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Amanpour
Interview With Rep. Jim Clyburn (D-SC); Interview With "Sapiens" And "Unstoppable Us" Author Yuval Noah Harari; Interview With American Academy Of Pediatrics Committee On Hospital Care Chair Dr. Daniel Rauch. Aired 1-2p ET
Aired November 23, 2022 - 13:00:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
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CHRISTIANE AMANPOUR, CNN CHIEF INTERNATIONAL ANCHOR: Hello, everyone. And welcome to AMANPOUR. Here's what's coming up.
In America, no end in sight to the scourge of mass shootings. As leadership changes hands in Congress, Veteran Lawmaker James Clyburn, weighs how
government could respond.
Then, the worst violence in years in Jerusalem, as new Israeli leadership goes back to the future. Historian Yuval Noah Harari, takes the long view.
And.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE (through translator): Vladimir Vladimirovich, please return our children.
(END VIDEO CLIP)
AMANPOUR: In Russia, mothers speak out of the miserable conditions for sons fighting Putin's war in Ukraine. Also.
(BEGIN VIDEO CLIP)
DR. DANIEL RAUCH, CHAIR, AMERICAN ACADEMY OF PEDIATRICS COMMITTEE ON HOSPITAL CARE: I'm scared for later in December, and January, and February
when the staff just can't keep up this pace any longer.
(END VIDEO CLIP)
AMANPOUR: A surge of infectious diseases leaves health care at the breaking point. Hari Sreenivasan speaks with pediatrician, Dr. Daniel Rauch.
Welcome to the program, everyone. I'm Christiane Amanpour in London.
Today, Americans woke up to news of yet another mass shooting. This time, at a Walmart in Chesapeake, Virginia, on the eve of Thanksgiving. The
gunman and employee at the store, killed six people and then took his own life. That makes two mass shootings in Virginia this month, and seven in
America in the past seven days, including the weekend killings of an LGBTQ club in Colorado.
This summer, President Biden signed the first major gun safety bill in nearly three decades. But any new progress is unlikely. On January 3rd,
gridlock returns to Washington as the House of Representatives moves to Republican control, and a generation of leading Democrats steps down.
Representative Jim Clyburn of South Carolina, is part of the Democratic oligarch, he plans to stay on as a younger generation steps in. And
republic -- Representative Clyburn, welcome to the program. Thank you very much for joining us. Can I ask you first to weigh in on this terrible
tragedy that has become, as we, know a numbing, almost everyday reality. Am I correct in thinking that maybe nothing will happen because will gridlock
return?
REP. JIM CLYBURN (D-SC): Well, thank you very much for having me. You know, I'm very hopeful that the closeness of this election, indicates that the
country is moving back to the center at a rapid pace. There are all kinds of -- predictions. And so, what the outcome of this election was going to
be. Democrats are going to lose (INAUDIBLE). The lowest number on the Senate was 22, and that soared as high as 60.
Well, it's closer to six than 60. That indicated to me that this country appreciated the approach of Joe Biden, the electors (ph), the agenda of Joe
Biden. And in that agenda happens to be the Safer Communities Act. And if you go back to his very first bill, The Rescue Act, we had in that bill
over $500 million for safer communities. Cops, programs, and many other millions of dollars to do things that are necessary to address this
epidemic of violence, and most especially gun violence, that seems to be taking over the country.
So, I believe that Joe Biden and our own House Democrats is leading (ph) the country on the right track. Let's just look at what happened in
Colorado Springs. We put in (INAUDIBLE) bill to Safer Communities Act and it didn't amount -- to $300 million to deal with what we call, probably,
these ratified laws. In (INAUDIBLE) law there in Colorado Springs, according to the Department of Justice (ph) district attorney made the
impossible shares for them to use that law.
[13:05:00]
So, I think that we need to sit down in this country. Federal legislators, state and local legislators, and let's do what's necessary to make our
communities safer and to make our families more secure. That has to be done. And we have to stop succumbing to the gun lobby or any other special
interests and doing what is necessary to put people over politics. Politics is ruining this debate.
AMANPOUR: So, Congressman, we do want to apologize to our viewers. There's a little bit of crackle in the audio, but we can definitely hear and
understand you. So, let me ask you then, you say, put politics -- put people over this kind of politics and partisan debate. And let's not forget
that the majority of the American people support the kind of gun control that has been proposed, sensible gun control of all parties. The majority
of American people overwhelmingly support it.
But, do you think there will be gridlock? I kind of asked you that before because the Republicans have already indicated that they intend to go
political. They want to bring up, let's say, rather than gun safety, Hunter Biden. They want to bring up certain, you know, go for impeachments and
this and that. Do you foresee that that will be a sensible track for the Republican leadership?
CLYBURN: That may be the apparent track, but it's not sensible. That does not make any sense at all. This election result demonstrates that. And if
you look at these close elections, I can pick out two states, and in two states you will come up with any congressional districts. And you can go in
other states and get it out to tell where Joe Biden wouldn't loss districts.
And it comes in a very (ph) insinuating circumstances, we lost those districts. Those people who has to run again during the presidential year,
and they are not going to find favor (INAUDIBLE) going on and looking at Joe Biden's son and programs as it relates to his taxes or his misuse of
(INAUDIBLE). That is silliness.
