In the latest installment of our occasional conversations with Fort Worth leaders, Charlotte Francis, a nurse practitioner and lead advanced practice provider at Texas Health Breeze Urgent Care, discusses how the omicron variant is affecting urgent cares in north Texas. 

This conversation has been edited for length and clarity. For the unabridged version, please listen to the audio file attached to this article.

Alexis Allison: Charlotte, we’re seeing the highest positivity rate of COVID-19 of the entire pandemic, both in Tarrant County and Texas. What does that look like in urgent cares on the ground?

Charlotte Francis: It looks like a big influx of patients seeking testing and seeking care. With a high rate of positive patients, that certainly translates to a wider and faster spread of the virus, so it’s just reaching more and more people every day. It also looks like a lot more questions from patients, as new Centers for Disease Control and Prevention guidelines are released and as treatment options change. But thankfully, clinics like Texas Health Breeze and other urgent cares are able to test and treat these patients, which I think has gone a long way in helping to decompress some of the hospital systems in north Texas. 

Allison: Can you tell us about the symptoms you’re seeing and how sick people are getting when they come in?

Francis: From the start of omicron, we’ve kind of seen a difference in the way that symptoms are presenting. We’re certainly seeing a difference in how transmissible the virus is, which is why we’re pushing getting vaccinated and getting boosters and washing hands frequently, wearing masks and isolating — all of that we just can’t stress enough. But some of the things that we’ve seen with this variant: It’s kind of presenting more like the flu. So, with headaches, body aches, chills, maybe some milder respiratory symptoms, like runny noses, coughs. Also, I think we’re seeing a bigger number of patients with gastrointestinal symptoms: nausea, diarrhea, upset stomach, decreased appetite, that sort of thing. That’s changed a little bit anyway from the first couple waves. But ultimately, we’re just not seeing the severe respiratory symptoms that we were seeing with things like delta. 

Possible COVID-19 symptoms (not variant-specific):

Fever or chills

Cough

Shortness of breath or difficulty breathing

Fatigue

Muscle or body aches

Headache

New loss of taste or smell

Sore throat

Congestion or runny nose

Nausea or vomiting

Diarrhea

Source: CDC

If you think you might have COVID-19, check your symptoms here with the CDC’s self-checker.

Allison: It’s my understanding that it can be tricky to sequence the virus and determine which person has which variant. So how do you go about navigating that portion?

Francis: It is, yes. There’s just a small portion of tests that gets sent out to labs that then get sent on to further labs to get sequenced. While we can’t specifically distinguish in clinic with just rapid antigen testing, really what we’re looking at is symptomology and the way that our patients are presenting. Things like time of symptom onset from when they were exposed, to the length of symptoms themselves has been a bit shorter with omicron. There are some things we can do to tell the difference between the two. But you’re correct that we can’t specifically distinguish. 

Allison: You mentioned that there have been patients who have been asking a lot of questions. What are some of the common questions, and could you answer them here?

Francis: What I hear is a lot about the new guidelines about isolation procedures and things like that. So just trying to keep the community updated on what’s new and coming from the National Institutes of Health and CDC. And then, just different treatment options. There have been some changes in what we’ve found with monoclonal antibodies, which ones work, which ones don’t work anymore, as well as some new oral medications that are hitting the market. Also with the new variant and these new symptoms that people are experiencing, what’s the best course of action for them and how to get better quickly.

Allison: When should someone seek out medical attention at an urgent care clinic?

Francis: There are a lot of reasons why someone might visit urgent care and I think that can look different for everyone. Certainly, if you’ve become symptomatic, and at-home treatments aren’t working. For the vast majority of our patients with omicron, it’s really just supportive care that they’re needing. Things like resting, hydrating really well, taking over the counter fever reducers, like acetaminophen or ibuprofen, and if those are working, that’s certainly a reason to seek care at an urgent care. 

With the amount of positive cases out there and that high rate of transmission, if you’ve been exposed, and you are developing symptoms, I think it’s pretty safe to assume that you have the virus. If your symptoms are mild, just stay home and quarantine. 

And really, especially for patients that aren’t symptomatic, or are just needing things like return to work notes or school notes, travel clearance, definitely more appropriate for them to use things like community-based testing centers or retail testing centers, just to free up some space in the urgent care so that we can really devote our time to patients who are symptomatic. All of us are still here caring for patients with other illnesses and injuries as well. 

Allison: How are you and your colleagues doing in the middle of this influx?

Francis: I think we’re faring well. It has certainly been a challenge, I think, for everyone in health care, and we’ve had our share of illnesses. But, we’re definitely following all the CDC guidance that we can, just trying to get back to treating patients as soon as it’s safe for us to do so. Morale-wise, I think we’re really holding strong, even with these really, really high patient volumes. We can attribute that to just strong leadership and the teamwork that we have in our centers. The days are long sometimes, challenging sometimes, but we’re showing up with positive attitudes and we’re here for those who are depending on us.

Allison: Is there anything else that you’d like us to know?

Francis: We’re just all in this together. Yes, we are providing medical care, but also that we’re out in the communities and out with our families like everyone and just trying to get through omicron, this wave, day by day. Adding for your Fort Worth audience that we’re really excited to announce our first Fort Worth location that’s opened. That’s our 15th location so far and we’ve got many more to come. We’re excited to finally be in Cowtown.

Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her by email or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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Alexis Allison

Alexis Allison covers health for the Fort Worth Report. When she can, she'll slip in an illustration or two. Allison is a former high school English teacher and hopes her journalism is likewise educational....

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