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Amanpour
Interview with Former U.S. Federal Prosecutor and "Untouchable" Author Elie Honig; Interview with California Lieutenant Governor Eleni Kounalakis; Interview with Norwegian Refugee Council Secretary General Jan Egeland; Interview with The Long COVID Initiative at Brown University Director and Brown University Epidemiology Department Associate Professor and Intern Chair Dr. Francesca Beaudoin. Aired 1-2p ET
Aired January 13, 2023 - 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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SARA SIDNER, CNN HOST: Hello, everyone. And welcome to "Amanpour." Here is what's coming up.
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JOE BIDEN, PRESIDENT OF THE UNITED STATES: People know I take classified documents and classified material seriously.
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SIDNER: Criticism grows as classified documents are found in President Biden's home. What are the legal and political implications? Important
context with legal analyst, Elie Honig. Plus.
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UNIDENTIFIED MALE: The magnitude of this is not isolated to smaller communities. It is scaled across the largest state in our union.
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SIDNER: California is being pummeled by relentless storms, with millions under flood alerts. The state's lieutenant governor, Eleni Kounalakis,
joins me. Then.
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CROWD: (Speaking in a foreign language).
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SIDNER: As the Taliban tightens its grip on Afghanistan's woman, I check in with Jan Egeland of the Norwegian Refugee Council. He is just back from
Kabul, where he tried to convince the Taliban to reverse their ban on women working with aid agencies. And.
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DR. FRANCESCA BEAUDOIN, DIRECTOR, THE LONG COVID INITIATIVE AT BROWN UNIVERSITY AND ASSOCIATE PROFESSOR AND INTERIM CHAIR, BROWN UNIVERSITY
EPIDEMIOLOGY DEPARTMENT: As we've seen with much of the pandemic, we're still racing to keep up in terms of the science. The science is racing to
keep up with the problem.
(END VIDEO CLIP)
SIDNER: Long COVID and it's unanswered questions. How many people are suffering and how do we treat them? Hari Sreenivasan speaks to Dr.
Francesca Beaudoin.
Welcome to the program. I'm Sara Sidner in Los Angeles, sitting in for Christiane Amanpour.
President Biden is busy at work today, welcoming Japanese Prime Minister, Fumio Kishida, to the White House. Meanwhile, a political scandal is
brewing over the discovery of classified documents at Mr. Biden's Delaware home and former office from his time as vice president. A special counsel
has been appointed to investigate. And as expected, Republicans are using it to slam Democrats as hypocrites.
The president was highly critical of Donald Trump when classified documents were found at his home in Mar-a-Lago last year. There are some key
differences though in the secret documents' debacle. Donald Trump had refused to return the files, even after being subpoenaed. Joe Biden's
lawyers turn the materials over voluntarily, and the White House has promised to fully cooperate. But it's still a political headache for the
president.
Let's get some important context now with our Elie Honig. he is a former federal and state prosecutor and he joins me now from New York.
Elie, thank you so much for joining me. This is a scandal that certainly the administration does not want because it has been so much in the news
when it comes to what Donald Trump did with these documents. Can you help us understand a bit of context here though. What exactly did President
Biden do when he was vice president? And what's the potential legal exposure for him as there is now an investigation?
ELIE HONIG, FORMER U.S. FEDERAL PROSECUTOR: Sure, Sara. So, here's what we know, Joe Biden, when he was vice president, he left the vice presidency in
January of 2017, then he took an honorary job with this think tank associated with the University of Pennsylvania where he had a private
office in Washington D.C. that he used from about 2017 to 2019.
Well, two months ago, in November, his attorneys were going through and packing up that private office, and they found a small number, about 10
classified documents. They immediately notified the National Archives, and in turn, DOJ got involved. And then, in December, last month, Biden's team
found more classified documents, we don't know the exact number at his private home in Wilmington, Delaware.
And so, that's what leads us here today. Now, if the question is, what types of federal laws may be implicated either as to Joe Biden or as to
Donald Trump on the Mar-a-Lago case? There is, sort of, a lattice work of different statutes here. Federal laws that essentially all boiled down to
making it a crime if a person knowingly and intentionally mishandles, destroyed, steals classified or other sensitive information.
And really, the crux of that is did the person, whether its Donald Trump or Joe Biden, know that they had these documents, and did they have criminal
intent?
SIDNER: And, in so doing, criminal intent is, for example, could that be someone subpoenas the documents and you refused to give them over? Is that
where the exposure is different with Donald Trump?
HONIG: Well, so, that's one key distinction between the Biden and Trump scenarios. By all facts that we have right now, Joe Biden's team was very
cooperative. They came forward with the information, and they've cooperated with Archives and DOJ, based on what we know so far.
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Now, Donald Trump's team was not. They did not fully comply with the subpoena. They actually falsely certified to DOJ that they had turned over
all classified documents when they had not. And as a result, there was an obstruction element of the investigation into Donald Trump but not Joe
Biden.
And that's significant for two reasons, Sara. First of all, of course, obstruction is a crime, a federal crime, on its own. But also, it gets to
the idea of intent, the basic premise there, that prosecutors often fall is a person doesn't obstruct justice unless they have reason to. Unless
they're trying to hide something, which could go to the sense of corrupt intent.