We must do what is necessary to bring the American people into a secure place, to help their families and pursue a more perfect union. That is what
people voted for. And if they go off in that kind of direction, I think they will -- at the polls in two years.
AMANPOUR: Let me ask you to reflect then because I did also talk about changing leadership in your own party. We know that Speaker Pelosi won't --
you know, she's announced her intentions. Obviously, she's not running again for leadership. Her deputy is stepping down. You have asked to step
down as the chief Whip, but you're staying, I believe, in the next most powerful position. So, you'll still be there in that leadership.
But Hakeem Jeffries looks set to be the next Democratic leader in Congress. You have mentored him. For people who don't know him, what would he bring
to the table?
CLYBURN: He brings knowledge and hope, right. People talk about youth. We must have strength and knowledge. And he is the total package. He has been
involved in the legislative process at the state level. He has chaired our caucus for the last 14 years. People at our caucus have gotten to know him.
They respect him. In a way, he is very acknowledging, a very smart, astute politician. And I have been very pleased to work closely with him. And I am
going to do my best to make sure he gets all (INAUDIBLE) what we call down here in the south (INAUDIBLE). And that's what we are going to work to do.
So, yes, I'll step out on the line of succession. And with that, I am going to spend as much time as I possibly can to make sure that this, at all
cost, that black church, historic Americans and universities, (INAUDIBLE) start the process for centuries have not been put into this process and we
must have a smooth transition for us to keep moving toward a more perfect union and regaining our majority in the House of Representatives.
AMANPOUR: And just finally then, your reflections on the end of the Pelosi era, really. Such a formidable speaker, along with you all, her leadership
contingent has -- had time there.
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Obviously, she was the first female speaker. And if Hakeem Jeffries becomes, he will be the first black in any leadership position of any party
in Congress. But reflect on Nancy Pelosi in what is a change -- changing era.
CLYBURN: Nancy has been one of the most consequential political figures this country has ever produced. She came into politics looking for life, as
I did. And then, she is a preformist (ph) when she got elected into the House of Representatives. And, of course, she has blazed a trail that is
enviable by any standards. She, probably, will go down in history. Definitely would be of a most effective -- could very well be the most
effective speaker of the House that we have ever had.
And so, it has been a joy to be a part of that. And I'd like to see that as a foundation upon which the bill as she has -- she's leaving at the top of
her game. She's leaving our party in a very good place. We defied all expectations in this recent election. And laws are managing because we
stayed the course. People can't tell us that people are not interested in maintaining democracy. They're only interested in cheaper gasoline at the
pump and a cheaper loaf of bread.
Now, people who are in democracy will then fetch to purchase groceries and to afford to buy gasoline. And that's why President Biden's speech, which
hours among those urging him to make it of maintaining this democracy was so important that people are telling us, that's not with people's minds
were.
That's exactly where people's minds were. And those of us who are out there campaigning every day, listening to people, we knew exactly what were on
other peoples' mind. And we Democrats stay close to the people, we produced for the people, and maybe wanted us at the polls on election day.
AMANPOUR: An amazing story indeed. Representative Clyburn, thank you so much for joining us. And again, sorry for the slight audio problems. But
you could hear loud and clear the important message from Representative Clyburn.
Now, leadership is also set to change hands in Israel, as Benjamin Netanyahu, once again forms a new government. This time with the support of
far-right extremists. Meanwhile, two bomb attacks shook Jerusalem today, killing a teenager and injuring 18 people. Officials suspect, "A combined
terror attack." The first to target Israeli citizens in years.
Mass selling author and historian, Yuval Noah Harari, grew up amidst conflict in Israel. He's just written a new book called "Unstoppable Us".
To inform and inspire the younger generation, perhaps future leaders, to take on even the most overwhelming crisis as we discussed when he joined me
from Tel Aviv.
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AMANPOUR: Yuval Noah Harari, welcome back to the program.
YUVAL NOAH HARARI, AUTHOR, "SAPIENS" AND "UNSTOPPABLE US": It's good to be here. Thank you.
AMANPOUR: So, we speak on a day where there's been terrorist attacks, some kind of attack, that details are coming in in Jerusalem. It's a long time
since we've seen this kind of thing. Very sadly, a young Israeli Canadian, a 16-year-old has been killed. And there are reports that a Palestinian was
killed yesterday. Why do you think this is happening now after such a long time?
HARARI: I don't know. I cannot get into the minds of the terrorists behind it. It's a very painful day, especially it seems that they targeted young
people on purpose. That they -- deliberately chose to attack -- I mean, many of the kids, not just the kid that was killed but also the injured are
kids on the way to school, and this was deliberate. And it's -- you know, you cannot really get into the mind of people who knowingly do something
like that.
AMANPOUR: And as we were just discussing, this terrible mass shooting of a different sort in the United States, has just happen. But you're in Israel,
the eternally unresolved situation. What do you think it will take to actually end this cycle of violence? I know.
HARARI: That's way above my pay grade. I -- you know, basically it's a problem of motivation. It seems that we have reached a point when many
people, even maybe most people on both sides, just don't have the motivation to solve this.
