Cease and Disease with Dr. Katrine Wallace (Epidemiologist Kat)

Disease. Sickness. Malady. These are words that can truly send a chill down the spine as they bring us to the reality of the fragility of life and our proximity to the brink of death. Greek physician Hippocrates, known as the "father of medicine" from the 4th century BC, was the first known person to investigate the reasoning behind disease and its relationship with environmental factors. What exactly is a disease? Is there a common denominator of why they happen? Is there a way to evade sickness and possibly attain everlasting life? In this episode, we investigate the science and nature of sickness with a disease scientist, specifically in light of the current novel coronavirus pandemic.

We are joined today by Dr. Katrine Wallace, also known as Epidemiologist Kat, a scientist with expertise in epidemiology, research methodology, biostatistics, and science communication. She received her PhD in Epidemiology from the University of Illinois at Chicago, where she currently serves as an Adjunct Assistant Professor of Epidemiology and Biostatistics. In 2022, she became Certified in Public Health by the National Board of Public Health Examiners. Previously a Director for several medical device companies’ Global Health Economics and Outcomes Research departments, Dr. Wallace now stands as an Advisory Board member for various projects focusing on infectious disease and public health practitioners funded by The Centers for Disease Control and Prevention. During the commencement of the 2019 pandemic, she provided public education and health misinformation debunking online, tackling the novel coronavirus, contagion data, and masking and immunization efforts. Dr. Wallace has become part of international science communication initiatives, such as “Team Halo” by the United Nations and Project FIDES by the World Health Organization. The UK government also recognized her as a “Vaccine Luminary” at the 2021 G7 Vaccine Confidence Summit. Dr. Wallace has extended her education in the classroom and online to international television as an expert opinion contributor for outlets such as BBC World News, CNN, CBS, The Washington Post, The New York Times, MSNBC, and NPR.

Livestream Air Date: April 11, 2023

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Episode Transcript

(00:00):
Hi friends, happy Friday.

(00:06):
Another Friday, another Friends of Franz episode.
Should I start calling it Friends of Franz Fridays?
Anywho, if anyone is aware, except me who still keeps writing 2023 when I date papers,
it's 2024.
2024.
It's technically been 4 years since the pandemic really started.
4 years since COVID-19 took over the world.

(00:28):
4 years since the world has changed forever.
And 4 years since my life and I know everybody's life has been changed forever.
4 years.
That's a whole ass college degree.
But I think about it and how much time has passed by.
I still feel like it's a daydream.
A distant nightmare.
A distant memory and friend.
I know all of our stories are different.

(00:51):
Many were stuck at home, in lockdown, quaranted and isolated, away from family, working from
home, fighting to get toilet paper from the stores.
Do you remember that?
And then I have the story of many others as well who were stuck in the hospital, working
throughout COVID.
Such a bleak memory.
When I think about it, I can still hear the ambulance sirens, the ventilator alarms, the

(01:13):
code blue calls, the telemetry monitors, the cries from loved ones through the phone, the
sniffs of tears from other healthcare workers and the freezer trucks driving in.
Such a dark memory.
I think I tried and still try to repress it all, but these memories definitely still flood
my mind through some nights.
It felt like I was living in an end of the world movie.

(01:34):
I remember during the first months of the COVID-19 epicenter here in New York City,
around March to April 2020, the hospital that I was working at that time coordinated healthcare
workers staying in a hotel to isolate my family so that we could go straight to work.
I stayed at Algonquin by Times Square.
I remember just being alone in the hotel and the quiet, getting ready in the evening to

(01:55):
go to work at night and walking through Times Square.
I wish I took videos during that time.
Hazy, empty, lights off, no people or cars in the street, no honking, no birds, no murmurs,
no tourists, no one, just me in Times Square.
Walking to the train station to get to work, walking to another night of God knows how

(02:17):
many people will die again.
How many family members do I have to call on my phone again so that they could FaceTime
and talk to their loved one on the bed so they could say their goodbye for the last
time?
How many cold blues will be caught again?
How many deaths pronounced during midnight?
I remember walking through that hazy avenue alone.
I felt so alone and so scared and so helpless and wondering if what I was doing meant anything

(02:42):
because all of our patients were dying.
You take an oath to serve and heal others, to no return at most times during this season.
I was worried that I would get sick too and also pass away.
We knew nothing about COVID, we knew nothing about how to contain it or how to treat it.
I remember almost 10 patients dying each night.
I remember wearing the same mask if we had any for one week straight, kept in a brown

(03:04):
bag for me to reuse for my next shift.
I remember sweating in my gown and running to another room to do chest compressions.
I remember it all.
But through all these dark remembrances, I did see lights.
The whole hospital team getting together to help each other take care of the sick.
And how so many people outside of real life inside my little phone on social media working

(03:24):
together to fight all of the evil misinformation constantly published online about what we
were going through.
The main reason I started this podcast was simply because of COVID.
After one arduous COVID night shift, I was walking outside the hospital into a COVID
is a hoax protest by a cathedral nearby.
Why?
Why all of these lies?
Why this effort to speak about something you don't know about?

(03:47):
Why this effort to speak when you didn't see what I just went through inside the hospital's
four worlds the past 14 hours?
And I knew that I had to contribute somehow to spreading the truth.
And I'm so glad that I was able to find friends of France to make this possible the past four
years to share not only their stories, but also their expertise in tearing down myths
and misinformation in their respective fields.

(04:09):
And our guest for today's episode was one of the lights I watched back in 2020 amidst
the heaps of misinformation, a true guiding light when it came to educating the fearful
and paranoid public when it came to preventing COVID, mitigating risk, and also making the
decision to get the vaccine.
It is such an honor, such an honor, it's just like full circle to sit down today with Dr.

(04:32):
Katrine Wallace, or you may know her as epidemiologist Kat, a scientist with expertise in the science
of diseases, research methodology, biostatistics and science communication, and adjunct assistant
professor certified in public health by the National Board of Public Health examiners,
recognized by the UK government as a vaccine luminary, the 2021 G7 vaccine confidence summit,

(04:55):
an international television expert opinion contributor, and just a brave and beautiful
heart to spread the truth.
I'm so honored and I hope you learn a lot from this episode.
Of note, this episode with Dr. Kat was recorded way back in April of 2023.
So up to date data addendum are provided in between the conversation.
I hope you take a lot from this conversation and not just about other diseases like polio

(05:18):
and the flu and RSV and monkeypox, but I hope at the end of it all, you see how far we've
come when the community cares about each other and how many things can change when we're
just kind and more understanding.
Have a great day everybody.