SIDNER: So, the Justice Department appointed former U.S. Attorney, Robert Hur, to investigate possible unauthorized removal and retention of these
documents. But they also said something to the effect of, you know, he was calling it, particularly sensitive matters. And so, by making this
appointment of someone that is not the attorney general at the time, who was, of course, put in place by Joe Biden, the Justice Department saying,
look it shows that we're acting independently.
Can you translate all of this into plain English when it comes to what exactly does sensitive matters mean? Is that just about the documents?
HONIG: So, the bottom line I would, sort of, start with here is there's nothing sort of special about the special counsel. The reason you would
appoint special counsel is if you have an extraordinarily sensitive situation like this or if you have a potential conflict of interest. And I
think, really, what's driving both of these special counsels, Sara, is the at least appearance of a conflict of interest.
Taking the Donald Trump scenario, of course. We had Jack Smith appointed as special counsel a couple of months ago. And Merrick Garland is thinking it
appears was well a reasonable normal person could look at this and say, look it's a potential conflict of interest to have Joe Biden's Justice
Department, criminally investigating Donald Trump, who is now likely running against Joe Biden for the presidency in 2024.
By that same logic, Sara, I think Merrick Garland left himself with no choice, and I think the right choice, in appointing a special counselor
because if it's a conflict of interest for Biden's DOJ to investigate Donald Trump, it sure is heck is a potential conflict of interest for Joe
Biden's DOJ to investigate Joe Biden.
SIDNER: Let me ask you about how long this investigation could go on. What timing and are we talking here. And let's first tackle what Joe Biden is
experiencing, and then tackle what Donald Trump is experiencing.
HONIG: So, the big answer here is we never know. Different prosecutors run different speeds. Some prosecutors get right to the point. Others like to,
sort of, fill out every blank. We do have a history in this country of special counsel investigations dragging on for years. The John Durham
special counsel investigation is still active, we're into year three now.
SIDNER: Wow.
HONIG: That said, the Biden investigation looks like it might be, sort of, narrow and discreet enough that this can move quickly. We're only, at this
point, talking about a handful of classified documents located in two different places. The fact that Biden's team is cooperating should shorten
the timeframe here, as opposed to somebody who's obstructing.
And there is a way -- if I'm prosecuting this case, the first thing I'm looking at, Sara, is knowledge. Because Joe Biden has denied knowledge.
Now, we don't know if that's true or not. We've not seen any counter evidence. But as a prosecutor, you have to test that. You have to talk to
all the other witnesses. And if you can confirm, solidly, beyond just Joe Biden's denial, but if you can confirm that he had no knowledge, then it's
over, legally, not politically, but legally because there is no crime if the person simply didn't know.
SIDNER: Can you give us a sense of the comparison between these two investigations. Because there is a large bit of nuance and difference at
this point, so far as we know, between these two presidents and, you know, Joe Biden was vice president at the time. But what they did with these
documents and how they handled them after they were discovered?
HONIG: Yes. So, a couple really important distinctions here. Start with just the sheer numbers. Donald Trump had many multiples, the number of
classified documents that we know. That Joe Biden has also the cooperativeness of both parties, I think, is really important.
You have Joe Biden's team, which thus far, has been fully compliant and forthcoming. Donald Trump's team was excessively obstructive. They refused
to comply with a lawful subpoena. They falsely told DOJ, we've given you everything, when they had not given everything. So, those are two important
differences. And really, the touchdowns here is going to be knowledge and intent. And there's also a key difference there.
Again, there is no evidence at this point that Joe Biden knew about those documents that may change, but that's where we are right now. Donald Trump
has openly acknowledged that he knew about the documents. He has put social media posts admitting that he knew about them. Now, he's offered other
excuses as to intent. He said yes, I had those documents. Yes, I knew it but they were declassified, or they were my property, or I never had any
criminal intent. And that, I think, is where prosecutors are really going to have to focus with Donald Trump.
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So, there are similarities. These are both classified documents cases. They both involve top secret, the highest level of classified documents. But
there are factual distinctions that matter here too.
SIDNER: Can you give us a sense of -- you know, I know you said that there is nothing particularly special about a special prosecutor. But is there a
mandate any different from, you know, what you were doing as a federal prosecutor?
HONIG: Yes. So, the most important thing that a special prosecutor is is a federal prosecutor, like I once was at a lower level. But a special
prosecutor, a special counsel has the ability to run grandeur investigations, to subpoena witnesses, to force them to testify, to obtain
documents, to do wiretaps, and most importantly to indict and then to carry cases through trial and sentencing. They can do all the things that a
federal prosecutor can do.
What makes a special counsel special, is that they have more distance, more independents, more insulation from the normal apparatus of the Justice
Department from the A.G. The regulations say that special counsel is not subject to the day-to-day supervision of the A.G. However, the special
counsel will make a recommendation, both special counsels to the attorney general.
And the regulations say that when that happens, the A.G. has to make his own call, but he also has to give, "Great weight to whatever the two
special counsels recommend." And there are other safeguards as well, for example, if the attorney general overrules of the special counsel, that has
to be reported to Congress. There has to be a written report. So, it's essentially a federal prosecutor with a lot more independents.
SIDNER: OK. So, I have to ask you the question I think that a lot of people are asking themselves as they see this happen. And that is, could either of
these presidents end up in jail over this?
