Instagram's Favorite Infectious Disease Researcher on Our Nightmare Year

In between ads for butt-less pajamas and photo spreads of celebrities having enormous, regrettable super-spreader parties, the odds are very good that you’ve seen Laurel Bristow on your Instagram feed over the last few months, talking about COVID-19. Bristow, an infectious disease researcher, has been studying COVID full-time since March. Her work focuses on treatments for hospitalized patients and the body's long-term immune response, as well as supporting the phase 3 clinical trial of the Moderna vaccine. Early in the pandemic, in her limited free time, she started using her personal Instagram page, where she goes by the handle KingGutterBaby, to demystify the latest research and other COVID developments for her friends.

It was, as it turned out, a grim sort of hit: today, Bristow has over 300,000 Instagram followers, who come for her lucid, funny, direct explanations of the latest COVID and vaccine research, her impassioned debunkings of ridiculous lies and dangerous faux cures (no, you should not take veterinary Ivermectin as a treatment or preventative for coronavirus) and zany stress-relievers, liked her “COVID Comedown” series, in which she merrily answers questions about anything other than the disease.

By presenting the science in such a clear, approachable way, broadcasting from her kitchen, Bristow understands that she’s been able to build a level of trust with her audience, she told Mother Jones in July. “We’ve built social media platforms in a way that people trust individuals accounts and are more inclined to listen to what they’re saying—whether it’s right or wrong—than they are to a government agency that feels outdated and inaccessible.”

But this year has been far from easy, for Bristow or for anyone else. VICE News talked to her about how she’s feeling about the various nightmare events of 2020, as well as mental health, caution fatigue, holiday travel, COVID mutations, and how we move forward through the next, likely very bad few months. “Unfortunately,” she told us, “I do think it's going to get worse before it gets better.”

This interview has been lightly edited for clarity.

VICE News: You've become a trusted source on social media for clear, scientifically accurate information about COVID-19, and you do it while being incredibly funny and often surprisingly upbeat. But this can't have been an easy year. How are you holding up? Are you feeling much relief now that people are finally being vaccinated on a larger scale?
Laurel Bristow: It's definitely hard to maintain my positive attitude or patience and I certainly slip sometimes. But I have the benefit that what I do is recorded, so if I'm having a particularly difficult day I can choose to just put it off until I regain my composure.  I think it's like being in crisis mode all the time.  I'm exhausted, but the people who are emailing me questions are really in a state of panic, which makes it easier for me to maintain a level head, because I have a job to do and I can help reel their anxiety in, which I like.  

The vaccine being available now is having a strange effect on my emotions, honestly.  It's so much relief, while also feeling scared that something will happen and take this away from us. It's the first opportunity in 10 months that people on the frontline have to do something that will directly protect us, rather than everything we've been doing (like masks and distancing) that we need to depend on OTHERS to do for us to benefit from it.

How worried should we be about an even greater surge in the next few months? We saw enormous crowds at airports for Thanksgiving and it seems quite likely Christmas will be the same. 
We're definitely in a bad situation where we are still seeing the effects of Thanksgiving gathering as we head into Christmas.  It's such a defense mechanism for my brain to prevent me from thinking about how it could get worse than it 's been the last month but ... unfortunately I do think it's going to get worse before it gets better.

There's been a lot of discussion this past few months of "caution fatigue" around COVID. Does this feel like a real problem to you, and if so, what should we do about it? If you're someone who cares a lot and has remained super cautious, are there ways to get through to friends and loved ones who are starting to get tired of being so restricted and might be starting to make unsafe choices?
People in a lot of places, especially the U.S., have been put in such a hard situation of being told what they need to do to stop the spread, while also not being supported to do those things.  I completely understand how exhausted everyone can be, but I think you have to remember the sacrifices we make aren't for nothing.  Altering your plans or your mitigation strategies can help save lives of vulnerable people and frontline workers.  It takes extra work to think things through or adjust plans to make them safer, but it really is worth it.

Cases are worse than they've ever been in some of the United States. For a lot of people who went through a horrible case surge back in April and May, for instance folks in New York, this feels like awful deja vu, and it's pretty brutal on folks' mental health. Do you have coping tips that have worked for you?
It's been really difficult. I have never hated being right so much in my entire life.  I like to remind myself of how far we've come in our understanding of this virus, and that we have such a better understanding of risk stratification of activities, which allows me to make choices that I feel more confident in, to keep some semblance of connection with the outside world. 

It's largely why I spend so much time explaining things on Instagram: because I feel like my understanding of the pandemic means that I’m not living in constant fear and anxiety and I want that for others, too. I think it's really helpful to remember that people who lived through the 1918 flu pandemic probably also thought it would never end, but it did.

I noticed that you used what seemed like harm reduction techniques in talking to people about going home for the holidays: acknowledging that it would be best if they didn't, but giving tips for how to reduce risk in the event that they chose to go. You also talked about how you joined your family for Thanksgiving, using a "holiday infection prevention plan," as you put it.

Do you think harm reduction is a more effective model for helping people behave more safely during the pandemic? Or is it likely that a lot of people will just do risky things like gathering in groups indoors, but tell themselves they're doing it "safely"?
After grad school I started working for the San Francisco Department of Public Health in the HIV prevention section, which is where I really learned about implementing harm reduction firsthand. There's some debate right now about if "harm reduction" is an appropriate term for our approach to COVID because traditional harm reduction provides resources (like clean needls for IV drug use, free condoms and testing for sex workers, naloxone access etc.) and really with COVID all we are currently doing is messaging.  We're telling people what strategies they can use without always having a realistic way to implement those.