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This is a political problem, not like mathematical problems. In mathematics, you have problems that you can really prove they have no
solution. This problem has no solution. There is no such thing in politics. All political problems have solutions. It all depends on how much
motivation people have. And unfortunately, we are in a time when they have no motivation.
AMANPOUR: And does it depend on the structural situation? I mean, we said that it's almost like back to the future with this new Israeli leadership,
Benjamin Netanyahu is bound to be made prime minister. And in his coalition, you know, it just keeps going further and further to the
extreme. And this is the most extreme anybody has seen.
I just want to read you a little bit about some of the names which are causing a lot of anxiety amongst your biggest allies, for instance in the
United States. You've got, you know, Itamar Ben-Gvir, he has been convicted for inciting anti-Arab racism, supporting terrorism. Until recently, he was
deemed even too extreme for government.
There's another one, Smotrich, who has wanted to be defense minister, and the U.S. has made it known that they don't -- they won't accept that, you
know. And he is very, very, very hard line. Some of them are openly homophobic. They won't shake hands with women. They say the Torah has to
rule. They want to annex the whole of the West Bank. What is going on here?
HARARI: I think, one of the key things is that a lot of the Israeli public has gradually switched from a belief in the two-state solution to, at
least, an implicit belief in the three classes solution. That you have just one country, between the Jordan River and the Mediterranean, with three
classes of people living there. Jews, who have all the rights, some Arabs who have some rights, and other Arabs with very little or no rights.
And this is increasingly the situation on the ground. And this is increasingly also the aspiration or the mindset of even people in the
government. And this is extremely worrying, but this is what is happening.
AMANPOUR: Wow. I've never heard you sound so fatalistic. You even think climate change can be mitigated.
HARARI: Yes, also, this again. It goes back to the issue of motivation. It's not that their conflict has reached a point when this is the only
solution possible. It's -- we've reached the point when this is the preferred solution, or the preferred situation, for at least some of the
Israeli public and also some of the Israeli government, of future government in it.
This is not deterministic. It's not written in the stars or anywhere else. It's a human choice. I hope that people will make different choices. But
that's -- it's -- we have to first of all acknowledge what is the reality before we can think of ways of improving it.
AMANPOUR: So, I wonder if that leads me to your new book. I mean, I have it here. It's an amazing book. We don't usually see your books, like "Sapiens"
and the others with this kind of childlike cover. And of course, behind you, you have an image from the book.
So, the question -- and it's called, you know, "Unstoppable Us: How Humans Took Over the World". It's your history lesson and civics lesson for young
people. In view of what we have just been talking about, motivation and understanding, what do you think telling kids will do to shape the future?
HARARI: I think in the long-term this is the key, because how kids view the world, this is how they later view the world as adults. It's -- you can
change your minds afterwards. But it's very difficult to unlearn what you have learned as a young person. If you were raised believing that, for
instance, your people is superior to other people or superior to everybody else, and this is what you have been fed for many years, it's, later on,
very difficult to change that.
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And unfortunately, we see it again. It's not an Israeli phenomenon. We see it in many countries around the world, in many people, in many nations
around the world, they raise their young people on this kind of view that we are better than everybody else. Our interests are more important than
those of everybody else.
And unfortunately, this leads today to an existential crisis for humankind, because this kind of thinking, of course, for thousands of years have led
to walls and persecutions and so forth. But now, we are facing some existential global problems, like climate change, or like the rise of
artificial intelligence, which cannot be solved unless you cooperate with the other people in the world. And if people have this mindset that we are
superior to everybody, and then only our interests' matter, then cooperation is almost impossible.
AMANPOUR: So, do you feel you that you lack that in your primary education?
HARARI: Yes, I think that when I grew up, I took it for granted that Jews are better than everybody else. And that we are more important than
everybody else. And it took me a lot of years that actually, this is not necessarily true.
AMANPOUR: And while it's a lovely, a colorful book full of images and pictures that would appeal to young people, it does not shy away, as you've
been saying, from very, very important issues, like climate change. And you say -- and I want you to talk a little bit about this because again, this
is a big issue that not only -- well, it seems that the world should be motivated and have the political will. But clearly, as we've just seen in
Sharm El-Sheikh, they couldn't even get to an agreement on the big issue climate, you know, emissions and the greenhouse gases and fossil fuels.
What are you saying to give people hope, particularly the capitalist world?
HARARI: But one thing that should be very clear is that humanity has the power to prevent catastrophic climate change. It's completely on us. It's
not an inevitable, natural disaster. We have scientific knowledge. We also have economic resources. It's estimated that if we invest about two percent
of global GDP in developing the right technology and infrastructure, we can prevent catastrophic climate change.
Now, two percent of global GDP is a lot of money, but it's completely feasible. It's what politicians do all the time, shifting resources from
here to there. Again, it's a question of motivation. Do people have the political motivation to do it?
And also -- you know, we now see the World Cup in Qatar. And for me the World Cup, despite, you know, all the criticism, it's a -- is very positive
sign, that look, people can agree on something globally. You know, with all the criticism that we hear about globalism, if you like the World Cup,
you're a globalist, because the World Cup is really globalism in action.