HONIG: Boy, that's a good question. Well, let's start with Joe Biden. It is long-standing DOJ policy, dating back to the early 1970s, the Watergate
era, that DOJ will not indict the sitting president. So, even if worst comes to worse for Joe Biden. Even if it turns out if he has criminal
exposure, the most special counsel could do would be to write a report saying, here's my findings and I recommend charges. And then when the day
comes when Joe Biden is no longer president, whether that's in 2025 or 2029, then he would be subject to indictment.
Donald Trump, sure. If the facts prove out that there's been a crime, either on Mar-a-Lago or January 6th, both of which are being investigated
by a special counsel. January 6th, then absolutely he can be indicted. And look, it's not going to be easy if he's indicted to turn that into a
conviction. This will be an enormously polarizing prosecution if it ever happens. But there's no legal or constitutional protection for either a
former president or a current candidate for office.
SIDNER: Elie Honig, you always have all the answers. I appreciate you coming on.
HONIG: Thanks, Sara. Great talking.
SIDNER: All right. Now, to here in California. People are once again faced with a catastrophic weather event. With many communities still rebuilding
from last summer's major wildfires. Thousands were again under evacuation orders this week after days of deadly storms. Millions are under flood
alerts, and at least 18 people have lost their lives.
Governor Gavin Newsom says he has never seen a storms of the scale, and more are on the way. Experts say. the intensity of these storms, plus the
spells of extreme heat are symptoms of a climate crisis. Eleni Kounalakis is the states' lieutenant governor, and she joins me now from Palm Springs.
Thank you so much for joining us.
LT. GOV. ELENI KOUNALAKIS (D-CA): Good to be with you, Sara.
SIDNER: All right. Let me ask you about what we're expecting to see. You know, I was here in 2018 when you had a huge mudslide, same place,
Montecito, that was devastating and deadly. But are these storms different? Do you see these storms in a different way than in the past?
KOUNALAKIS: Well, Sara, to give you some context over the last two and a half weeks, we have had six of these so-called, atmospheric rivers coming
in through our state. About as much rainfall has fallen on her state in two and a half weeks as what happened in a normal year. Not a drought year, but
a normal wet year.
The ground is saturated. We are simply overwhelmed with water, and we have two more major storm set to come in starting tomorrow. So, this is a very
significant emergency. We have lost about 19 people and about 100,000 people are currently under an evacuation order. We are looking at flood
alerts across the state, potential for more power outages, mudslides, massive amounts of snow up in the mountains.
So, we're bracing for more. And it's very difficult because when the ground is so saturated, any additional rain has a trigger effect of even the
potential for more and greater flooding and mudslides, and other emergencies.
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SIDNER: I think it's been referred to as whiplash weather, where you go from a drought to a deluge. And you don't get, sort of, the calm in
between. I do want to ask you about whether you think that this is going to be the new norm for California, and frankly, for the world, that we are
going to be doing this sort of whiplash, back and forth, with deadly storms and then, you know, really problematic droughts, extreme weather in
general. If that's going to be the thing that we're going to all have to get used to?
KOUNALAKIS: Yes. The answer is, yes. And in California we are very science- based in our approach, the problem solving. We've known for a long time that extreme weather is coming driven by a warming climate and climate
change. And we have been investing in ensuring up our levies and our infrastructure, in building out one of the largest and most extensive
emergency response systems anywhere in the world, with helicopters, and the kinds of boats that can come in in the case of flooding. But at the same
time, the kind of ability to mobilize for wildfires.
So, we have been preparing for some time. Nevertheless, the magnitude of what we are up against in the coming days is very severe and we are asking
people in their homes to get ready. To get ready to evacuate if they have to. To watch for rising water. To look at their local news. To have
batteries for flashlights. And to get ready because of these swings between drought and then the kind of atmospheric rivers that we're saying, they are
here to stay.
And again, we are wide-eyed. We are clear eyed about what we are up against. But as prepared as we are, mother nature has the capacity to wreak
havoc. And we are doing our best to get ready for it.
SIDNER: Lieutenant Governor, I want to ask you about getting ready for it. Because if this is the new norm, as you say, how are you, as one of the
leaders of the state, making sure that California is prepared? And when I say that, what are some of the things on the table that are being done to
try and mitigate some of this for the citizens of the state?
KOUNALAKIS: So, for decades now, we have been putting state money and federal resources into building up flood control and improving our levies.
As well as doing things like improving the ability to store water so that when it rains, whether it's in surface water storage, or frankly, charging
our aquifers, we're doing the most to take advantage of the water that is coming into the state right now. While at the same time, preventing loss of
life and being able to respond to emergencies.
So, all of this is happening at the same time and we've been working on it for decades. So, that's all great. But what we are also doing, and I think
this is really important, it's something California is known for, that because we know that climate change is real, we are investing in a carbon
free energy future. So, we have about $48 billion over the last two years in the kind of tax credits that will allow the private sector to come up
with a kind of innovations that we hope will change the ability of us on a global level to be able to combat climate change and deal with or try to
avoid further climate change in the future.
Of course, that's a much bigger goal. But we are responding to this from everything from responding to extreme weather, to trying to prevent more
climate change in the future by transitioning to a carbon free energy future. This is California. We have the capacity to have it all. To deal
with it on both of these levels. And that's what we're trying to do.
