The first cases

The call came on a Monday morning last month around 3 a.m. A plane chartered by the federal government would be landing soon. Its cargo: one of the largest groups of coronavirus patients this hemisphere had seen.

A few hours later, on a chilly tarmac near the Missouri River, more than a dozen Americans from a cruise ship were greeted by doctors in elaborate protective gear. They stepped slowly down a towering metal staircase. And they headed off to quarantine.

The country’s goals at that time were clear: help those ailing citizens recover. And keep the Covid-19 disease from spreading within the United States.

As the days passed in Nebraska, most evacuees never developed serious symptoms, and those who did were stabilized. The two patients with the most severe cases became the first people enrolled in a national clinical trial for a medication intended to curb the progression of the illness. Neither Dr. Andre Kalil, who is overseeing their treatment, nor the patients know whether they received the actual drug or a placebo.

“In a dire situation like in the middle of an outbreak, we have to do the best science we can,” said Dr. Kalil, whose phone buzzes twice a day and reminds him to take his temperature, a precaution to ensure that none of the doctors seeing the coronavirus patients become infected themselves. “If you don’t do the right science, we’re never going to find what works.”