured the facility following news that two Americans had become infected by Ebola in West Africa, Medical Director Dr. Philip Smith said.
Although Dr. Kent Brantly and missionary Nancy Writebol ultimately landed in Atlanta and are being treated at Emory University -- a choice Smith said "made sense because of its proximity to the Centers for Disease Control" -- speculation of the Nebraska unit's capabilities has been the source of fear spreading across the state.
Dr. Angela Hewlett, the biocontainment unit’s associate medical director and a specialist in infectious diseases, said the two Americans' presence in Atlanta and the possibility that more patients may be treated in Nebraska are not a cause for concern.
“We’re here exactly for this reason,” she said. “We’ve seen all the fear factors going into Ebola, and a lot of it is unfounded. We can safely take care of these patients and the people who take care of them, which is a huge issue.”
Built for $1 million in 2004 following a deadly outbreak of severe acute respiratory syndrome (SARS) in Canada and the threat of biological terrorism in the wake of the Sept. 11, 2001, attacks, the biocontainment unit is on the seventh floor of the Nebraska Medical Center in what is essentially a series of independent concrete boxes within a larger concrete box.
The unit is sealed off both physically and environmentally from the rest of the hospital using a series of independent air circulation systems to keep the atmosphere in each of the five two-bed rooms entirely isolated.
A “negative airflow” system pumps air into each room, preventing pathogens from escaping. The hallway connected to each of the rooms is equipped with the same system as an extra safeguard.
Inside the rooms, a “single pass” environment prevents air from being recycled in the unit. Over the course of an hour, the atmosphere of one room may be replaced as many as 25 times, as air from the room is sucked into a special high-efficiency particulate air filtration and ventilation system.
Hewlett said most hospitals have at least one negative airflow area capable of treating patients with diseases that can spread through airborne pathogens.
Nebraska's biocontainment center has five.
Staffed by 30 medical professionals, the facility's capabilities are only one part of the equation.
Kate Boulter, the lead nurse on the unit, said the doctors, nurses, respiratory therapists and technicians who make up the biocontainment team constantly review protocols and hold drills for "real-world" situations four to six times per year.
"The thing we stress the most is personal protective equipment protocols," Boulter said. "We want to make sure that everyone on the unit is properly in their suits and protected from the infectious diseases the patients may carry."
Posters hang on several walls detailing the meticulous steps of sealing oneself in a biological protective suit, complete with multiple-layering, duct-tape-reinforced seals, and hooking up a personal negative airflow system which prevents airborne pathogens from entering the suit.
That gives medical workers a second layer of protection from patients who arrive inside an ISO-POD unit -- a kind of plastic cocoon sealed from the outside world -- kept in several locations around the state.
Although there has only been one instance in the last decade when the Omaha biocontainment unit has entered an active state -- for a potential Ebola case which turned out to be malaria -- Smith said the $25,000 spent each year, paying staff for training time and maintenance and equipment costs to keep the center operational, is justified.
“It is an asset to be prepared for something that may not occur, but if it did occur would pose a potential hazard to the entire community,” Smith said. “You can’t wait until an Ebola patient shows up and then put together a unit.”