(05:44):
Thank you so much for having me on.
I'm so excited.
Thank you.
I mean, this is not flurry or whatever.
Like the past hour, I'm just like feeling kind of so touched because I'm like, I feel
so honored that you're going to be tonight.
You're so crazy.
I feel the same.
Oh my gosh.
I love the hair.

(06:05):
Thank you.
What's going on here is it worked until like a half hour ago and went, I don't have time
to shower.
So we're going with braids tonight.
I love it.
Braids is always a great option.
I never claimed to be a fashion plate.
Not like you.
You're extremely fashionable.
I always whenever you post pictures, I'm just like, damn, I need to up my game.

(06:27):
I need to step it up.
Oh my gosh.
Everyone has to step it up tonight because you're going to have the most awesome conversation
tonight.
Last week was national public health week.
And for the past year, I was like, have to get Dr. Kat, I had to get Kat on such a crazy
three years, right?
I mean, I first found you on Tik Tok and I feel like how things have changed throughout

(06:53):
the months and throughout the years.
Just like bewildering to me.
I sent a nurse who worked in the COVID ICU here in New York City during epicenter.
I was talking to my friends last week and I said, it's like a bleak memory.
It's like a dream.
It's like a daydream.
Sometimes you sit down like, did it really happen?
Is it really for real?
And I was like, well, for a scientist, it's still very, very real because you're getting

(07:17):
hardcore real time data.
And that's why it's such an honor and such an excitement for you to be here with me.
And I'm so excited to hear from your nuggets of information.
If you could just first please introduce yourself to everybody.
You don't need no introduction.
No, no, definitely.
My name is Katrine Wallace.

(07:37):
I work at UIC, University of Illinois, Chicago.
I'm an epidemiologist and I also teach there.
So I pretty much just teach classes mostly now.
I was doing a lot of research there and teaching, but now I've mostly just transitioned to
teaching at UIC.
And I am also known to people on here probably as Dr. Kat on my social media pages where

(08:03):
I sort of started to make social media content as you were saying back in 2020, just because
I was trying to get information out to like my own friends and family.
And it just sort of started getting shared and more people wanted to watch them.
So now here I am still doing it.
I started this podcast series, an Instagram live series back in, I believe the end of

(08:29):
2020.
Like I said, I was working in the hospital at that time.
And there was one time after, I think it was a 13 or 14 hour shift where we had 10 patients
died to COVID that time.
For those watching, it's true.
We had like the ice trucks outside.
And so I left work that morning because I worked night shift and I was walking past the

(08:49):
freezing trucks and then there's like a cathedral around five blocks from my hospital.
And there was like a protest going on.
I said, what's going on here?
Like 730 AM in the morning.
And it's a COVID is a hoax protest.
Yeah.
That's what inspired me too is that.
Yeah.
And this was like what months into since the rise, the epicenter here in New York.

(09:11):
And I was like, oh my gosh, we need so much more education.
Right.
And it's so crazy of what's the dichotomy between what's going on inside the hospitals
and the research labs and the outside world, right?
From people who may not be in touch with what's really going on and what media portrays.
So I was like, I need to get on the actual educated and trained experts of the field

(09:33):
because they are the rightful sources of information.
Right.
And that's why I always like to ask, what is the training and the education that it
took to get to the expertise that you are now?
So basically what's your journey into it?
Yeah.
I just have like a regular bachelor's of science degree and then sort of have like a little
bit of an untraditional path, but then it got more into public health.

(09:55):
So I started out wanting to do research.
I liked research and I liked statistics.
So I went into quantitative research methods, kind of social sciency kind of path, you know,
doing analysis and research methods.
And then after that I went and got a job and I ended up working in medical research.

(10:16):
And so I really liked medical research and I thought, well, this is what I want to do.
I don't really want to make surveys.
So I went back to school again and was in a master's of science and Epi program.
And then I got my PhD in Epi.
So I started out kind of not really knowing what I wanted to do, but knowing I wanted

(10:37):
to do research, but then when I started working is when I really liked working with health
data.
And so then I went back to school and got a master's and a PhD in Epi too.
There we go.
There was a lot going on for a long time and it sort of was like, are she ever going to
be done with school?
Like some of my friends would be like, are you still in, still taking classes?

(11:03):
But I'm also one of those people that like, even when I was done with my PhD, I'm like,
okay, now what can I do?
And I've had to like kind of push myself away from like, oh, I could maybe get another certificate
in something or, you know, like, you know, I'm just one of these people that always wants
to be learning stuff.
I love it because you know, they always say the doctoral degree is a terminal degree,

(11:26):
but not for you, right?
Like what's next?
I'm like, I'm like, I want to, I have like Duolingo and I got all the, you know, informal
stuff and I love listening to podcasts in different fields of science that I didn't
study, you know, like, so yeah, there's a lot of learning you can do that's like informal
like that, you know, which I, which I, I'm trying to appreciate that stuff more.

(11:49):
Yeah.
I mean, all of that learning and all the education and years, you know, has led me to the expertise
and just feel the epi as you call it.
You know, this field of epidemiology that most people can't really spell correctly because
it's the I and the E somewhere there.
Well, what's funny is before, and some of the epidemiologists in the chat can back me

(12:11):
up on this before the pandemic, no one knew what an epidemiologist was.
So when I would say what I did, they would say, oh, is that skin like epidermis?
And so everyone thought I was like a skin doctor, like a dermatologist.
And I felt very like fancy that people thought I was a skin doctor.
But now that we've had a pandemic, everyone knows what an epidemiologist is now.

(12:34):
My cover is now blown.
No one thinks I'm a fancy skin doctor anymore.
I kind of miss my career.
I know.
I was going to say that I feel like prior to the pandemic, no one might really know
what epidemiology really means.
Right.
And maybe for those who may not still be familiar with the term in the field, what this exact

(12:56):
epidemiology, what is it?
I can even say epidemiology study.
What is the experts?
So the dictionary definition that we teach on day one of our Epi 101 class is the we
study the distribution and determinants of diseases in populations.
Right.
So what that means in real English is we count cases, we count cases of disease.

