Dr. Bianka Soria-Olmos '07

Bianka Soria-Olmos Name & Degree Program:
Bianka Soria-Olmos '07 - Biology

My life as a doctor battling COVID-19

Tell us about your role and how you’ve experienced COVID-19 in your profession.
I’m an outpatient pediatrician, and I’ve been a pediatrician with Cook Children’s in Fort Worth since I finished my residency. I used to take care of the sick kids admitted to the hospital. I did that for four years. Two years ago, I transferred to a clinic, more of an outpatient setting.

COVID-19 changed a lot of what we were doing, because what we’re hearing currently, and it changes every day, is that luckily right now the numbers of children that the virus is affecting are low, which is good. However, the social distancing aspect of what we’re having to do to keep everybody safe has affected families as a whole, so what is happening to the kids? The big worry has always been we need to keep kids up to date on vaccines. This has impacted how we do that safely. We’ve had to really think hard and basically changed the way we do our day-to-day stuff.

Before, we would schedule patients and a parent would call needing to have their child have their one-year checkup. We would have a schedule and whenever was convenient for the family to come in, either morning or afternoon. But to have better control, we’ve had to separate well care from sick care in order to reassure the families who are doing their due diligence to staying safe and keeping their child well. So we only see well children in the morning, and if a sick child needs to be seen, we offer it either via telemedicine, if it’s a complaint that can be addressed via telemedicine, or we offer the afternoons, so we can hopefully physically separate sick children from well children.

The big worry for pediatricians across the country is parents have the fear of leaving. If they can stay home, they want to stay home. A lot of the questions we’ve been getting is “Is it safe for me to come? I know you’re saying it’s important for my child to get their vaccines, but should I come?” Day to day I get questions about that, and I try to ensure parents that it is safe. This is considered an essential visit, if your child is at an age that’s due for a vaccine. The last thing you want to do is delay those inadvertently, because of fear of something and then having an illness occur due to a delay in a vaccine, such as pertussis, chicken pox, measles. The good news is once parents can sit down and talk with you about it, they’re reassured. The majority of my patients, once they’ve gotten the reassurance that we have policies in place protecting them and their kids, they’re not delaying significantly and they’re getting their vaccines on time.

How much of this was on your radar ahead of March?
It came on my radar, the week my oldest, who is in kindergarten had his spring break. I took that week off and we had made plans that I completely changed. We basically stayed home. Our spring break plans were null and void. When the news really hit of what was happening in Seattle and New York, that’s when me and my husband said it’s not really worth going where we were going, since we don’t know what’s going on. The week I was off, I don’t know if I would have been working, if I would have been as attuned to all of the social media postings from doctor boards, physician groups specifically on what was going on around the country and other countries like Italy. I don’t know if that was a blessing in disguise being off. I was able to sit at home and was following quickly. Even though I was off, I was spending time trying to connect with doctors in our system, to get their opinion on “What are we going to do to prepare for this? It sounds like it’s coming.” It was a common week for doctors with children to take off, so there were other colleagues of mine who I knew were off because we had talked about it. We were text messaging or sharing articles with each other and brainstorming with each other how we were going to contribute to the response. As a whole, Cook Children’s, we knew had the alarm sounded to them that a special team had to come together to formulate a response to this. It was probably the second week of March that I learned about all this.

How do you pivot with appointments that were made in the future?
In taking recommendations from the AAP, we felt that when we mention essential, any child under the age of two, because that’s the main time that vaccinations are administered, between birth and 18 months, according to the CDC/AAP vaccine schedule, the child should be fully finished with infancy vaccines by 18 months. Then there’s a break between 18 months and four years of age. Any child under the age of two we were going to shift it from the afternoon to the morning, but we were going to keep it. Any older children that were full up to date on vaccines, in order to minimize their risk, we said we can postpone those until we got a better date. We’ve had a moving target as to when it is safe to bring those kids back in. It has always been our goal to make sure that those children who needed vaccines, to get them in, in a safe manner. That meant we were seeing a lot of the younger ones, two and under in March. As the Texas Medical Board has guidelines about how to safely reopen, we now have guidelines in place with a safety plan to open up to the older children. That would be preschoolers who would be enrolling in kindergarten and need vaccines.

Did you have telehealth practices in place, or did you have to create it?
It was something we did not have, meaning it was in existence and there were a few practices and physicians that had the capability to do it. It was a thing that everyone wanted to do, so it was a busy few weeks for the IT department in March, as they were setting it up.

How do you provide same standard of care when patient is not physically with you?
We decided certain things would be okay to do via telemedicine. When we had a parent call that “My child is sick and I don’t know if I need an appointment or want an appointment,” we were definitely asking a lot more questions to determine if it’s appropriate to do via telemedicine or bring this person in the office.

Have you seen calls go up out of an abundance of concern their child may have the virus but don’t know what to do?
The calls including concern about “My child has a cough, is it the virus?” definitely went up. As we do our typical diligence we would ask “Does the child have a fever, is there an adult sick in the home?” All that sort of stuff and then we could typically tease it out if the child was well or if we needed to bring the child in.

What’s the forecast for the virus?
I’m very comfortable telling you I don’t know. I think the hospital system I work for, Cook Children’s, is doing a very good job of taking everything we do know and making decisions on how to safely expand and open up without increasing transmission of a patient being next to another sick patient or a staff member acquiring it from a sick patient.

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