As hospitals and clinics across the country attempted to navigate the early days of the COVID-19 pandemic, so many things were happening in such a short amount of time. Pharmacists, including Erin McCreary, a 2015 graduate of the Harrison College of Pharmacy, and other health care workers worked tirelessly to identify treatments for struggling patients.
Never one to be afraid of “work, hard work,” McCreary did not stand idly by. Asking questions at a crucial time, she assumed a vital leadership role within the hospital system and became a key resource in pharmacy circles across the country for COVID-19 treatment and protocols.
An infectious diseases pharmacist and director of Stewardship Innovation, Infectious Disease Connect with the University of Pittsburgh Medical Center, or UPMC, as well as a clinical assistant professor of medicine with the University of Pittsburgh School of Medicine, McCreary noticed some trends in orders coming through the pharmacy. With so much information coming through her system, she spoke up and volunteered to coordinate the summarization and cataloging of information coming through the pharmacy.
Just by asking the question, she became a pivotal leader in the health system’s approach to COVID-19.
“That led to the first draft of our first COVID-19 treatment guideline. We started truly putting out systems and protocols and information technology support across the entire health care system: rural, critical access hospitals, community and the academic and urban areas. They were all operating under the same oversight, which was our committee,” said McCreary.
“I went from being kind of one pharmacist at one hospital, to being the system lead pharmacist for all COVID-19 therapeutics basically by asking if anyone was writing a basic guideline.”
As pharmacists and physicians learned more about COVID-19 and ways to combat the disease, monoclonal antibodies became an important tool in treating those infected with COVID-19. Made for use in people already infected with it, monoclonal antibodies look for and attach to the spike protein that sticks out of the coronavirus that causes COVID-19. When monoclonal antibodies attach to the spike protein, they can block the virus’ ability to enter cells and slow down the infection.
With this treatment coming to the forefront, McCreary once again stepped to the front to lead the charge and is the lead pharmacist for the UPMC Monoclonal Antibody Network. When the antibody treatments received emergency use authorization in November 2020, McCreary and her team shifted their inpatient work to outpatient, utilizing their network to treat as many patients as possible.
“Monoclonal antibodies are highly effective, but they are logistically challenging to get to patients, and it takes a whole village of people to coordinate this,” she said.
Their success did not go unnoticed. Soon The White House was calling to find out what exactly they were doing at UPMC.
“They said, ‘We have invested in all of these drugs, and people aren’t using them and you guys seem to have figured out how to use them, we want to help you do more of this,’” recalled McCreary. “So, with these efforts from an incredible team of people, we were able to go from treating about 3% of all eligible patients to 35% of all eligible patients in just shy of a couple months, which is a really, really tremendous increase in access and something we are very proud of.”
The leadership and determination shown by McCreary during such a critical time exemplifies why she was selected as the Young Alumni Achievement Award winner by the Auburn Alumni Association.
“I am so honored and humbled to receive this award, it still doesn’t feel real,” said McCreary. “I’m so proud to represent pharmacists and to represent women. It admittedly feels a bit odd to celebrate work related to COVID-19 since the pandemic has been such a horrible experience in so many ways; however, when I step back and think more about the systems we built, the ways we collaborated, the patients we helped and the path forged for future young female scientists, I am so proud and this award recognizes a path forward for so many more future leaders to continue this work and improve it even more.”
McCreary is the first graduate of the Harrison College of Pharmacy to receive the Young Alumni Achievement Award and just the second graduate in as many years to be recognized by the Auburn Alumni Association. With the valuable contributions of pharmacists, particularly during the COVID-19 era, McCreary is happy to see the spotlight shown on the meaningful work as part of patients’ health care teams.
“Pharmacists are an essential member of every patient care team—no matter the location of the patient or the specialty or medical condition requiring care,” said McCreary. “When we collaborate with our physician, nursing and other health care partners, we truly can design trials and build systems that optimize care while using resources judiciously. It’s never too early to work hard and make a difference.”
For McCreary, her interest in infectious diseases started during her second year of pharmacy school in Jack DeRuiter’s class.
“Pharmacokinetics and pharmacodynamics fascinate me, and I think one of the best parts of being a pharmacist is diving into these data for different compounds, combining that knowledge with available clinical data and optimizing dosing to a desired effect,” she said. “During our ‘bugs and drugs’ course P2 year, I realized antimicrobials were the coolest drug class ever. I think it’s fascinating how the chemical structures directly relate to their spectrum of activity against various pathogens and adverse events we see in patients.”
Along with DeRuiter, she credits several others from the Auburn Pharmacy Family for helping her along the way. Salisa Westrick taught the research elective where she learned about writing research studies and applying for grants, and the late Anne Marie Liles was an important faculty mentor who helped McCreary and others start and grow the Equal Access Birmingham interprofessional free clinic in Birmingham. She also credits Courtney Watts Alexander and Kent Owusu, members of the HCOP Class of 2014, who taught her about residencies and getting involved with professional organizations.
She also credits Brent Fox for helping her create her first Twitter account. That account now has a blue checkmark beside it, boasting nearly 15,000 followers as she has become one of the leading voices around the country regarding COVID-19 treatment.
Upon leaving Auburn, McCreary completed two years of residency work with University of Wisconsin Health, specializing in infectious diseases in her second year. Additionally, she has served as a member of the American Society for Microbiology Planning Committee and is chair of the Society of Infectious Disease Pharmacists, or SIDP, publications committee. She was recently elected to the executive board of SIDP and will complete a two-year term from 2021-23.
Her practice interests include infectious diseases and antimicrobial stewardship in immunocompromised hosts, antimicrobial resistance and antimicrobial pharmacokinetic/pharmacodynamic optimization.
Within UPMC, she chairs the COVID-19 Therapeutics Committee, which oversees writing guidelines and developing order sets for all inpatient and outpatient COVID-19 treatments across 35 hospitals and eight electronic health records. She is the pharmacy lead for two large randomized, adaptive trials: REMAP-CAP COVID-19 and OPTIMISE-C19 and leads UPMC’s outpatient monoclonal antibody treatment network and 22 Evusheld administration clinics.
With all the data, studies and trials, McCreary is still shocked at how complex and unique COVID-19 is, making it all the more difficult to treat.
“COVID-19 is phenotypically complex, meaning it presents very differently for different patients. We see patients with absolutely no symptoms and patients that die tragically,” she said. “It also has very heterogeneous sequela, meaning outside of respiratory symptoms, patients can present with maladies of almost every other organ system which range in severity.
“Finally, we’re just now beginning to understand the terrible consequences of ‘Long COVID and so we will not only be trying to optimize care for acute illness for the foreseeable future, but now we are learning how to manage patients with long-term comorbidities associated with their infection.”
Still in her first 10 years as a professional, McCreary has seen her whole world change in a small amount of time.
“COVID-19 changed everything. For the past two-plus years, the majority of my work and the work of many on my teams has shifted to exclusively COVID-19,” she said. “We also had to learn to navigate providing clinical care and collaborating with teams almost exclusively virtually for a while, appreciate the social and mental challenges we all faced throughout the pandemic and work faster and more ready to pivot plans completely with changing information more so than ever before.
“The silver lining has been meeting people all throughout the health system, in various roles, as we all collaborated to improve outcomes.”
Erin McCreary, a 2015 graduate of the Harrison College of Pharmacy, was recognized this year by the Auburn Alumni Association with the Young Alumni Achievement Award as a key resource in pharmacy circles across the country for COVID-19 treatment and protocols.