(13:21):
And then the other part of that is we try to fit the that's like the descriptive epidemiology
piece.
There's descriptive and then there's analytical epi.
All the epi's in the chat are like, oh, having PTSD from class right now, as I say this.
But so there's descriptive epi where we count cases and then we figure out what those cases
have in common.

(13:41):
So like, does everybody who has this X disease, do they all work at the same place?
Or are they all women or are they all, you know, white people that get, you know, so
what do these people have all in common?
And then based on that, we can try to figure out the determinants based on what these people
have in common and try to then put into practice prevention once we figure it out.

(14:07):
So a good example, like a smaller scale than COVID is this monkeypox, right?
When we started seeing cases of monkeypox, it was like, what do all these people have
in common?
What are the characteristics?
And then what can we do?
Can we identify a target population that's at risk and then really drive target prevention
to that population?

(14:27):
So that's a good example of like the descriptive and then the, you know, prevention.
Yeah, I mean, it's such a complex topic, even just the word disease, right?
I mean, I wanted to really, you know, grapple with you like this word of disease.
I mean, disease, disease, it's been, you've been giving this word for many, many years,
but I think it just became very pop, right?

(14:49):
The past few years, because it's like combined with infectious disease, right?
But I wanted to ask about disease itself.
What do you define as disease?
What's the difference between a quote unquote, what you define as disease and like, oh, I'm
not feeling well.
Right.
So it's interesting because as an epi, you can be a lot of different types of epidemiology

(15:12):
too.
So to your point, there's infectious disease, right?
Where people study infectious disease and that's their specialty.
There's chronic disease and people who those epi mostly study like behavioral risk factors,
modifiable risk factors like smoking and exercise and food intake and things like that.
And then there's injury and drug abuse and like, there's all kinds of different types

(15:36):
of diseases, right?
So your question, like what's the difference between like a formal disease and just like
like feeling kind of at home.
I mean, I would say that feeling kind of bad at home.
If you went to the emergency room, they'll diagnose you with something.
And then I guess that's the divider because they'll, even if you don't really have anything

(16:00):
serious, they'll say, oh, you have like, no, a throat infection or you have, you know,
so I guess that's like how you, where's a cutoff is, right?
But it doesn't, but that doesn't mean that somebody who doesn't go to the doctor doesn't
have a disease, right?
Because you can be really sick and just not go and not get diagnosed and then, you know,

(16:21):
have lots of problems later.
So I don't really know the answer where that cutoff is, but I guess for our data purposes,
it's that diagnosis.
And I feel like it's such a hard demarcation line too between this and that as well, right?
And you know, you were talking about modifiable risk factors and also the definition of determinants
earlier.

(16:42):
I mean, as your work is an epi, I mean, you've been seeing on paper and I guess in lab and
research, right?
So many diseases.
I mean, you hear from history and until now, I wanted to ask if there's a common denominator
in most of the diseases that we know in this world, like is there a common determinants

(17:02):
of why diseases happen or where they come from or what they're caused by?
It totally depends on what we're talking about, right?
So what we were talking about, there's all these different types of diseases.
So infectious disease, there's a pathogen, right?
So that's what causes, those are pretty straightforward, right?
You can't get COVID unless you're infected with SARS-CoV-2, the virus.

(17:24):
So that's very, there's a direct straight line there for like agent and then what happens
to the person mostly.
So those are pretty straightforward.
For chronic disease, it's a lot more complicated because those are like multifactorial.
So you can have genetic risk factors, you can have environmental risk factors, you can
be, you know, born with certain risk factors, you can have behavioral risk factors, like

(17:49):
you participate in habits that are not good for you.
So all kinds of things in a constellation and, you know, the more things on board, the
more your risk increases, right?
So it's important to really make sure you understand things like, you know, smoking
is a risk factor for pretty much every chronic disease we have, right?

(18:10):
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Like that's a pretty direct causal link, you know, so it's like things like that, just
things you can do like put sunscreen on as prevention, you know, just so the difference

(18:32):
there is just that infectious, it's pretty direct like agent and then the disease, whereas
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(21:53):
You mentioned about increased risk as well and I think few terms also that came up as
the pandemic was going on, I guess the general public really took attention to this greater
risk, increased risk, increased susceptibility and pointing into SARS-CoV-2, you know, I
feel like the past year, aside from COVID, it feels like there's something new every

(22:15):
single month, right?
It's like, oh yeah, there's the line of virus from China.
Oh yeah, there's smokeypox.
Oh yeah, there's like a polio, you know, occurring somewhere and then an outbreak somewhere.
I think a common question that has been in my DM since I posted our IG Live is, do you

(22:35):
think COVID-2 has caused us to be more susceptible to infectious diseases or other diseases in
general or do you think it's just that it's always been like this but people are just
more hyper aware of the outbreaks because of social media?
So that's an excellent question and there's a lot of layers to your question so I'll go

(22:55):
through a few.
COVID did have a direct impact on other infectious diseases like the flu and RSV and while we
were mitigating for COVID, it also mitigated for other respiratory viruses, right?
So those were directly affected by behaviors that we were taking for COVID and we've actually

(23:20):
been able to have a nice kind of natural experiment to show that if we wore masks, we could pretty
much get rid of the flu, right?
Because we saw that it went down to like nothing when we were masking.
So that is one way that COVID affected disease rates and then once we gave up all those mitigations
kind of all at once, we had like surges of those other viruses like immediately, right?