Globalism doesn't mean the establishment of some dictatorial global government that forces us to do things we don't want. It simply means that
different countries can reach agreement on common rules of how to behave. You know, for Brazil to play football against Germany, first of all,
Brazilians and Germans need to agree on some common rules.
It doesn't mean they are not patriotic. It doesn't mean they still share the national team. They're still fiercely patriotic, but this patriotism
can go hand in hand with agreeing with the other countries on common rules. And this should be the basis for how we approach other problems, like
climate change, like global inequality, like AI.
AMANPOUR: I just want to pick up on the Qatar thing, because obviously the huge controversy has been and remains the FIFA ban on players, and
particularly team captains, using any kind of one love symbol that demonstrates inclusion when it comes to LGBTQ and all of that.
HARARI: Yes.
AMANPOUR: You are openly gay. And I just wonder --
HARARI: Yes.
AMANPOUR: -- do you think it's Qatar's right to, basically, flip on a dime, by the way because they said they were going to provide a hospitable place
for all and sundry.
HARARI: Uh-huh.
AMANPOUR: And for the FIFA chief to say, who are we in the west to tell them and it's up to Qatar. That goes against what you just said about
globalism and a global set of rules.
HARARI: Yes, it's very difficult to reach agreement about everything. I think it's the responsibility of the country who hosts an event like this
to be hospitable for people from all over the world.
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I think specifically the controversy about the armband, even though some of the captains and teams backed down, it achieved the critical aim of
focusing attention on this issue. And I was also, you know, on a slightly side issue, I was (INAUDIBLE) very touched and impressed by the bravery of
the Iranian football players, who did not sing the national anthem as a gesture of solidarity with the people of Iran. And I think that this stage
of the world, when the eyes of the entire world is on that, it's a very powerful platform to convey these kinds of messages.
AMANPOUR: And as you mentioned, of course, the Iranians had a lot more at stake in a lot more, you know, risk --
HARARI: A lot more at stake.
AMANPOUR: -- than a yellow card. So, your point is very well taken and their gesture was very well received around the world. I want to ask you
about false narratives. Because all of this also does promote the false narrative of hate and otherism and, you know, just this increasing
intolerance that seems to be happening, which of course is globally demonstrated in Russia's false narrative about its war in Ukraine.
But here I want to ask you particularly about what you've written about the kids. You've said, it's possible to trace a direct line from Genesis decree
of fill the Earth and subdue it to the Industrial Revolution and today's ecological crisis. Another direct line of influence can be drawn from the
historical narratives that Russian children learn in school to Putin's invasion of Ukraine and the ensuing global food crisis.
What are you saying to children into us?
HARARI: The stories that we hear as children shape our mind and then go on to shape the entire world. The ecology, the economy, politics and therefore
we have to be extremely careful. It's like planting a seed, of sowing a seed. You sow a seed in the mind of a 10-year-old kid, this will shape the
future. You have to be very careful.
If you are sowing seeds of hatred or fear, then in 10, 20, 30 years later, you will get a harvest of violence. If you sow seeds of compassion, then
maybe in 20 or 30 years, you get a harvest of cooperation and peace. So -- and you know, it's also the same of what's happening here between you and
me. We are talking on television. There are -- I don't know how many thousands of people or hundreds of thousands of people who are watching us.
Our words, are again, like seeds that go into the minds of the viewers. And so, we have to be very careful about that.
AMANPOUR: Yes.
HARARI: And also, the viewers, the people who consume information, I think that with this epidemic of toxic information, people should go on a kind of
information diet. You know, we have learned to be very, very careful about the food that we put into our mouth. We should be even more careful about
the information that we put into our minds.
You know, we are careful, we look at how much sugar, how much fat there is and what we eat. We should look at how much hatred and how much anger is in
the information we consume. And, you know, they have on -- I don't know, in every TikTok video, something, you have this label just before it, this
contains 20 percent hate, 40 percent greed.
AMANPOUR: Yes.
HARARI: Now, if you want to take it. OK. So, take it. But at least know what you are doing to your mind.
AMANPOUR: Exactly. I'm really mindful on that. And I'm glad you mentioned in this program. I'm really mindful about that and the responsibility. But
I want to end by asking you something. Because, you know, talking about harvesting what you sow, even in the first couple of days of the war in
February, you wrote that Putin was heading towards historic defeat, just four days.
And it looks like, you know, with all battlefield losses in the vengeance that he is wreaking as punishment on Ukrainian civilians right now, that
you were right. How did you -- how were you so right? Everybody else thought he was going to win outright.
HARARI: Actually, I also thought he was going to win outright. And then, you know, you saw the just amazing bravery of the Ukrainians, and when I
were -- I wrote this, I still thought he would be able to conquer most of the country, but I realized he would not achieve his war aim.
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Because his war aim was to destroy Ukraine and to reestablish the Russian empire. To absorb Ukraine into Russia, because he had this fantasy that
Ukraine is not really a nation. And when -- even in the first few days, when you saw the bravery of the Ukrainian people, and army, and the Ukraine
-- and Zelenskyy, it was clear that he will not get away with it. He can't, because Ukrainians are very real and courageous nation.
