Q&A with Marilyn Stebbins, PharmD: Pharmacy Advocate and COVID-19 Patient Zero

In early 2020, before the coronavirus took over global headlines, professor Marilyn Stebbins, PharmD, found herself in the unexpected role of receiving one of California’s first COVID-19 diagnoses, navigating uncharted territory as both a patient and a health care professional.

On COVID-19’s five-year anniversary, Stebbins, who has built her career around developing innovative pharmacy practice models for underserved populations, reflected on her experience, the evolution of COVID care and the pandemic’s lasting impact on pharmacy practice.

What was it like being one of the first diagnosed COVID-19 patients in California?

It was surreal. I was the first in my county, one of the first at UC Davis and possibly the first UCSF faculty member with COVID. It felt like having the plague. Everyone wore respirators, but there weren’t enough, so they avoided my room unless absolutely necessary. I didn’t receive any treatment — just medication for nausea — because there were no established protocols yet. Even getting tested was a challenge. I wasn’t tested until I was admitted to the hospital, and my husband was never tested because tests simply weren’t available.

How long were you hospitalized, and what was recovery like?

I was in the hospital for eight days. The acute phase was intense, but I lingered because no one knew how to discharge a COVID-positive patient safely. My husband couldn’t pick me up, and I couldn’t take an Uber without putting someone at risk. Ultimately, a family member left my car in a remote parking lot, and a staff member in protective gear wheeled me out the back door so I could drive myself home — even though I could barely walk and was utterly exhausted.

My post-COVID recovery was rough. Though my breathing improved quickly, I had gastrointestinal issues — constant diarrhea for six months. It took time to rebuild my strength.

As a pharmacist, how did your perspective shape your understanding of your COVID experience?

I really feel that knowledge is power, and at that time, nobody had any knowledge. At least I had a little glimpse of what was going on. It was really important to let people know at that point that it wasn't just people in nursing homes that were getting it. Healthy, active people like me were getting hit hard. This was before widespread quarantining, and the lockdown happened just after I was discharged, around March 8, 2020.

How did your experience inspire you to get involved in COVID-related research?

I joined UCSF’s partner trial, studying why some people got COVID while their partners didn’t. Researchers collected every possible bodily fluid from me for months, trying to collect data and uncover patterns. I also tested antibody kits for companies and even tried to donate plasma. I felt it was my duty to help in any way I could.

When I went to pharmacy school, pharmacists weren’t allowed to give vaccines, so I was never trained to give them. So when COVID-19 vaccines became available, I got certified to give vaccines and then helped provide vaccine training for our students. I gave many vaccines in my county and in the Sacramento area.

How did the pandemic change your approach to pharmacy education?

COVID-19 provided opportunities to collaborate in post-COVID-19 care. I was able to work with UCSF Pulmonology to include pharmacists and pharmacy students as part of the team for their post-COVID clinic. Since in-person rotations were shut down, it was important to find clinical opportunities for our students. Virtual programs allowed students to perform medication reconciliations and engage in patient care from anywhere.

You are a board member of the California Society of Health-System Pharmacists. How do you think the pandemic transformed the pharmacy profession?

From the innovation perspective, we’ve never seen drugs approved so quickly as vaccines. And it was a huge win for community pharmacies to become hubs for testing and immunization –– one of the few places people could access care –– and many pharmacists were the surrogate health care providers for their communities.

However, expanding pharmacists’ scope of practice must extend beyond pandemics and crisis situations. We have to continue to push every day to have the pharmacist recognized and reimbursed as the health care provider that they are.

What lessons should health care take from the pandemic?

The pandemic showcased innovation and collaboration. Pharmacists felt really good about their roles and the system working in a time of need. However, burnout became real, and we must find ways to address it so that we don’t deter people from entering health care careers.

It was such a great time to be part of UCSF because our weekly COVID updates were so inspiring and we were learning so much so quickly. Those weekly calls brought together so many experts looking at so many different treatments and sharing epidemiology and statistics. Their insights were on the forefront of therapy and medical care. It was fascinating –– a challenging yet rewarding time to be part of the health care community.

More

• Stebbins named Pharmacist of the Year by California Society of Health-System Pharmacists (CSHP)

• Stebbins named CPhA Innovative Pharmacist of the Year