(23:44):
We had like weird unseasonal flu and weird, I'm sure being an ICU nurse, you know what
I'm talking about.
You had like all these, you know, and sometimes very severe cases in kids and stuff like having
all these respiratory viruses.
So that was, it sort of threw off our seasonality and our schedule.
Secondly, there are less people because I think of all the way that COVID and the vaccines

(24:07):
were politicized during the pandemic, I think less people are willing to vaccinate their
kids and so the polio question and things like other, these vaccine preventable illnesses
that are coming back could be a result of that and is actually a result of that because
we're seeing them pop up in areas like that Rockland County, New York paralysis polio

(24:30):
case was in an area that has very low vaccine uptake.
So that's a problem and there's now political movements, you know, asking to pass laws where
they don't have to vaccinate their kids to go to public school and stuff.
So it's really concerning.
So that's another way I think.
But there is this question about whether or not COVID like does something to our immune

(24:55):
system, right?
That is making people susceptible to more illnesses.
And to be honest, the literature is kind of all over the place on it.
You see papers saying, yes, it damages your immune system and makes you susceptible to
other things.
And then you see studies that, so I think any kind of longitudinal stuff like that after
COVID, I think there just needs to be a lot more data collected on not only just that,

(25:21):
but long COVID.
And I just get the sense we're going to learn so much more in like the next 10 years about
any kind of post-acute sequelae because yeah, it's just so hard to say if it's real or if
it's just artifacts.
Because like you said, we also are much more vigilant of things going on.

(25:43):
Like when we would hear about things happening, we would hear about things on the news happening
in like Sub-Saharan Africa or SARS the first time.
People were just kind of like, because it was not everybody, but I'm just saying like
a lot of people, if it wasn't like in their backyard, weren't like as hanging on every
news story, right?

(26:03):
So because we've all just kind of been through this collective trauma, I do think people
are paying a lot more attention to like health news.
So like I said, there's a lot of layers to your question.
And so I would say yes and no.
Yeah, totally possible.
Yeah, I mean, it's true that I mean, COVID is still going on.

(26:24):
You know, it's still very much present.
Oh, for sure.
For sure.
And people that think it's like completely done, I mean, I just had it a couple weeks
ago, so I know it's still a thing.
How many times did you have COVID?
I've only had it the one time.
I went three years without having it.
And I still wear a mask and everything.

(26:44):
And it's funny because in my comments that when I made my video about how I had COVID
rebound, I just kind of want to educate about the rebound issue because it happened and
it happened to me.
People were the most common questions like, how did you get it?
I want to know what happened.
And I'm just like, well, it's the most contagious variant we've had.
And I'm a person with a job and occupying the world.

(27:08):
Like it's not a moral failing.
I was going to say it's the opposite for me because I had it three times.
Oh, no.
Well, your job, I can't even, you're like intubating people.
So I can't even.
It's like I had every variant, the alpha.
I'm just counting every variant.
I'm like, I'm going to get the next one.

(27:28):
Oh my God, you have like a variety pack.
I hope you don't get the gift of the purchase.
My friends were like, you're like a collector of gems.
You're trying to collect all the gemstones of the year.
I was like, oh, it's tiring.
You're like, I had all the variants.
I had all the variants.
People were like, you should add that to your resume.

(27:50):
I was like, should I?
Yeah, you should.
You've got all the expertise.
Though I just only had this last XBB-15 or whatever's going around now.
I had gone three years without having it.
And I was actually shocked when I tested positive because I'd been wasting so many tests over
the last three years because every little sniffle, I'm like, oh, I've got COVID and
I'm testing.

(28:10):
I get it.
I get it.
There's another $25.
But yeah, I am shocking.
I was like, oh, this time it's real.
It's real.
It happened.
It finally happened.
When we're talking about COVID and this topic of disease, it definitely does not affect
the person who was inflicted by it.
But basically everyone around us, our loved ones, our community, when we're here in New

(28:32):
York, when you go on the subway or we talked about kids in school, we talked about vaccination,
immunization.
And I feel like a lot of epidemiology, it's like linked and has a sisterhood with the
field of public health.
Right?
It's like, you cannot separate the two.
And I know that you have a certificate in public health and most of the work you're

(28:54):
doing now is also in public health and you do obviously a great deal of education to
the public regarding all of these matters.
To you, what does public health actually mean?
So epidemiology is the science of public health.
So we are part of the team.
So I mean, I could give the textbook answer of like our role and stuff.

(29:17):
But what I will say is what it means personally to me is just caring about other people, taking
care of your community, doing your part to keep your community healthy.
It's very much a community mindset.
Right?
And it's basically like, you know, that's been the most surprising thing in this pandemic

(29:39):
to me is that I feel like for the first month, everyone was community minded.
Everyone's like, stay home and be safe.
And everybody was kind of doing happy hours on Zoom and everybody was kind of doing their
part.
But as time went by, there was a real like, you can't make me wear a mask and you can't
make me get this and you can't make me do that.

(30:00):
And it just really kind of became this like toxic individualistic kind of, you know, some
people were in that kind of camp.
And then there were still people in the I wear my mask to protect others camp.
And like, so that was just shocking to me because in the face of a pandemic with a deadly
virus, I just never would have imagined that that would be the way people were thinking.

(30:24):
But to me, that was counter to public health.
That's almost sentiment.
Yeah, definitely.
I mean, I completely agree with that.
We're like thinking alike because when I think of public health, I also think of like caring
for others, right?
Like to beyond the textbook definition, beyond all the logistics of public health, it's really
just like caring for our community, caring for our loved ones.

(30:45):
Right?
And I think this was tested and shown through the whole vaccination series, especially I
remember, I think I was one of the first people in my hospital who got the first dose of the
Pfizer vaccine.
But I think I guess it was December of twenty.
Twenty twenty.
Twenty twenty.
Twenty twenty.
Twenty twenty.

(31:06):
Yeah.
That was when I got it too.
Yeah.
Yeah.
And I was like, it feels like this rewarding moment of, you know, not just protection for
myself, but protection for people.
But I wanted to ask you is we have seen the waves and the waves of the trio and bipartisan
debate when it comes to immunization.

(31:27):
I will divide this into two questions.
One as a scientist, what is the premise of vaccines just for the lay person to understand
and to what is it about the covid vaccines that was extra controversial as opposed to
the other vaccines that we know also have controversies amongst the public and people

(31:49):
who have been vaccinated or assisted.
But what is said about the covid 19 vaccine?
Yeah.
So I mean, just basically for for everybody, the premise of vaccination is to give you
a little bit of like a piece of a virus or a deactivated virus or in this case, an mRNA,
like a piece of directions on how to make proteins to fight a virus.