And you know, we still don't know how the war will end even though Putin made a terrible mistake, he's just doubling down on it and creating more
and more violence and hatred in the process. And you know, he's also destroying any dream of resurrecting Russia as a great power. He's
basically turning Russia into a vasal state of China. He single-handedly destroyed Russia's position as a great power.
AMANPOUR: Well, a lesson for children indeed. Yuval Noah Harari, thanks so much, indeed, for joining us.
HARARI: Thank you.
(END VIDEO CLIP)
AMANPOUR: And we just want to get an update on the attack today in Jerusalem. Correspondent Hadas Gold has been tracking those developments
all day.
Hadas, do the authorities know any more about the cause, the people, the institutions behind this?
HADAS GOLD, CNN JERUSALEM CORRESPONDENT: Well, so far Christiane, no militant group has claimed responsibility. Although Hamas and others, like
Palestinian Islamic Jihad and Hezbollah have praised the attack. And the Israeli authorities have not identified anybody, at least publicly, that
they believe is behind this attack.
What they are saying is that it was a very well organized and sophisticated attack. It started just after 7:00 a.m., not far from actually where we are
sitting at a bus stop that is on one of the major routes in and out of the city. And then 30 minutes later, another explosion at another bus stop,
just down the hill from the first one.
Israeli police say that what happened was two bags were placed, one at each of these bus stops in hidden areas. They say that they were packed with
things like nails and ball bearings, and that they were actually detonated remotely by cell phone, they believe. And they believe that they were
detonated in order to cause maximum harm. One Canadian Israeli teenager, a 15-year-old was killed in that first initial bombing, and more than 14 have
been injured.
Now, Christiane, it's been a very violent year for Israelis and Palestinians. It's been the most violent for both sides that we've seen in
many years. But this is a new, deadly escalation. And it's very reminiscent of the suicide attacks and the bombings that we saw in the Second Intifada.
There hasn't been bombing like this, one of -- you know, bags being placed at remotely detonated. There hasn't been an expulsion like this and many,
many years, especially one in Central Jerusalem as well organized and as well planned as this.
And so far, Israeli authorities have not given any indication, at least, publicly of who is behind this or that they are close to catching them.
AMANPOUR: So, can I just switch gears for a second and very briefly, we've been talking with Yuval Noah Harari, and of course it's all across the
press, the new Israeli government that's being formed. Give us a little bit more about how it's going down there, these very extreme members of these
parties who we've been talking about, who are forming a majority for Benjamin Netanyahu, who are causing great worry amongst Americas allies
too.
GOLD: Yes. So, actually, Itamar Ben-Gvir, he's the leader of one of these far-right parties called Jewish Power, essentially being seen as a
kingmaker in this new government, showed up to the scene of the first attack. Pretty soon after it happened, calling on Israeli authorities to go
in -- to go house by house he says, in the West Bank to try and find the people behind this and bring them to justice.
Now, he is somebody who was angling to be put in charge, minister of public security, that would make him in charge of the police. This is a far-right
person himself. Actually, being convicted in the past of inciting racism and supporting terrorism who is angling to be put in charge of police. And
there's a lot of pressure on soon to be, once again, Prime Minister Benjamin Netanyahu, to essentially give the right wing who is putting him
in power what they want in terms of the positions that they want.
But by putting them in these positions of power, that can really change how things happen on the ground. How police respond to these types of
situations. So, there's a lot of concern, as you noted, from international allies of what that could potentially look like in the future, especially
as we're seeing this escalating violence. Christiane.
AMANPOUR: Indeed, it could not happen at a more tense and difficult moment. Hadas Gold, thank you very much for being with us from Jerusalem.
Now, as we mentioned, Yuval Noah Harari earlier spoke of the bravery of Ukrainians in this war that Russia has launched on them. Today, it's being
sorely tested yet again as barrages of missiles have targeted Ukraine.
[13:35:00]
A national power supply company says, every region is seeing outages after strikes hit critical infrastructure. That means also water. Now, in Russia,
tension is growing among soldiers and their families as complaints flood social media about conditions they're facing on the front line.
Correspondent Fred Pleitgen has that story.
(BEGIN VIDEO CLIP)
FREDERIK PLEITGEN, CNN SENIOR INTERNATIONAL CORRESPONDENT (voiceover): Stark images from what many believe to be the second strongest military in
the world. This video posted on social media purports to show new Russian recruits camped out in the snow and cold with little more than tarps for
shelter, some trying to warm up by fires.
CNN cannot independently verify its authenticity, but those posting it say the soldiers even had to buy their own food to survive. Problems during
training, problems on the battlefield, these recruits vent their anger at the Russian military.
UNIDENTIFIED MALE (through translator): We were abandoned without equipment, without everything. Where are the tanks? Where are the armored
personnel carriers? Come on. Bring it or I'll come for you.
PLEITGEN (voiceover): Dilapidated barracks, horrendous sanitary conditions, poor food. The list of complaints often documented in social media posts
like this runs long since Russia says it has mobilized more than 300,000 men for the war in Ukraine since September with more than 50,000 allegedly
already on the battlefield, the Kremlin says.
Some relatives, especially mothers, complaining about the treatment of their loved ones. This group at southwestern Russia saying their husbands
and sons had been sent to the front line without adequate training or gear.