SIDNER: California is something like the fifth largest economy in the world. And I want to ask you about that, because right now California is
facing a potential $22 billion plus budget deficit. And, you know, I -- we've been looking at the fact that Governor Newsom has proposed cutting $6
billion of the $54 billion that was set aside for a multi-year spend on climate. That's going to be cut down some because of this deficit,
potentially.
Why do that, at a time, when you know this is going to be the new norm, and it really is needed?
KOUNALAKIS: So, last year, we had a $100 billion budget surplus, and that is a big part of where that $54 -- $56 billion came from in order to
transition to a carbon free energy future. Cutting it by $6 billion is a relatively small difference. And what it did was allow us to not have to
tap into our rainy day fund.
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So, our rainy day fund is higher than it's ever been. We feel very strongly positioned to be able to deal with this deficit but also, to an economic
turned down that is happening nationwide. So, we still have enormous resources that are going into combatting climate change in the future. And
we encourage entrepreneurs to take advantage of these programs because they're mostly coming in the forms of tax credits and grants to leverage
innovation for new approaches to everything from battery storage and offshore wind, to developing sun and wind as alternatives to these -- to
nonrenewable energy sources that dominate in the world today.
SIDNER: Well, there is plenty of sun here, most of the time, although the last couple of weeks have proven otherwise. I do want to talk to you about
some research that was published by the Academic Journal, Science. ExxonMobil accurately forecasted that, you know, how climate change was
going to cause this global temperature to rise as long as the 1970s, according to this research. And they predict how burning fossil fuels would
warm the planet. And -- but they publicly denied the link.
ExxonMobil has come out and said look, this issue has come up several times in recent years. And in each case our answer is the same. Those who talk
about how Exxon knew were -- are wrong in their conclusions. But this is the research being done by the Academic Journal, Science.
I'd like to know from you, do you think that big oil is responsible, in part, and should take part in the solution? In other words, pay up?
KOUNALAKIS: Yes. And thank you for bringing this to the awareness of CNN International because you have people watching around the world. But here
in California, we have known that this is happening for a very long time. That is why our 2045 goals in California be carbon neutral -- 2035 goal.
That's starting 2035, the only new cars that can be sold in California must be zero-emission vehicles.
The standards that we put in place in our state are way ahead of anywhere else in the country and almost anywhere else in the world. And we are
putting our money where our mouth is, and in particular trying to leverage our dollars with the private sector, with innovation, with the next
generation that considers a change in climate to be, you know, their moon shot.
So, we're moving forward into the future. But at the same time, absolutely, oil companies have to be held accountable. You know, in California we're
also feeling a backlash from them because they've jacked up our gas prices here beyond what they are in other parts of the country and then blame it
on us, which was absolutely wrong and unfair.
So, the future is renewable energy sources. And I hope that all of your viewers, particularly young people and young people who are ambitious and
want to make a difference in the world, get on board and help. Because this is really where we have to go.
SIDNER: I want to ask you about -- you know, study after study, and a look at climate change, again and again, tells us that those who have the least,
those who are the poorest, those were the least opportunities are affected the most and affected the most negatively. Can you give me a sense, because
the homeless situation in California as a whole is extreme, 170,000 people in California are in very precarious conditions at this point in time.
What is the state doing to try and help those who really have very little to protect themselves from the deluge that climate change causes or the
extreme heat?
KOUNALAKIS: So, this is also very good question. California has extremes. You know, we are, you said the fifth largest, by some accounts, we are now
the fourth largest economy in the world. Being ready to surpass the size of the German economy. We have extremes here. And we certainly know that
homelessness and housing is one of the challenges that we are confronting regularly.
We have higher numbers of homelessness here for a variety of reasons. Disproportionate to the rest of the country. One reason is that we
generally do have mild climates, and it's easier for instance, for people to be able to survive outside here than in Boston.
So, we have with these budget surpluses over the last two years made more investments to be able to house the unhouse in our states than ever before.
But again, this is a generational problem that we have.
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And we -- we have -- we are united in our political leadership that this is a priority that we need to invest in.
SIDNER: Do you think it's solvable. Because, at the moment, it appears that no matter how much money is thrown at it, there's still a really massive
homeless issue here?
KOUNALAKIS: Well, more money is being programed than ever before just over the last two years. It takes time to turn that money into roofs over
peoples' heads. But we are looking at about 55,000 people being able to be brought in off the streets through our project home key. And now the
project, the additional funds going into buy properties and develop properties for the homeless.
It's still, by your numbers, only about a third of the problem, but it is more of an investment than we have ever made, and we should start seeing a
difference. But let's face, we also need federal support for this as well. When we disproportionately have more homeless that anywhere else in the
country, this is a national emergency that requires national support.
SIDNER: Lieutenant Governor, Eleni Kounalakis, thank you so much for coming on and answering all the questions. I appreciate it.
KOUNALAKIS: Sara, can I just say once again, for everyone in California watching. Please watch local news. Get ready. Get prepared. The water --
more water is coming and we all have to be vigilant.
SIDNER: Thank you for that. Thank you for the warning.
To Afghanistan next, where the plight of women is increasingly dire. Since the Taliban banned women from working with ad agencies, many groups have
suspended their operations in the country. And without women, their work is essentially impossible, that's according to Jan Egeland, secretary general
of the Norwegian Refugee Council, an NGO that provides food, clean water, education, and more.