(32:12):
So it's it's just basically a safer way for you to build immunity against a disease that
can cause a lot of harm otherwise if you just get it without that.
So I was very grateful that I was vaccinated when I got covid a couple of weeks ago because
I basically slept a lot and had a sore throat and, you know, I didn't end up in your ICU

(32:34):
and I wasn't one of your patients.
I was just a pest calling my doctor for packs a little bit and sleeping.
So I mean, that was a safer way for me to build immunity by getting the vaccines and
keeping myself current with the boosters because the booster then gave a new piece of information
to my body by giving a little bit of the Omicron variant.

(32:57):
So it's like, you know, because before we only had the vaccine to the original virus.
And as we all know, it's changed a lot.
So your second part of your question is, I honestly believe that the resistance to covid
vaccine and the political stuff really started because of misinformation.

(33:17):
It started with misinformation about covid.
And that was to your original point, like a like a while ago when we were talking about
like what kind of started us doing social media is that's really what started me doing
social media too is because I started seeing, you know, I was like I downloaded Tik Tok
at the beginning of the pandemic just because I was bored and I'm scrolling and, you know,

(33:38):
watching videos and whatever.
And eventually the algorithm starts to show you stuff you're more interested in.
So it started selling, you know, sending me like health videos.
And then I got one, you know, all about how covid was a hoax to throw the presidential
election.
And I'm like, but covid is all over the world.
Like, what are they talking about?
Like, it just made no sense.

(33:59):
And as an epidemiologist, I felt like I was motivated by some sense of duty to like put
out real information because I'm like, well, this is ridiculous.
Why are people saying this?
And so obviously there's there's two different kinds of misinformation.
There's misinformation that people just propagate and then there's disinformation that people

(34:19):
create and those people who create disinformation have a motive, whether it's money or power
or political gain or something like that.
There is some kind of motivation behind the spreading of disinformation.
And misinformation is like your aunt sharing a meme on Facebook because your neighbor sent,

(34:40):
you know, like that's it's bad and it's a really big part of the problem.
But they're not like the creators of the misinformation.
And a lot of times they probably forward it thinking it's true, you know.
So I think that the disinformation spreaders just kind of got a taste of that grift.
And then it became impossible for them to give it up because it was like so, you know,

(35:03):
they've got substacks.
They have Facebook pages that have a link that has like a storefront with products they're
selling vitamins, supplements.
You don't need the vaccine.
Take these supplements and they're all one hundred dollars a bottle.
You know, so I think that the misinformation just kind of went wild and then it became

(35:23):
partisan and because there was also political gain to be made by disinformation.
So that's my guess on why the covid vaccine got because the pandemic actually gave all
these people an opportunity, right?
To disseminate this bad information because it's profitable.
Yeah.

(35:44):
And if you like, many people don't know how rich the anti vaccine is.
They're billionaires.
It's a billion dollar industry.
Absolutely.
And the social media platforms, high Instagram, if you're listening, are complicit because
they make advertising dollars off of the viral videos.
And so they're complicit as well.
So it's everybody's got their little grift going on.

(36:07):
And misinformation and disinformation tends to go viral more so than like me making a
video saying you should wear a mask.
Right.
So if somebody is saying, well, like masks don't work, masks cause health problems, that
video is going to go viral because people are like, oh, this is what the government
doesn't want you to know.
You know, like that kind of thing.
So those videos tend to just go like wildfire.

(36:30):
Those are the videos that are making everybody money.
You know?
Yeah.
I mean, it's really crazy how the algorithm works, right?
Especially on Instagram, especially on TikTok.
Now for some reason, like I'm not getting any more TikToks on my for you page about
like updated booster guides.
I'm not either.
Right.
But I'm still seeing some misinformation videos about COVID.

(36:53):
And so from the expert, let's change everyone's algorithm through this video.
I know it's really weird too.
Cause when I start following somebody on TikTok, I stopped seeing their videos.
It's like, it keeps sending me more people or something.
So I guess you can create the algorithm now for people.
What are the updated booster guidelines and where are we now in this pandemic?

(37:14):
Yeah.
So if you haven't gotten a booster since September, so a new booster came out in September
and it's was for Omicron.
So if you haven't gotten any COVID vaccines since September, you can get this booster
that's out now.
So what is different kind of that is happening now versus last year is that we had a booster

(37:36):
every like six months before that we could get.
And now we're kind of waiting and just going to have, I think a booster once a year for
most people.
So it'll be like your fall vaccines, like your flu shot and it'll be, there are people
that really want a booster now.
And I was one of those people like exactly six months I got COVID, right?

(38:01):
So there's people that really want a booster, you know, and I think that if you are immunocompromised
are 65, like, and you really want one and you're nervous or you are going to fly to
Europe or something, you know, talk to your doctor, you know, definitely talk to your
doctor and see if there's a case to be made for you getting another one.
I don't, I don't know what they'll say, but for most people, I think they want us to be

(38:24):
on that annual fall schedule.
And the reason for that, that's positive is that, you know, we have coming out the lower
is because people just don't really understand that it's a new one and that they don't know
if they've gotten the new one or the old one.
And it's confusing to people when they're coming out all the time.
And the communication has not been stellar about the boosters.

(38:46):
So having it the annual booster, people are already used to that, right?
We're already used to getting a booster in the fall.
So that's, I think, what's going to happen.
Although the one kind of strange thing about it is that we really haven't really established
this winter seasonal pattern with COVID.
Like we've still been seeing summer surges and things.