UNIDENTIFIED FEMALE (through translator): The commander who gave the order that our men should hold the defense ignored the decree of the supreme
commander in chief that the newly mobilized should not be sent to the first line of contact.
PLEITGEN (voiceover): Even in the areas of Ukraine that Russia has annexed, mothers are taking a stand. Return students to their studies, this sign in
Donetsk says.
UNIDENTIFIED FEMALE (through translator): Vladimir Vladimirovich, please return our children. There are many dead. Many captured. The rest of the
children are physically and morally decimated.
PLEITGEN (voiceover): Soldier's mothers traditionally carry a lot of sway in Russia. And Russian president, Vladimir Putin, seems eager to show he's
not tone-deaf to their plight. Recently visiting with the military says, were new recruits, even firing a sniper rifle himself. Trying to convey he
cares about the new recruits.
VLADIMIR PUTIN, RUSSIAN PRESIDENT (through translator): About our country, you know, of course, we have costs. Most notably regarding losses in the
special military operation. I think about it all the time.
PLEITGEN (voiceover): But many mobilized Russians and their relatives seem to feel left out in the cold after their country called them up to serve in
a war that was never supposed to last this long.
(END VIDEO CLIP)
AMANPOUR: And historically in Russia, mother's pressure has bought a huge amount of change, and this is mounting now on Vladimir Putin. Fred Pleitgen
reporting there.
Now, from one front to another, front line workers battle an exponential rise in cases of RSV among young children. This respiratory virus is the
latest that is wreaking havoc and filling up hospital beds in the United States. Our next guest details the dire situation that many hospitals are
facing again. Dr. Daniel Rauch, chief of Pediatric Hospital Medicine at Tufts Medical Center is joining Hari Sreenivasan.
(BEGIN VIDEO TAPE)
HARI SREENIVASAN, CNN INTERNATIONAL CORRESPONDENT: Christiane, thanks. Dr. Daniel Rauch, thanks so much for joining us. You are the chief of Pediatric
Hospital Medicine at the Tufts Medical Center. What are you seeing right now when it comes to cases of RSV?
DR. DANIEL RAUCH, CHAIR, AMERICAN ACADEMY OF PEDIATRICS COMMITTEE ON HOSPITAL CARE: We are seeing more than we have ever seen before. We are
absolutely swamped with kids who are getting this. And the age distribution is a little bit different from prior years. We are seeing more older
toddlers and preschoolers than the typical age group which are infants.
SREENIVASAN: For people who might not know what RSV is, what is it and what does it do?
DR. RAUCH: RSV stands for respiratory syncytial virus. In most people it causes just cold symptoms, upper airway congestion, snotty nose. The
problem with little infants is that they breathe through their nose, they're obligate nasal breathers. So, if they get cold and congestion, it's
hard for them to breathe.
The other problem is it does crawl down into the lungs and causes damage to the lining of the lungs, which is where you change oxygen and carbon
dioxide. So, that's where it causes some significant breathing problems.
SREENIVASAN: So, why are we seeing so much of it this year?
DR. RAUCH: That's a great question and I wish I had a good answer for you. RSV is around all the time. So, even in the summer, we see some of it. It
typically peaks in early winter and lasts until about March.
[13:40:00]
And last year and this year, we see -- we're seeing very early peeks where it's starting in September and October. And we're knee deep or shoulder
deep in it already.
SREENIVASAN: So, give us an idea. It's not just your hospital in Boston. It's around the -- I mean, how bad is it when it comes to ERs and pediatric
beds around the country?
DR. RAUCH: It's bad. They're -- it's regularly now that there is not an available pediatric intensive care unit bed in all of New England. And
we've called down in New York to see about availability. And we're ending up taking care of kids in our community settings and in our emergency rooms
that typically would have been transferred to children's hospital or facilities that can do higher level of care.
And our pediatric providers on the front line and the emergency medicine people and the nurses and the respiratory therapists are doing an
unbelievable job in keeping these kids in the settings that they weren't used to having them and making sure that nothing bad happens to them.
The question is, how long can they keep that up? Different from the initial COVID surge, this is hitting the whole country at once. So, I can't ask for
help from providers from the south and the west and -- to come to the northeast now and then promise them that I'll return the favor later on in
the year when it hits them, because it's hitting the whole country at once.
SREENIVASAN: So, the American Academy of Pediatrics alongside the Children's Hospital Association are -- asked the Biden administration to
declare, essentially, a national emergency. What would that get you? What are the gaps that need to be filled?
DR. RAUCH: So, we learned some things dealing with adults during COVID, that if you break down some barriers to providing care and community
centers, like telehealth and credentialing issues and cross state issues, it improves the ability of people to share their expertise and to provide
help. And we need to do that for our kids. We did it for our adults. A lot of those exceptions expired as the pandemic lessened a little bit, but we
need to reinstate them to help our pediatric providers.
It's challenging to be in a community health center or emergency room and be dealing with a kid who needs ICU level care and not have that available.
And then not have anybody be able to talk to you because there's -- the people you normally call are across the state border and they're not
licensed in your state, or they're not credentialed in your institution, or there's fear about malpractice issues. We need to break those barriers and
make the care deliver easier.