He's just spent the week in Kabul, meeting with Taliban officials in an attempt to convince them to reverse the ban. Remember, Afghanistan is
facing one of the world's worst humanitarian crises, with millions of people going hungry. Jan Egeland joins me now from Dubai.
Thank you so much for coming on the program.
JAN EGELAND, SECRETARY GENERAL, NORWEGIAN REFUGEE COUNCIL: Thank you.
SIDNER: Can you first tell me, give people a sense, who may not be familiar what's -- with what's going on on the ground. What is happening, from your
perspective, to the -- particularly to women in Afghanistan right now.
EGELAND: Well, we are in a large operation, precisely for women. 10 percent of all of the families in Afghanistan are single mother-led. There is a lot
of widows. It's been a country in war, and in turmoil, and with disasters over very long time.
So, on the 24th of December, on Christmas Eve, out of the blue comes this ban on all female humanitarian workers in all the non-governmental
organizations, it had a paralyzing effect. It's an existential crisis for our work for millions of people.
In the middle of the winter, when I left Kabul today, it was minus 20 degrees Celsius. Freezing cold. And millions out in the open. So, this
decree out of Kandahar where the Taliban supreme leader sits a really paralyzing for humanitarian relief for the population of the country
controlled by the Taliban.
SIDNER: We're looking at some pictures of -- just showing how cold it is in the snow, and the sort of, the roadways with the few people out in it. You
just mentioned that you left Afghanistan, and you went there and you met with Taliban leaders in Kabul. Can you give us a sense of what came out of
those talks. Did you get anything that you felt would be helpful to women who have now been not allowed to work at NGOs, not allowed to go to
university and to school. Was there anything that came out of it that gave you hope?
EGELAND: Well, I am hopeful, yes. But we will see. I met three Taliban ministers in Kabul, minister of economy, through whom this decree, the ban
on women in work, in relief came. He got it from the supreme leader, and paradoxically he said, the minister of economy, as did the minister for
refugees and repatriation, as did the deputy foreign minister, all said, we agreed there should be no ban on female work in your organizations. And we
also very much are in favor of female education on all levels.
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So, I asked them, so why are you doing this? And they say, it's a supreme leader edict. We have to obey. And then they promised to work to overturn
it with a second degree, a new decree, that two claimers ever hope of light, we will, as humanitarian organizations be able to work with male and
female staff in health, and also probably in a primary education. But in all other areas, we cannot.
SIDNER: You know, it's really striking what you say. Because here you are, trying to negotiate to make a better life for women there with the Taliban
in Kabul. And they're telling you, we don't have power, it's in Kandahar where all the power resides, with the supreme leader.
So, is it worth even speaking to them? Is there any way to find progress with the leaders in Kandahar through those who are in Kabul?
EGELAND: Yes, it is possible to get to this Shura Council, the Council of Islamic Scholars, that advices the emir as this -- he's called, the
governor of Kandahar as well, and all of these ministers, six in the Taliban leadership and have a say. So, I told them to their face, you
misled us. You lied to us, really. Because in Doha, in Islamabad, in Oslo, where they came, in Kabul, when I came just after the NATO countries left,
they said there would be no problems with the female work. No problems with female education. And now we have this.
Because this -- in this tug of war, the extreme factions now have the upper hand. We have to have it overturned. If not, thousands, scores of people
will die. It's in the middle of winter. And starvation, famine is around the corner.
SIDNER: Jan, I'm really curious as to what happened when you said, you are liars. You came out and said that women would be educated, that they can
continue to work and continue to live their lives, and that is not what happened here and it's very clear. How did they respond to that?
EGELAND: Well, they were embarrassed. They were embarrassed and say that, well, things happen in any government. How could we predict the future and
how could we predict what the emir, the supreme leader, would decide. But then they also said, we will fight to overturn it.
Why can you not start to work with male staff only? With men only? And then I said, we cannot work with men only, because we wouldn't reach women.
Women would not be reached. Widows would not be reached. Single mothers would not be reached with their children. But we can't -- we will not
either.
I mean, you have, I say. You say you have values. This dress code and all of the things regarding to relations by -- from -- between men and women.
We have values too, and one of them is the equality between men and women. It's a fundamental value for us, and we will not cast aside all of our
female colleagues.
That's why they -- we stopped all work, or they -- they stopped all work. And at the moment, it is a crisis in Afghanistan. I hope more western
countries will send envoys there. I hope more leaders will go there. I met with several Islamic countries, Turkey, Qatar, Iran, they all say also that
they tried to overturn this in Kandahar.
SIDNER: You know, I find it maddening that you have the Taliban saying things like, we want women to only go to female doctors. And yet, we don't
want women to go to university. So, in essence, women can't see male doctors, and there's no more doctors who are being created through
education. So, you're taking away their ability to get medical care, essentially, overtime. What -- I mean, what do you do with that?
EGELAND: No -- I mean, absolutely. It is self-destructive. And I said it in so many words to those Taliban leaders. You're destroying your own country.
If there cannot be educated women, how can you then hold this -- hold on this traditional value that men cannot have contact with females outside of
their own family? It means that women will not get any help. But it's also -- paradoxical.
[13:35:00]
Here are Taliban ministers having female employees in their own ministries, and then they prohibit that with us as non-governmental organizations. It's
not thought through at all. But we have to fight it. We can fight it. We must fight it. There must be a united front against this in -- not only in
Afghanistan, but also in the neighboring countries, the Islamic countries and on the western countries.
