As news broke that a deadly international virus was churning its way across the United States and killing the country’s most vulnerable population, Dr. Irene Hamrick wasted no time in battening down the hatches to protect her patients at a Department of Veterans Affairs nursing home in Ohio.
As medical director of the Cincinnati VA Medical Center’s Community Living Center, Hamrick was quick to recommend closing the center to visitors and limiting the number of providers who accessed patients, to prevent the accidental spread of what became known as COVID-19, the novel coronavirus that has baffled the medical establishment with its unpredictable attack. Her leadership early in the virus’s arrival to the U.S. proved prescient — so far, she has no positive COVID-19 patients.
Hamrick graduated from Western Carolina University’s School of Nursing in 1991and East Carolina University Brody School of Medicine in 1995, choosing to do her residency in family medicine and a fellowship in geriatrics — all while single-parenting two boys. She earned her nursing degree while also taking pre-med courses because she wasn’t confident she would get into medical school. She had already received a college degree in biology and chemistry in her native Germany, but was required to repeat all the courses for WCU’s nursing degree.
“I needed a degree where I could make a living,” said Hamrick, who received WCU’s Alumni Association Award for Academic Achievement in 2017, which is given annually to a WCU alumnus or alumna who has attained extraordinary distinction and success in academe and has demonstrated exceptional leadership.
That exceptional leadership has been obvious throughout Hamrick’s medical career. She came to the University of Cincinnati College of Medicine in July of 2019 as chief of the geriatrics division in the Department of Family and Community Medicine. She also is the Martha Betty Semmons Endowed Chair in Geriatric Medicine Education, splitting her time between her university duties and her position as chief of geriatrics and palliative care at the VA.
“At the university, I supervise multiple faculty who are medical directors in many of the nursing homes in town. So, we have been collaboratively coming up with strategies to protect our patients, which included early sequestration, closing to visitors,” she said. “We have also reassigned our faculty and our providers who come to the facility. We shuffled our patients so they have fewer providers come in to the facility to see the patient, and those providers take on patients of other providers who have fewer patients in the facility so they don’t have to come in at all.”
Before coming to Cincinnati, she worked at the University of Wisconsin at Madison School of Medicine and Public Health as the geriatric services director and as the medical director for the university’s long-term care facilities program. She found working with geriatric patients satisfied an intellectual stimulation and fulfilled her knack for problem-solving.
“I like the challenge of having complex patients and being able to identify things that could improve their quality of life,” she said. “They are so appreciative of improvement in their quality of life.”
COVID-19 has presented her with plenty of challenges, but she’s determined to do everything in her power to keep her staff and patients safe. “My biggest fear is that we providers and staff could bring the virus in to the facility,” she said, despite the hand-washing, mask-wearing and other preventative measures designed to minimize the health care teams’ exposure to their patients.
“We are doing our very, very best to keep it out by doing everything that we know to do, but we still can get it,” she said. “Somebody who is asymptomatic may come in and give it to our patients. Some patients may come back from the hospital and bring it in and spread it. I want to convey that we should not blame nursing homes or assisted living facilities or group homes or caregivers for people dying, because about half of patients who get admitted to the hospital from the nursing home with COVID-19 die, and all of my patients who have to get on the ventilator die.
“The first nursing home that had COVID in the U.S., in Washington state, was a five-star facility,” she said. “It was an excellent nursing home. When there is an outbreak in a facility, you can do everything possible and you might still end up with COVID.”
Hamrick knows firsthand the discomfort the virus can cause when its symptoms present themselves. She believes she was infected with the virus on a flight from Germany to the United States in early February, a trip she had taken to see her family.
“When we landed in New York, we were not allowed to get off the airplane and I wondered why not,” she said. “Well, they had to test the crew’s temperature. Then we were told that the airplane had come from China, which they didn’t tell us when we took off. So, during the flight, I touched all the surfaces, I talked to the crew, who didn’t wear masks.”
"We are doing our very, very best to keep it out by doing everything that we know to do, but we still can get it..."
Her symptoms were unmistakable: cough, very high fever, high heart rate for her (she’s a runner) and a respiratory rate in the abnormal range. Because her cough began just outside the two-week window for testing, she was not allowed to be tested. She rode it out at home and eventually recovered.
“It took me a month to get back to running because my lung capacity was so damaged,” she said.
Hamrick is reflective when she considers all the measures she and her staff are taking to protect themselves and their patients. She works 16 to 18 hours most every day, she said, and has been told she will soon have to take a 30 percent pay cut because the hospital has to reduce the number of its elective surgeries and other procedures to make room for an expected surge of new COVID-19 patients.
“I am grateful for governors who have imposed physical distancing and restrictions because that has made the pandemic manageable in those areas. We do not have the stats that New York City has because people stayed away and slowed the spread of the virus so that health care systems could manage the onslaught of sick people,” she said. “And that has preserved lives, that has prevented mortality because the health care system is not overwhelmed and can safely take care of these patients in the ICU and not in the hallway.”