SREENIVASAN: I don't want to be alarmist, but the idea that the -- you know, basically, pediatricians are asking the government for help about
this. How close is the, I guess, the pediatric health care system close to a breaking point here? I mean, the -- you're asking for help that the beds
are too full, that you're not able to find the kind of resources necessary, this seems pretty dire.
DR. RAUCH: I agree. And as I said earlier, I'm scared for later in December, in January, in February when the staff just can't keep up this
pace any longer. We can't make more people. We can make people more effective.
So, again, the -- ask for the emergency declaration was to help people be more efficient in their care and to get help via other methods than people
just physically showing up. But -- and hopefully, we will be able to figure out ways to extend the care that we deliver. People already being very
resourceful in providing levels of care in emergency rooms and in community centers that they never did before. And I'm hopeful that'll help us keep on
top of this as the winter goes on. But I share your concern.
SREENIVASAN: You know, one of the things that people became acutely aware of is how tight, I guess, the supply and demand are balanced out. Meaning,
whether it comes to hospital beds or ventilators, and then we have almost a just in time health care delivery system. Did we -- you know, were there
any changes that we could have made after having gone through this global pandemic that said, maybe we should keep a couple of free beds extra
knowing that there could be surges of things?
DR. RAUCH: So, unfortunately, there has been a detriment in pediatric bed capacity over the last two decades. And it only accelerated during the
pandemic because in institutions that had both pediatric beds and adult beds, when you needed those adult beds and they weren't pediatric cases,
the beds got transferred over to adults. And the adult volume hasn't gone down a lot. So, a lot of those beds have not been transferred back to
pediatrics.
And the other trend that happened over that time was pediatric beds just aren't, unfortunately, very profitable for hospitals. And so, for hospitals
that have a small component of pediatric beds and have been under a lot of economic pressure, it just made sense over the last 20 years to convert
those to adult beds where the reimbursement was better.
[13:45:00]
On top of all that is we have a mental health crisis, and a lot of beds that would have been freed up for acute care are being filled now with
children with mental health care issues and there's no place for those kids to go. And they stay in those beds for days to weeks. Your RSV patient is
hospitalized for a few days and there's a lot of turn over. So, we can generally take care of that which we've done in past seasons. But if a lot
of your bed capacity is with kids who cannot go anywhere else, that's a real problem. So, it's a combination of events.
SREENIVASAN: So, adults can get this, but why are children suffering in this way?
DR. RAUCH: So, it -- the infants who gets it, it suffers for two reasons, as I explained before, they're obligate nasal breathers. So, if you get all
congested and you can't breathe through your nose, you can't feed, and it's hard to open your mouth to breath.
They're also -- because they're younger and they're not as well developed, it's hard for them to cough and clear their lungs. It's hard for them to
have the stamina to keep up breathing fast for hours and days, whereas your -- even the older child, your two-year-old typically do that and get
through this without needing to be hospitalized.
SREENIVASAN: So, how long can this kind of congestion last? Because it's hard for parents sometimes to figure out, is this something that I should
take my child to the doctor for? Is this just a cough? Is this a runny nose that they may have gotten at school?
DR. RAUCH: That's a great question. The things to worry about are if your child is having significant trouble breathing. There's nothing we can do
for your child once they've been infected to stop the progression. So, unless your child needs intervention, keep them at home. You're better off
at home. Your child's better off at home. Talk to your doctor about things you can do like cleaning out your child's nose and making it easier for
them to breathe and feed. But there's nothing that can stop the progression once they've had it.
SREENIVASAN: What about children who might already have different types of breathing conditions, say asthma? Are they at higher risk for this or does
it not matter?
DR. RAUCH: It's another great question. Typically, the age range of asthma is older children, two and up. And the age range that gets affected by RSV
is under two years old. And that's the surprise this season is we're seeing those older, two, three, four years old get this. And there is some overlap
in symptoms and things that are going on between asthma and RSV.
Certainly, if your child has any underlying illness, getting RSV can make it a little bit worse. And the RSV can be a little bit harder for them to
fight off. So, if your child is that risk, then definitely speak to your health care provider.
SREENIVASAN: You know, early on in the pandemic, we saw a disproportionate amount of number people of color that were impacted by coronavirus and had
COVID. Do we see any disparities in how RSV is making its way through the pediatric population?
DR. RAUCH: It's persisted all the health inequity that we see in the United States. And communities of color, unfortunately. have very good reasons to
be historically skeptical of the medical community and interventions that are suggested. Additionally, the closure of pediatric beds happens more in
rural communities and lower socioeconomic stature communities. So, that getting to acceptable care is harder for people in those communities.
And so, we need to do more to reach out to all the communities and explain to them, what to be worried about. When to bring your child in. And to get
all the vaccines that are available to them.
SREENIVASAN: Considering we're just coming off a pandemic where vaccines have been proven to be effective. Is there or has there ever been a vaccine
for this? Are there people working on it? Is it even possible?
DR. RAUCH: There are people working on a vaccine. One of the interesting things about RSV, in particular, is it doesn't promote a lot of immunity
even from natural infection. So, your child could get RSV now and in March could get it again. That's how poor the immunity is and that's why we've
struggled to get a good vaccine for this.