SIDNER: I want to ask you about that. Is their leverage? I mean, what kind of leverage do you have as an NGO, and other international organizations
have in this situation? Because you're in a conundrum yourself. Some organizations have shut down because they're like, if women can't work
here, and they're like, that's not our values. We cannot allow this to go on. But then you're hurting the very people who need the services.
So, is there any leverage that you have that can be used to try and push forward for the rights of women?
EGELAND: Well, of course, the main leverage really is that the population, including the families of the Talibans, they come largely from the Pashtun
areas which is in the south and in the east. They will not have aid. I think there will be pressure bottom up.
I spoke to maybe, 30 important Afghan media when I was there. It's all over the Pashtun news. News in Persian. News in all of the local languages that
we said we were lied to. That we say there will not be aid. That we say that this edict leads to starvation in the population. And that the ban on
female education will destroy the economy and the welfare of the population, first and foremost, women but also the entire population.
So, I am hopeful. I think we have leverage. I think it's a mistake that the NATO countries rushed through the door, one and a half years ago, and there
is not -- the only envoys there now is the European Union Commission. Where are they? We're too alone, as humanitarian organizations, in Afghanistan.
It's the same 40 million women, children, civilians there, as when NATO left one and a half years ago.
SIDNER: Jan Egeland, thank you so much for bravery and trying to get some movement there. I appreciate you coming on the show.
EGELAND: Thank you.
SIDNER: Now, to China. China's reversal on its zero-COVID policy is seeing a wave that is overwhelming some hospitals. Research published in Chinese
state media suggests more than 900 million people in the country have likely been infected with COVID now, peaking nearly two weeks after the
restrictions were eased.
For millions of people, symptoms can persist be on the initial infections, lasting weeks, months, or sometimes years. Doctor Francesca Beaudoin is the
director of the Long COVID Initiative at Brown University, and joins Hari Sreenivasan to explain why it is so difficult to diagnose.
(BEGIN VIDEO CLIP)
HARI SREENIVASAN, CNN INTERNATIONAL CORRESPONDENT: Dr. Francesca Beaudoin, thanks so much for joining us. You wrote a recent column in "The Washington
Post" that almost look like a frequently asked questions section. And --but your point is, is that we actually don't have the answers to some of those
most frequently asked questions. Like, for example, what is long COVID? Here we are, year three of this, do we know for sure?
DR. FRANCESCA BEAUDOIN, DIRECTOR, THE LONG COVID INITIATIVE AT BROWN UNIVERSITY AND ASSOCIATE PROFESSOR AND INTERIM CHAIR, BROWN UNIVERSITY
EPIDEMIOLOGY DEPARTMENT: Yes, that's exactly right. You hit the nail on the head. We still don't really know what we're dealing with when we're talking
about long COVID.
SREENIVASAN: Why is that?
DR. BEAUDOIN: You know, part of this, it should not -- long COVID should not have surprised us. We have been dealing with post-viral syndromes for a
long time. In fact, if you -- looking back at the 1918 flu pandemic, which we make a lot of references to in talking about COVID, we saw a post-flu
syndrome during that pandemic as well.
But for some reason, long COVID caught us off guard. And, I think part of the reason that we don't understand it is that is very heterogeneous,
meaning long COVID means a lot of different things to different people. When we look at the symptoms of long COVID, we're talking about anything
ranging from loss of taste and smell, all the way to pretty debilitating fatigue and shortness of breath.
And then the other thing playing into it is that we don't -- we still don't understand what's driving it. What's causing it. The underlined biology or
sometimes it's called pathophysiology. We still don't really have a good hold on what is driving those symptoms.
SREENIVASAN: Usually, our problems are, we don't have a large enough data set. We don't have a great population mix. That's not the case for this. I
mean, we -- every kind of person has been infected by this all over the world.
[13:40:00]
DR. BEAUDOIN: That's exactly right. And we all, probably, know somebody that is suffering the long-term consequences of COVID, or long COVID as
we're calling it. So, you're right there's not an absence of people or problems to study. It's that, as we've seen with much of the pandemic,
we're still racing to keep up in terms of the science. The science is racing to keep up with the problem.
SREENIVASAN: You know, the Center for Disease Control had estimate that as of May 5, you know, several months ago in 2022, the U.S. has had roughly 81
million cases of COVID-19, and nearly a million COVID deaths, right.
So, even on a lower end, let's say, 12 percent with three or more symptoms of long COVID, of that huge number, that would be almost 10 million people
in the U.S. that would have developed this. That's roughly 10 times the number of people who have died with it. I mean, we've had -- you know, we
have a tendency to focus on the people who have died, and rightfully so, but the people who are still alive with this is a huge problem.
DR. BEAUDOIN: Huge problem, but what those numbers don't really tell you is the severity piece.
SREENIVASAN: Uh-huh.
DR. BEAUDOIN: And it's very different for somebody to be dealing with, maybe, some very mild fatigue but they can still go to the gym, they can go
to work, they can take care of their kids, from somebody that can't get out of bed and is disabled from COVID. And we know that those people exist.
And so, sometimes I worry a little bit that when we're talking about those huge numbers, staggering numbers --
SREENIVASAN: Uh-huh.