(39:08):
So hopefully that will happen.
Hi friends, doing a quick interruption here.
I hope you're enjoying this episode so far.
As I mentioned in the intro, this episode with Dr. Kat was recorded way back on April
11th, 2023, which is almost a year ago.
Definitely the guidelines when it came to COVID-19 vaccinations set forth by the Centers
for Disease Control and Prevention, the CDC have changed up to today, Friday, January

(39:33):
26th, 2024.
In the spirit of remaining as up to date with the current data as possible, I will summarize
the updated guidelines that the CDC has uploaded in its official website as of January 10th,
2024.
There are different immunization guidelines for both children and adults.
But for the sake of our podcast audience demographic, our upcoming information is applicable to

(39:54):
adult vaccine recipients only.
So as of January 2024, the CDC recommends that 2023 to 2024 updated COVID-19 vaccines,
as from Pfizer, BioNTech, Moderna or Novavax to protect against serious illness from COVID-19.
These updated vaccines more closely target the XPB lineage of the Omicron variant and

(40:17):
could restore protection against severe COVID-19 that may have decreased over time.
Now if you are aged 12 years and older and you have gotten a COVID-19 vaccine in the
past before September 12th, 2023, you should get one updated Pfizer, Moderna or Novavax
COVID-19 vaccine.
Now again, if you are aged 12 years or older, but you've never been vaccinated for COVID-19

(40:40):
at all, you still get one dose of the updated Pfizer or Moderna vaccine, but you would need
two doses of the Novavax vaccine, 8 weeks apart.
Additionally, if you recently had COVID-19, you still need to stay up to date with your
vaccines.
But you may consider delaying your vaccine by 3 months as reinfection is said to be less
likely in the weeks to months after infection.

(41:02):
But the CDC does recognize some factors that may be reasons to get your vaccine sooner
than later, such as personal risk of severe disease like being immunocompromised, what's
the most common variant right now, your local COVID-19 hospital admission levels and the
risk of disease in a loved one or close contact.
I hope all this updated information helps.
Please visit CDC's website, thecdc.gov for any updates and guidelines and definitely

(41:27):
speak to your doctor about it.
Let's get back to our episode.
Aside from like not seeing videos about it now, like booster requests, again, I was talking
to someone the other day and they're like, oh, there was a new booster out.
So I feel like the dissemination of news is also very, you know, if you any comes to this,
right?
But in another light, as we mentioned, monkeypox earlier, monkeypox, I think during the summer

(41:51):
was like, it was so, so high up in the news.
And all of a sudden also like disappeared from the news right away.
What was it about monkeypox that it got everyone so afraid and then all of a sudden disappeared
in the news?
So there's a couple of reasons why that disappeared.
One was because we had a vaccine already that we could deploy for monkeypox.

(42:14):
So for anybody that doesn't know, monkeypox is part of the orthopox virus family and smallpox
is part of that family too.
And the smallpox vaccine that's already approved by the FDA was able to be used for monkeypox
because they're very similar, not similar in their case fatality rate, but they're similar

(42:35):
viruses enough so that the vaccine works for the other one.
They're like cousins, cousins, not siblings.
So that was one reason we could vaccinate kind of relatively quickly, although there
were some hiccups with the different dosing and all that stuff, but they did get the vaccine
out to people.
Secondly, the LGBTQ AI plus community was, I want to be as inclusive as I can here.

(43:04):
That community was extremely compliant with public health measures regarding monkeypox.
So they got their vaccines.
They went to these community meetings, at least here in Chicago, we had community meetings
at bars, at sex clubs, at all kinds of stuff.
We had at market days, our big festival every summer, there were health booths that were

(43:28):
from the Chicago Department of Public Health where they were giving vaccines.
There was a lot going on around dissemination within the community and the community itself
was really compliant.
So behavior change was huge, limiting sex partners, limiting sex from apps, limiting
going to sex clubs, like all of that dropped because we did surveys in Chicago and all

(43:50):
that dropped by like half.
So our curve in the US went up and then it went down because A, vaccine and B, the community
was just stellar with behavior change.
Same in New York.
I was working in Mount Sinai and I know they were sending out flyers of any volunteers
who wanted to do surveys or promoting the flyers with the vaccine sites to clubs and

(44:16):
to restaurants and to sensors and stuff like that.
Here in Chicago, we had a couple of meetings, Zoom calls with some of the people that were
coordinating these events and the owners of the bars and the owners of the clubs, they're
older people who've been through this before with AIDS, right?

(44:36):
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They were, you know, and they're the role models for the community and they really stepped
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(48:12):
Express yourself and apologetically.
A lot of this information is so hopeful, right?
And it's like, oh, we have research, we have immunization, but it's also a subset of people
that everything that we've been saying is probably so confusing to them, right?

(48:34):
And I think it's also due to the fact that, especially for sure in the early rises of
COVID, there's like so much information going around.
Again, sound information, misinformation, disinformation, but I think also from the
official centers of guidelines.
Absolutely.
It's like, the WHO calls it an infodemic because there's this info coming in from all directions,

(48:57):
good, bad, and everything.
Do we mask?
Do we not mask?
This it?
Is this not it?
Like, what do we do?
I feel like everyone's like, do we do this?
Do we do that?
Do we do that?
Or do we not?
What you just said, actually, if you don't mind me just jumping in for a second, is another
problem when you say, do we mask?
Do we not mask?
There was so many dichotomies set up during this pandemic, like I'm not getting vaccinated,

(49:19):
I am getting vaccinated, I'm not wearing a mask, I am wearing a mask.
All of this stuff is just the wrong way to go about this.
What we should have done from the start is kind of set up like a continuum.
When rates are high, we do, and we did this towards the end, but it was not soon enough.

(49:41):
It was like when rates are high, more layers are needed.
When rates are low, you can maybe get rid of a couple things or open restaurants or
like things like that.
But we didn't do that.
We did do the all or nothing kind of like we don't have to mask anymore.
We do have to mask again.
And that is not, I just don't think people really understood why the choices were being

(50:03):
made because people weren't following the data as closely.
And it just seemed very arbitrary flipping back and forth.
Hi, another interruption.
As Dr. Kat and I mentioned, there is a lot of confusion when it comes to recommendations
and guidelines when it comes to the mitigation of contagion and prevention of disease due
to the melting pot of so many sources of news.

(50:24):
In this upcoming recent transcript from Dr. Kat herself from December 22nd, 2023, she
lays down what we're seeing around us.
Because as you know, everyone has been sick recently.
Is it COVID?
Is it flu?
Is it RSV?
Let's hear what she has to say.
We have a lot of sick people right now with colds and flus and all kinds of things.

(50:45):
In terms of COVID, we have many variants circulating.
And when we have this kind of potpourri of variants, it really increases our chances
of getting reinfected.
Also, we are seeing many, what we call novids, getting COVID now for the first time.
And this may be due to this rapid increase in the variant called JN1 that we're seeing.