I would tell people to get the other vaccines that are out there. It is worse to get RSV and another virus. The tripledemic that we're looking at
now of RSV, flu, and COVID is what we were afraid of when COVID first hit. Thankfully, COVID doesn't seem to affect children as badly as it affects
adults. And we didn't see bad flu season the last two seasons.
The flu is bad in Australia this year, and that predicts a bad season, typically in the United States. And we're seeing spiking cases of flu now.
And there's a vaccine for that starting at six months old. Similarly, get your kid protected against COVID, that vaccine also starts at six months
old.
SREENIVASAN: Is part of the lower number of flu cases and other respiratory illnesses over the past two years because at least for large parts of the
country in the world, people were wearing masks.
[13:50:00]
DR. RAUCH: Yes, there's no question that having people be protected from other sick people protects them from other sick people. So, if you are not
circulating around with other people who are coughing and sneezing and blowing their nose and doing all the rest of that. You don't get exposed to
that and kids weren't exposed to that.
And now that everybody is up in about, that's getting spread around like wildfire again which is what we used to see every winter. Epidemics of RSV
and flu varying severity with the season. But we saw all of that, it's all three of them at once. And for reasons we don't understand a slightly
different age group is getting hit this year.
SREENIVASAN: What about the frontline workers? I mean, they've literally been on one stress after another stress after another stress. And I'm just
thinking about the people who are working the pediatric departments inside hospitals right now. It seems like there's just no relief here because now
there is another wave of illnesses keeping them very busy.
DR. RAUCH: Yes, I worry about that, too. I think this surge is going to continue through the winter. And we have a health care system for which the
answer to surges is heroic efforts by people on the front line. And that works for a couple of days, maybe even a few weeks. But I'm very scared
about going to happen in December, January, February, when people just can't keep up this pace any longer.
SREENIVASAN: What are the things that parents should be doing to try to both get better care but also ease the strain? I mean, are you seeing
people show up in the ER because of what they've heard about RSV versus taking your child to their pediatrician?
DR. RAUCH: Yes. So, we're definitely seeing that. There's a lot of worried -- I don't want to say, well, but there's a lot of worry not sick enough to
show up into the emergency room. Definitely call your health care provider. Your pediatrician or whoever else you are using for your child and run the
symptoms by them.
This is where a telehealth can really help because if someone can lay eyes on your child and help you through an exam in your home, you don't have to
go anywhere. And they maybe able to reassure you enough that you're not going into the emergency room. We also need places that can see kids
outside of the emergency room. A lot of pediatric practices limited their sick care visits during COVID and haven't ramped up again. And urgent care
also, if there's a pediatrician available who is comfortable assessing your child can be another outlet rather than going to the emergency room.
SREENIVASAN: We're heading into a holiday season, and for millions of people, if they didn't have an opportunity last year or certainly the year
before. This is one of the first times that they're going to be able to gather with family and friends again. What would you advise parents about
holiday travel given that you've got higher cases of flu than average, you've got RSV and COVID is still not over?
DR. RAUCH: Yes. So, again, get your child vaccinated and get yourself vaccinated for everything that's available because vaccines work. That's
not going to help you over this coming weekend. But you should do that anyway.
Standard precautions are important. Wash your hands, wash your hands, wash your hands. Be careful what you touch. Wipe down surfaces that other people
have touched. And don't think that just because the person next to you is going to look at you funny that you're doing something wrong. No, wipe
things down. If you are going to be in crowded areas, you're going to be on an airplane, you're going to be in bus stations. Masks work. And they don't
harm anybody. So, don't be afraid about wearing a mask.
And lastly, if you've got the sniffles in a cold, I understand you want to see your family. But it's not fun to spread this stuff. You don't want to
be the person who gives grandpa the flu or you don't want to be the person who gives the new baby that you've been waiting to see RSV. It -- in no
year was it OK to spread those illnesses and it's not good this year either.
SREENIVASAN: How much do you think that vaccine hesitancy or at least the lower adoption rates of vaccines among children is contributing to any of
this? I know we have -- I'm specifically talking about right now COVID vaccines. But I don't know how that will translate out to the normal flu
shot that lots of kids used to get every year.
DR. RAUCH: Yes, I'm afraid about that. We don't have good statistics on the uptake of the flu vaccine although we know in the last couple of years it
has not been as high as it typically was. And the flu vaccine was never a particularly high uptake among the general population. Anyway, it's not
required for school like some of the other standard vaccines. And we saw drops in all the other vaccines.
So, I'm afraid that people aren't getting the vaccines that they need and should have. There is no RSV vaccine. So, RSV is not a consideration here.
[13:55:00]
Flu definitely is and it's -- and we're seeing, again, the flu cases really shoot up. And we are -- and a lot of the providers are afraid that flu plus
RSV or flu plus COVID is going to be really severe illness.
SREENIVASAN: Dr. Daniel Rauch, chief of Pediatric Hospital Medicine at the Tufts Medical Center, thanks so much for joining us.
DR. RAUCH: Thank you.
(END VIDEO CLIP)
AMANPOUR: And that is it for now. Thank you for watching and goodbye from London.
(COMMERCIAL BREAK)
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