DR. BEAUDOIN: -- that a lot of people, it doesn't hold validity for them. And they say, well, jeez. I don't know 30 people that are -- that can't get
out of bed from long COVID. This can't be real. This can't exist. And I think we do a disservice to the people that are truly suffering from severe
long COVID.
And so, I do believe that there are many, many people suffering the aftereffects of long COVID. And there are some of those people have quite
severe aftereffects and I think we're not helping those people.
SREENIVASAN: Does it exacerbate underlying conditions?
DR. BEAUDOIN: I think that's one of the biggest things that we ought to be worried about. You know, it's interesting, the CDC published a study
relating long COVID to mortality, to deaths, and that made a lot of headlines. Long COVID kills.
And I wanted to push back a little bit on that. And that I think that's the wrong headline. Long COVID is not deadly. Actually, if you look at the
numbers, the -- probably people that are dying directly as a result of long COVID are very, very few and far between. But I think what we should be
worried about is how long COVID might exacerbate or hasten other chronic health conditions.
Either because you have a long COVID, so you're now not managing your other health conditions in the way that you should, maybe going to the doctor or
taking medications or treatment like you should because you're so exhausted or you're having trouble breathing or you have cognitive impairment, or it
may be that long COVID itself and the biology that's driving long COVID are interacting with other chronic health conditions like diabetes and
dementia. So, more of the work we need to focus is on just that. The interaction of long COVID and other health conditions.
SREENIVASAN: What have we learned over these past couple of years about who is affected more? I mean, I've seen reports that two thirds of the patients
with long COVID are women versus a third are men. I mean, have we -- is there a way to establish with the numbers of people we've already seen and
the research that's been done so far? Any kind of patterns?
DR. BEAUDOIN: The things we know -- I think at this point, we really do understand well the types of symptoms that people have following a COVID
infection in kind of the lasting symptoms. So, I think we understand that well. And we understand who is at risk, or at least we're starting to, as
you highlight, are in subgroups of people seem to be at higher risk for long COVID symptoms, women, older adults.
You do have to interpret that a little bit cautiously because a lot of the studies that have been done relied on volunteers. And so, that does not
tell us the whole denominator of people, the true head count of long COVID cases. And so, sometimes those findings can be bias. For instance, maybe
women are more likely to volunteer for research studies about long COVID, and so that might lead us to false conclusions.
That being said, I do think that there is something there. And it is a pattern that we sometimes observe it with other chronic illnesses. The
other thing that we need to be thinking about in terms of who is impacted by long COVID is through a health equity lens.
We know that certain communities were disproportionately affected by the initial phases of the pandemic, in particular. So, they have -- are black
and brown communities had disproportionate rates of COVID in the beginning. And so, the way that you get long COVID is through having a COVID
infection.
[13:45:00]
And so, certain communities are disproportionately impacted by acute infection. It then reasons to stand that they're also going to be more
impacted by long COVID.
The other thing to consider is that long COVID, differentially impacts people depending on what type of work they do. If you have a very physical
job, you know, if you're doing construction, or you're in a warehouse, you might be more impacted by long COVID than somebody that is a data analyst,
that works at home on their computer and can work flexibly and remote.
And so, there's many places that health equity plays out. And then we haven't even talked about health care access. And these are the things that
we need to be really pressing as we're thinking about how the pandemic continues to play out in the U.S.
SREENIVASAN: I mean, the way you're talking about it. there isn't any single treatment. I mean, because the symptoms present differently for
individual by individual. It's not like you can say, all right, well, we've created this pill and this is going to solve it.
DR. BEAUDOIN: That's exactly right. We still don't know the best way to treat long COVID. And right now, it's almost like whack-a-mole with the
different symptoms that people have. And a lot of this is falling to the primary care providers. We did have a lot of optimism, I think, in the
beginning that long COVID specialty clinics would provide, you know, an umbrella, you know, a place of multi-disciplinary care where people with
long COVID could have all of their needs met.
I think that long COVID clinics have not delivered quite on those promises and probably the experience of patients varies depending on their geography
and what academic medical center they might happen to be near, locally. Our long COVID clinic that was affiliated with our largest academic medical
center just closed. And so, that's something that we're hearing from patients as well.
SREENIVASAN: Speaking of research, the NIH is funding something -- I want to say something around $1.2 billion study called RECOVER. 40,000 patients
to studying long COVID. What do you think that they need to be asking if they're not already asking?
DR. BEAUDOIN: So, RECOVER was a massive investment. Taxpayer dollars, $1.2 billion. Probably one of the single largest research investments on behalf
of the government for a specific problem at one point in time. And some people have likened RECOVER to a glacier, and that it really was this slow-
moving mass.
And in the beginning, I don't think there was a lot of productivity coming from RECOVER, and it was quite opaque. There has been some increased
transparency and momentum around patient recruitment. And so, about two years in, and there has not -- I can't point to a single, like, landmark
study that has come from a RECOVER, but there is a lot of work ongoing.
In addition, a massive amount of infrastructure being built up in terms of data and just ability to recruit a lot of patients. So, I'm hopeful that in
the next year, we will start to see some products coming from RECOVER that tell us really, like, what causes long COVID. You know, the basic biology
and pathophysiology, and also treatment, an evidence-based treatment for long COVID.