(51:09):
And this proportion of this variant rose from about 8% of cases at the end of November to
estimates of about 40% or even more in some parts of the country now.
So it contains mutations, this variant JN1, that make it more contagious.
However, JN1 does not appear to cause greater severity than other SARS-CoV-2 variants.

(51:32):
Evidence does suggest that the new vaccines should be effective against JN1 and home tests
do work.
The uptake on the new vaccine has been very, very poor.
Make sure that if you have not already gotten your booster, that you schedule an appointment
because this is the best thing you can do to prevent severe COVID.
Flu is really taking off.

(51:53):
We are heading into peak flu season.
As always, we have a safe and effective flu vaccine widely available.
And remember that most of the things we learned over the past few years that prevent COVID
also prevent other respiratory viruses.
Moving into our holiday gatherings, this is what I recommend that you do.

(52:14):
I would test if you're symptomatic or test following any COVID exposure that you have.
I would test before gathering with family and friends no matter what to make sure that
you're not asymptomatic.
Make sure that you practice good respiratory etiquette, cover your mouth.
Also, masks do work and it's very recommended to wear a mask in crowded or poorly ventilated

(52:40):
areas.
It gives you an extra layer of protection in times like this when there's a lot of
COVID around.
Definitely stay up to date with your COVID flu and the RSV vaccine if you are eligible.
And most importantly, stay home if you are sick.
Do not attend that gathering if you are symptomatic or if you are sick.

(53:03):
It isn't worth it.
People were afraid, you know.
Of course.
Of course.
People were concerned and just, besides just afraid of going out, people's families were
in the hospital, right?
It's like, so what do we do?
What do we do to not end up in the same situation they are in?
And I feel like guidelines were also like, I mean, that's science, right?
Guidelines are updated, new data comes out.
Right, with data, yeah.

(53:23):
And the way that it was disseminated from the government, right, too, it's like, so
people...
It was confusing.
It was a very...
And especially the first year was just like, nobody, yeah, it was very hard.
And that's really why I kept kind of making videos because I felt like people didn't really
understand.
I would walk through papers, because we didn't have that much data at first.

(53:47):
So it's funny, like the first 2020, we didn't really have any data.
We were basing everything on viruses from the past, like the way things usually go or
something.
But then when we started to get data, and I would literally walk through papers and
show people the data.
And I think data is soothing, like data is calming to people.

(54:08):
Even when it's not completely positive, at least it gives people the sense of empowerment
of understanding that I think really helps.
Just at least knowing what's going on and having somebody walk through and say, okay,
this is bad because this is above that, and that this is significant.
So I think that helps.
And in that topic of data and coupled along again with the fear and the confusion of the

(54:32):
public, so who should people listen to in times of confusion?
Which is the data that the public should go to?
So I think that the WHO, the CDC, they put out good infographics.
I just don't think that they always hit on the hot topics that everybody wants to know
about.

(54:53):
And the issue is, I think that they are doing their best, but things move very slowly in
these big institutions.
So the misinformation, unfortunately, moves a lot faster than the good information.
Because when they're putting out an infographic, the reason there's no mistakes in it is because
probably 100 people sign off on it before it gets posted on Instagram.

(55:16):
So they're great, but they just aren't quick because there's just so many eyes that need
to look at it.
So that's kind of the void that our science communicators are filling, because we're reading
the papers and we're reading the literature and we understand that stuff.
So we don't need to go through 100 signatures to put a video out.

(55:37):
So I feel like, and I'm not trying to say like everyone should listen to me, but there's
tons of good ones if I'm not your cup of tea.
But I think that anybody that's educated and speaks to their field and is trained is good
to listen to.
But obviously, I always default to the data, like the actual collected data at the WHO,

(55:58):
the CDC, the official data sets.
Yeah, I mean, honestly, it's so refreshing to hear and receive information from those
who are actually, you know, doing stuff.
Right, and you too, like you're treating patients like the what's really infuriated me throughout
this pandemic is medical professionals who maybe aren't certified anymore or don't treat

(56:22):
COVID patients going online and saying, I'm a nurse and who knows what that even means?
Are they like a nurse's assistant from 10 years ago or like, you know, saying like,
don't take the vaccine.
I'm a nurse or, you know, Dr. Malone, he's a some doctor in a different field that's
not even infection, you know, it just makes it makes me crazy.

(56:44):
So like you are actually in the emergency, you are in the ICU treating patients.
And you know, so it's very your experience is very valuable to people.
Yeah, I mean, you know, being in the COVID ICU during those times, I mean, again, it
feels like a dream, a bad daydream at times.
I mean, I can just remember, you know, all the patients had to be intubated.

(57:08):
I mean, using my this phone, this same phone to FaceTime family members, it's a good
trauma, right?
For the last time and I remember holding the patient's hands and they're like, you
know, as they take their last breath.
And I think a lot of this may not have been shown in media.
No, because of that, because of that, a lot of fear and fear mongering came out.

(57:32):
And I think the reactions of the public who may not see these things, right, or may not
be trained to interpret data as you are right, definitely fear and anxiety is a very valid
and appropriate response to all of this, right?
As the expert in this and as someone who's like educated about diseases and see real

(57:54):
time data and also, you know, educate students about this, there is someone and I'm sure
there is someone out there in the world who's just like, until now, just so afraid and fearful
and anxious of everything that's going on.
Right.
With your expertise, what would be your message to that person?

(58:16):
So if there's different fears, right, so there's vaccination fear.
And I talked to a lot of those people because they'll DM me.
And sometimes they're disingenuous questions.
But sometimes people are really just genuinely afraid.
I had one person once a year and a half ago or something telling me that she wants to

(58:37):
get vaccinated, but she can't tell her husband because they are together anti-vaxxers.
But she was terrified of getting covid without being vaccinated because they had a couple
friends end up really severely ill.
And it just I just don't I can't really relate to seeing people severely ill and then still

(59:00):
deciding like, oh, I'm good.
You know, it just doesn't make sense to me.
But you know, but people are scared of vaccinations.
And I tend to like for those people, I try to get to the bottom of what the hesitation
actually is, because it's very it's very all over the map.

(59:20):
It's like there's cultural reasons, mistrust of the health care system.
There's you know, people's parents put the fear of God about vaccines into them and now
they're 18 and they don't know what to do.
And then there you know, there's tons of different reasons.
And so like really listening to the rationale of why they're scared and why they aren't
vaccinated is very helpful because sometimes it's just plain misinformation.

