Voices from the Front Lines: Melissa Thompson-Bastin

We recently joined hospital staff for a few days to document the reality of treating COVID-19 patients in UK HealthCare clinical settings.

This edited interview is part of our ongoing series, “UK HealthCare: Voices from the Front Lines,” highlighting stories and perspectives from our frontline staff who have cared for the sickest COVID-19 patients since March 2020.

Melissa Thompson-Bastin, PharmD, PhD, is a clinical pharmacist in the medical intensive care unit who has been with UK HealthCare since 2010.

How has this most recent wave of COVID differed from the first waves?

It is different now. It's better and worse in some ways. There was a lot of unknown initially; ‘how contagious is this virus? How infectious is this? Do we have enough equipment? Do we have the right equipment? What drugs do we use? What drugs should we avoid?’

We (now) know how to treat these patients, what we need to do. I think what's different about this wave (is) the patients themselves seem to be a lot sicker, to be honest with you, they're getting sicker faster.

The other thing layered into all of this is, now it's a preventable disease, right? Now it just feels like these people could have prevented this, you know, and I think I feel really bad for our patients because … they're really, really sick. We admit husband and wife pairs, grandparents together, mothers and sons and daughters and fathers together.

Whole families are coming into our ICU (and) none of them are vaccinated. And you just kind of wonder what kind of misinformation have they been given. The data is kind of going in the direction that around 80-90% of our patients are unvaccinated, so that makes it really hard.

But I will say, we treat every patient the same. We would never treat anybody differently because they made a different decision.

Can you talk about your perspective on COVID vaccines in relation to pregnancy?

I got vaccinated in December (2020) before I was pregnant. I think at that time, there were a lot of people hesitant to take the vaccine when they were pregnant, and I think that's totally reasonable. I think if you had asked me when I got my shot, if I knew I was pregnant, would I have taken it? I don't know. I think that was a legitimate concern.

But there's a lot of really brave women who got vaccinated in that first round – they got pregnant or they were already pregnant – and they were willing to track their outcomes. Even as recent as February or March there was a big study published in New England Journal about pregnancy outcomes … and the babies are fine. The neonatal outcomes and the pregnancy outcomes are identical to the general population. Knowing what we know now, I think there's absolutely no reason to avoid the vaccine if you're pregnant.

I'm looking forward to my booster. It's hard to make those decisions when you're pregnant, because it's not just about you. And there's just so much unfortunate misinformation going around that … it’s a very valid concern about your unborn baby.

I would say talk to your OB/GYNs, talk to the friends and trusted people that can provide you an objective opinion, but there's actually more pregnancy safety data with this drug than probably any drug that's been approved so quickly. And it's just because of the numbers, the sheer numbers (of people who have taken the vaccine). And I think people need to be confident in that. Millions and millions and millions of people have gotten these vaccines and they're extremely safe.

What's the most important thing that you'd want someone else to understand about what's happening?

The vaccine is the only drug that works for COVID; it's the only drug that works. Because if you come into my ICU, vaccinated or not, we're going to give you these other drugs… but they don't work that well, and it's all we have. I think it's silly to think that the vaccine is experimental because it's not; it was studied rigorously and the clinical trials have FDA approval. If you do get sick and come to the ICU, you will get a potential option list of truly experimental drugs with risks and maybe some benefit we don't yet know. The vaccine is the only one that really works and I really encourage people to get their vaccine.