And then thirdly, hoping to better classify long COVID. Right now, we call long COVID this whole bucket of things. But it may be that it really is
discreet, kind of, syndromes that were all -- that are all called long COVID now but may actually be different things. And that may be really
important for figuring out who develops long COVID, but also treatment.
SREENIVASAN: A 2021 study in the Journal of American Medical Association pointed out that nearly half of Americans reported signs of depression
after being diagnosed with COVID-19. Is there a mental health epidemic that's running in parallel to the COVID one?
DR. BEAUDOIN: Hard to know, and I think that the current studies really don't lend themselves to teasing apart those two things, and it probably is
cyclical. And what I think we're starting to observe is that long COVID itself, directly either exacerbates underlying mental health conditions.
And there's evidence that people do have new mental health diagnoses following COVID.
But it is really a complicated question to answer because multiple different things are happening at the same time. And so, teasing that
apart, you know, is important to understanding how long COVID plays out in different individuals. But in some regard, it doesn't matter.
We know that following a COVID diagnosis, you are more likely to develop worsening depression or anxiety. We should just -- we should be in tuned to
that. We should be aware in screening people and accessing treatment for depression and anxiety. I'm not sure that long COVID being the driver
changes the treatment of those things, if that makes sense?
[13:50:00]
SREENIVASAN: Yes. So how is our current health care system dealing with, say, conservatively, an extra million or 2 million people who have
different symptoms that require their doctor, a hospital, kind of different needs?
DR. BEAUDOIN: So, I don't think we're handling this well at all. I mean, health care, as you highlight, is in crisis to begin with. And now, we have
a new chronic health condition that that system is not equipped to handle both in the outpatient settings, and certainly in our safety nets, the
emergency departments. And so, it doesn't take very much to, you know, tip things over.
And again, I think part of the lesson learned here in moving forward, we talk a lot about the pandemic, and future pandemic preparedness, is how is
our experience with long COVID going to inform future pandemics so that we are ready for these ongoing sequelae of the initial infection.
SREENIVASAN: I know your organization is also working with insurance companies to try to calculate the cost of -- kind of, the added cost, I
should say, that there is for patients that are suffering from this. What's the impact?
DR. BEAUDOIN: We, at the Long COVID Initiative at Brown University are working closely with our partners at Blue Cross Blue Shield, Rhode Island
to try and understand that because that's another unknown with long COVID. You know, we've spent some time talking about the health effects, but what
are the economic costs of long COVID, just even from a preparedness standpoint.
You know, we all in the U.S., in some fashion pay for our health insurance. And so, we need to understand what the downstream implications of that. The
results are not fully available yet, but based on some preliminary analysis, there is an -- just following an initial COVID diagnosis, there
is an increased monthly and annual spent in that year following a COVID diagnosis.
SREENIVASAN: So, somebody looking at this from just, kind of, an economic lens, you're talking about increased health care costs right away. And
there's also got to be economic impacts for a number of days or hours these individuals spend no longer participating in the workforce. I'm not talking
not just sick days, but really if it's a chronic condition, they might be out of the workforce altogether.
DR. BEAUDOIN: That's absolutely right. So, the economic piece starts at the individual. And that, you know, we have talked to patients who are no
longer working and bringing in a paycheck into their house because they can't work because of long COVID, and now that person is no longer in the
workforce.
There's obviously been a tremendous amount of tension -- attention on the labor shortage in the U.S. and some have even populated that long COVID is
a contributor to that. And then, you know, bring back -- circle back to health care costs. And so, the ripple effect in terms of the economy can
be, I think, quite staggering.
SREENIVASAN: So, where would you say we are now in terms of being prepared for something like this to happen again? Considering that we're having a
conversation almost three years in and we still don't know exactly what it's doing to the bodies of people who are suffering from this. How do we
prioritize, how do we prepare, how do we get our minds around that a pandemic doesn't just mean the immediate virus and the first symptoms?
DR. BEAUDOIN: I hope that were there and, you know, again part of the infrastructure that's being built up from the RECOVER initiative would
poise us to be able to address this in a more real-time fashion. Part of it was that we started -- you know, the signal that long COVID was a thing
really started happening -- I don't know, several months, maybe a year into the pandemic.
And I think, next time, if we have learned our lesson, we will be looking for that early signal, you know, as soon as we know that a new disease or
virus has emerged. And we will be anticipating, kind of, the ongoing health care burden cost, and be thinking about health care access.
We have so much data at our fingertips. We need to use that data. We need to use it well. And we need to use it in real-time to not just surveil the
ongoing infection but to surveil the after effects.
SREENIVASAN: Dr. Francesca Beaudoin from the Long COVID Initiative at Brown University, thanks so much for joining us.
DR. BEAUDOIN: Thank you so much for having me.
(END VIDEO CLIP)
SIDNER: And finally. Earlier, we spoke about the importance of protecting our planet. Well, on the border of Brazil and Bolivia, an annual hatching
of baby turtles has created the world's largest gathering of those creatures. These are the progeny of some 80,000 female turtles who laid
their eggs in September. God, they're so cute.
[13:55:00]
They look so tiny now. But when they grow up to be giant river turtles, they can weigh up to 200 pounds. And, by the way, they'll help sustain the
ecosystem of the Amazon Basin. How adorable.
That is it for us for now. Thank you so much for watching, and goodbye from Los Angeles.
(COMMERCIAL BREAK)
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END