(59:45):
But other times it's more complicated.
And the person is doesn't fall neatly into that like anti vaxxer box, you know.
So listening with empathy and really kind of trying to talk them through their actual
fears, it helps because sometimes they get to the idea on their own.
Like you say, well, why do you feel that way?
Well, how did you make that decision that that was scary?

(01:00:06):
And sometimes they realize there's not based on anything, you know, it helps for them to
have somebody to talk to and just to ask questions, just to keep them talking about it.
And being fearful of covid is a little bit more difficult because, you know, we have
seen people get severely ill from covid.
But you know, if people are vaccinated now, we do.

(01:00:26):
I'm not saying there is no long covid and that, you know, we shouldn't be worried.
And I will definitely still be continuing to mask in indoors and things like that.
But I do think that if you are up to date on your vaccines and as soon as you test positive,
you get tax-loved, your chances of getting long covid or some kind of sequelae, I think,

(01:00:48):
are probably pretty low.
I mean, we might find a year down the road that that's wrong.
But at this point, it seems like this is working against severe illness.
Obviously, having covid is not fun at all.
Three times in a row, no.
Yeah, I get.
Yeah.
And they're all they were all different, right?

(01:01:09):
So the first talk about that, maybe because that's really interesting for people.
I'm sure the first one I had, the first one I had was September of 2020.
So there was no vaccines yet.
No, exactly.
That one was probably I thought I was going to take myself to the emergency room.

(01:01:30):
I probably should have.
And that was the time when I locked myself in the basement for 14 days.
I think that was the guidelines before.
Like I know I live with my mom, who's also a nurse, and she also working the curvy disease.
So you're always getting like, oh, my gosh, you work in the same hospital.
They're hospitals.
So that would have been so that would have been so funny.

(01:01:51):
Yeah.
So I got it first before the first one.
The first time I got it, I had it before the vaccines came out.
And how old was I that time?
I think I was 23 that time.
And, you know, healthy.
I had no I had no really active medical problems, but I was like, oh, my gosh, I cannot breathe.
I had the post-oxidant.
Oh, yeah, because that's what they say to go when you can't breathe.

(01:02:14):
You should have probably gone.
Once my resting oxygen rate, 89 percent, then I'm just like laying down.
And then so I actually had to take a trip to the urgent care and get some like, you
know, some after steroids.
And I really thought I was going to not make it.

(01:02:34):
And then the second time I had it was the summer after the vaccines came out and Delta
second time.
I was like, OK, I had one day of fever, two days of sore throat.
And then I was like up and running after that.
Well, you had that nice hybrid immunity that not a lot of people had at that point, too.

(01:02:55):
So wow, that's crazy.
The third time it was after I think I had the first booster, like a month or so later.
And that was even quote unquote better because I had a fever for one day, sore throat for
one day.
And I was like, obviously, I still did my isolation precautions, my quarantine precautions.

(01:03:15):
I was like, I feel fine.
So I saw the difference.
It's amazing.
Pre vaccination and the post vaccination and the post booster effects of COVID.
Oh, that's right.
That's really interesting.
So you did have the entire continuum of.
Yeah, I did.
And now you've got like all the antibodies.
I should get my antibody count.

(01:03:37):
I should get my titers and see how it is because my friends are like, it's probably up the
roof because you have the hybrid immunity.
You know, I don't think that matters, the number.
It's well, it might.
So here's the thing.
I get that question a lot, actually, because people who have COVID, then they want to know,
do I really need to get a booster because my antibodies are really high?

(01:04:00):
And I'm like, well, that doesn't really correspond to anything clinically.
Like we've never done validation studies on that number to say like this number means
you're immune and this number under that number means you're not.
Those studies have never been done.
So I always tell people like you can do whatever you want, but I can't give you a cutoff.

(01:04:22):
Yeah, there's no numerical cutoff for that.
Right.
Yeah, but it's just it's just been again, it's been such a whirlwind the past few years.
I know this feels like therapy.
Thank you so much.
I feel like I should pay a co-pay.

(01:04:44):
I'd be happy to accept it.
Just kidding.
And you know, I will say, and this is not flattered, that one of the highlights of the past three
years and even though how rough it has been was really stumbling upon a lot of, you know,
science communicators online.
Same.
Yeah.
And one of them being you.

(01:05:04):
I mean, people tell me all the time, like, oh, you helped save lives.
Like, yeah, it is our job.
But also, like the amount of information that you put out, like using people's fears and
people getting that sense of encouragement and that informed decision to get vaccinated
or wear your mask.
It's just it's just priceless.

(01:05:25):
And I just want to thank you for all you do.
Thank you.
That's so nice.
Well, I feel like the same.
And the silver lining of the pandemic, I say this all the time, was meeting other cool,
like minded science folks that because that's been awesome and from all over the place.
Right.
We all were sort of like forced together in our phones.

(01:05:45):
Right.
So it's like we all met each other just because of this.
Really.
I mean, there would be no other reason we would have all been so, you know, together talking
all the time if it wasn't for this.
So that's been one silver lining is the connections that I've made.
Me too.
Dr. Cat, it's been such a huge honor and such an enjoyment to talk to you and learn so much

(01:06:09):
from you.
And thank you so much for saying yes to this.
Oh, my gosh.
I'm of course I'm honored that you asked me.
I'm glad I'm like cool enough to be a friend of Franz.
Oh, please.
I mean, you're a skin doctor.
What can I do?
I know, right?
If you have any blemishes, I'm your girl.
You have that epi-derm physiologist.
Though your skin is so beautiful and you probably never do.
Dr. Cat, thank you so much for being here.
I'm so glad to be here.
I'm so glad to be here.
I'm so glad to be here.

(01:06:29):
I'm so glad to be here.
I'm so glad to be here.
Dr. Cat, thank you so much again and thank you everybody for joining.
Yeah, thank you for joining.
This is really fun and your questions were really good.
You kind of made me think.
That's what I like to do too is thinking all the time.
I'm like I have to ask her this.
Thank you so much.
I hope you get rest for the rest of the night.

(01:06:50):
Thank you.
Bye.
Bye.