So I think in that regard, harm reduction COULD be a very useful tool if we dedicated resources to support it.  It doesn't help to tell people they can lower their pre-holiday quarantine time to seven days if the only testing they have access to is for symptomatic people or takes five days to results. It doesn't help to tell people to gather outside if they live in a freezing area and there are no spaces designed to keep them warm, etc. etc.  I think there is benefit to a "harm reduction" messaging campaign, but to really make it effective we need to increase the resources to support the message.  But with how bad things have been, for the people who are going to gather regardless, I will take any percentage of risk reduction I can get.

I have to imagine that for someone who's spent the entire pandemic thinking about COVID, interacting with COVID patients, and working to get us out of this mess, it has to be really frustrating to see the large-scale misinformation that's been circulating about the disease. Now, of course, we're getting tons of COVID vaccine conspiracy theories. How are you choosing to address (or not address) those? Recently you were getting baited by an anti-vax account and you very clearly chose to respond to the misinformation without naming the person directly or tagging the account. Can you talk about that?
It's really a situation of "pick your battles" for me.  Luckily, the conspiracy theories are almost always based in cherry-picking data or pulling things out of context, so you can quickly debunk them, which, if I am in the right mindset, can be really cathartic. 

It's also been really important to remember the difference between people who are "anti" something and those who have genuine hesitancy or questions about why we do what we do. I want the hesitant people to be able to come to me and get information to answer their questions and concerns. People who are straight anti, the ones who won't do it and also don't want anyone else to do it, are the people I am less gentle with, but I try to stick to ripping their arguments to shreds, rather than them as people.

For the most part I will get an attitude about the claim and not even mention the person, because I don't care who's posting it, just what misinformation they're spreading that I can clear up for someone who have genuine concerns or curiosity.

Is mask hostility/"COVID's not a big deal"-ism something you've encountered IRL, and how do you choose to handle it?
It's not really something I've had to experience first hand because ... I don't go anywhere.  There certainly have been acquaintances on social media I've unfollowed or muted.  It feels very hurtful for someone who knows me personally, who sees what I deal with, to not only disregard what I'm saying about the state of COVID in the country, but to also vocalize how they doubt it. 

We're dealing with public concern right now around COVID mutations. You've discussed this a bit on Instagram, but just briefly: do you find these apparent mutations concerning? Do you think they got too much press coverage?
I think everyone loves a zombie movie and focusing headlines on mutations is an exciting way to get clicks, but the reality is viruses mutate constantly, and for the most part it doesn't impact anything about them.  I've had to talk about virus mutations at least three times now and the ending is always the same "no change in severity of disease or how lethal it is. No concern it will affect the vaccine’s ability to work."

I think people are also scared something will happen to take away the glimmer of hope we have now that a vaccine is available, but even something like the flu (which is known to mutate rapidly) still takes years of mutations before it renders our vaccines ineffective.

Similar to that, we're starting to get a lot of stories about "long COVID." Is it your sense that people really can suffer permanent health effects from COVID? I'm a little worried by the very broad ranges of symptoms I'm seeing attributed to it, and concerned it's going to be a magnet for profiteering health quacks and bogus cures. 
Well, I certainly hope they're not permanent. It's been less than a year that the virus has been in the U.S., so here's hoping the worst of it is still self-limiting. But I do agree it's something that is happening and needs to be given proper attention, because if evidence-based medicine overlooks it, pseudo-science areas will be more than happy to tell people they have the answers, which would most likely prolong suffering.

Going back to those crowds at the airport for Thanksgiving—it seems obvious that U.S. policy has massively failed to keep us safe during the pandemic, but it also feels a lot like individual people are just hellbent on making bad or selfish choices. Are you feeling any anger or disappointment at your fellow Americans here? How do you manage those feelings, if they're coming up? Did we just completely blow it?
It's been a long, exhausting 10 months and I've really gotten to the point where I just had to accept that there will be some people who will disregard all the rules or precautions and hold on to the idea that COVID is a hoax and a lot of those people will be just fine, and that will make them think they were right. And there's nothing I can do about that but let it go and try to focus on people who are good and want to help and just need that motivation to keep going. 

All I can do is take comfort in the fact I am doing everything I can to protect others, and that is the life I want to live.  I think we suffered from a lot of mistakes and hubris early on, but it's never too late to change directions and start implementing strategies that will benefit everyone. 

I, like everyone else, am extremely ready for COVID to be over and I want to get out of it as quickly as possible, even if that means that people who did nothing for anyone else during the pandemic get to benefit from our work.  It's a group project and at this point I don't care if they're just putting their name on it, as long as we still get that passing grade.

When do you expect you're going to be able to get vaccinated yourself? What's on your shortlist of post-pandemic things you're looking forward to? What's an ideal post-pandemic day look like?
Still waiting for my call to be vaccinated, but I'm not worried. It's got to be a logistical nightmare but I'm hoping to get dose one before the new year. 

For post-pandemic things it's pretty basic: hug my friends, see my family without agonizing about risks, sit at a bar and chat with the bartender.  Pretty much just looking forward to not having to think about COVID every minute of every day.