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Fareed Zakaria GPS

Sizing Up Biden's $1.9 Trillion Relief Package; Biden Rallies "The Quad;" Walter Isaacson On The Next Great Scientific Revolution. Aired 10-11a ET

Aired March 14, 2021 - 10:00   ET



FAREED ZAKARIA, CNN ANCHOR: This is GPS, the GLOBAL PUBLIC SQUARE. Welcome to all of you in the United States and around the world. I'm Fareed Zakaria, coming to you live.


ZAKARIA (voice-over): Today on the show, President Biden has signed into law a $1.9 trillion relief package that will deliver much aid to America's poorest. But the economic world is asking the Goldilocks question. Is it too big, too small or just the right size?

I'll talk to two of the world's foremost economists, Larry Summers and Paul Krugman.

Then what is the Quad? President Biden met with the leaders of Japan, India and Australia, a new block focused on deterring China. Will it work? I'll talk to an expert.

And the biotech revolution brought us to the COVID-19 vaccines more swiftly than almost anyone imagined possible. It's given us the ability to edit genes to cure diseases and the innovations on the horizon are even more extraordinary.

I will ask Walter Isaacson to describe what's next.


ZAKARIA: But first, here is my take. Within hours of being inaugurated, President Biden began to roll back Donald Trump's most egregious immigration policies, including the so-called Muslim ban which Biden called a stain on our national conscience.

He signed six executive actions all geared toward a more humane and generous policy, and outlined an ambitious proposal for comprehensive immigration reform, including a path to citizenship for the more than 10 million undocumented migrants living and working in America.

The Biden administration has begun the work of reversing literally hundreds of other rules, regulations and fees put in place by Trump all designed to make it harder for foreigners at every stage of the process, from tourists to immigrants, to enter or stay in the United States. Unfortunately, all these vital efforts could be undermined by decisions that are producing a new immigration crisis on America's southern border.

In recent years, hundreds of thousands of Central Americans have tried to enter the United States to ask for asylum. The Trump administration initially used cruel tactics including separating children from their parents and putting them in cages.

But eventually arrived at a practical policy. It stopped taking in asylum seekers at the southern border, forcing them instead to wait in Mexico for their cases to be resolved and it negotiated agreements that allowed the U.S. to send people back to Central America to seek asylum in a neighboring country rather than in the United States.

Now Biden has overturned those policies and that, combined with expectations of a more generous approach to immigration, have contributed to the current surge of migrants. Nearly 180,000 people have arrived at the southern border or tried to cross illegally in 2021. More than double as many as in the first two months of 2020. These numbers will increase as it gets warmer. Officials at the border are already overwhelmed.

There has been a particularly large surge of unaccompanied children, probably the result of a Biden decision to create an exception to them to a Trump rule barring migrants on health grounds. As of Friday, federal authorities were scrambling to find places to house some 4,000 children languishing at Border Patrol stations, and were even looking at an airfield and an army base.

The truth is the asylum system is out of control. The concept of asylum dates to the years after World War II when the United States created a separate path to legal status for those who feared religious, ethnic or political persecution. A noble idea born in the shadow of America's refusal to take in the Jews in the 1930s.

It was used sparingly for decades, mostly applying to cases of extreme discrimination. But the vast majority of people entering the southern border are really traditional immigrants fleeing poverty and violence.


This is a sad situation, but it does not justify giving them special consideration above others around the world who seek to come to the United States for similar reasons but go through the normal process.

Trump already smells blood. Having been elected in 2016 in some large measure because of fears about illegal immigration, he's already attacking Biden on this issue. It dominated his speech at CPAC last month, where he said with his usual hyperbole --


DONALD TRUMP, FORMER PRESIDENT OF THE UNITED STATES: Joe Biden has triggered a mass of flood of illegal immigration into our country the likes of which we have never seen before.

(END VIDEO CLIP) ZAKARIA: Last week he issued another statement claiming many of these people were criminals and COVID carriers. The tragedy is that this border crisis and Trump's demagoguery around it could hinder Biden's efforts to achieve comprehensive reform of the whole system.

Asylum seekers make up a small minority of immigrants. There is a much larger group that includes those who have skills the United States needs as well as those entering to reunite with their families. Thanks to Trump's policies these immigrants and would-be immigrants now face a more hostile environment than at any point since the United States ended quotas in 1965.

You can see it in the numbers. With pandemic restrictions on top of everything else, immigration to the United States has plunged to levels not seen in four decades. Some of the world's best and brightest are now choosing to good to more hospitable countries, from Canada to Britain to Australia.

Census data showed that without immigration, the United States faces a dire demographic future. It would mean fewer people and especially fewer young people which would mean less growth, less dynamism and less opportunity for everyone. That is the real immigration crisis, not the one at the southern border.

Go to for a link to my "Washington Post" column this week. And let's get started.


JOE BIDEN, PRESIDENT OF THE UNITED STATES: I believe this is, and most people I think do as well, this historic legislation is about rebuilding the backbone of this country and giving people in this nation, working people, middle class folks, people who built the country a fighting chance.


ZAKARIA: That was President Biden in the Oval Office on Thursday just before signing the $1.9 trillion COVID relief bill into law. It was passed, it should be noted, without a single Republican vote despite polls showing that it had support of somewhere around two-thirds of all Americans.

To help us make sense of it all are two of the world's most distinguished economists. Paul Krugman won the 2008 Nobel Prize in economics. He is now columnist for "The New York Times." Larry Summers was Treasury secretary under President Clinton and director of National Economic Council under President Obama.

Paul, let me ask you, what's the headline here of how we would describe this bill? How do you think it will go down in history? What I'm struck by is I think in my adult lifetime this is the first major fiscal policy where the benefits go primarily to the poor.

PAUL KRUGMAN, COLUMNIST, THE NEW YORK TIMES: Yes. This is definitely -- I can't think of anything like this. Maybe if you have to go back to the New Deal to see anything like this. I mean, you'd certainly don't see -- we really don't have a fiscal expansion on this scale, a spending expansion on this scale.

You have to go back to the Korean War to find anything on this -- of this magnitude and of course that was about a war and this one is very much, it's very much that the benefits are concentrated into the bottom half and to an important extent the bottom 20 percent of the income distribution.

ZAKARIA: Larry, you have dealt with the politics of this kind of thing, both under the Obama and the Clinton years, and I'm thinking of the Obama stimulus which got not a single Republican vote. What do you think the calculus of Republicans is here? Two-thirds of the country seems to approve it. What is going on?

LARRY SUMMERS, FORMER U.S. TREASURY SECRETARY: I'm not going to try to speak for Republicans, Fareed. Look, there is a historic achievement in reducing child poverty in this fiscal stimulus. It's cost is about 7 percent of the total. I think the concern about this bill is that its sheer scale, relative -- the economy needs a lot of energy but if you put too much water in the bathtub, it starts to overflow.

And as I look at this bill, we're just trying to pour too much water in and I wish it were actually true that even a third of the money was going to people who were in poverty.


Most of it is not. Most of it is going to the middle of the population and it is going in one shot transfers, not in things that are ultimately going to build and strengthen the economy. And that's why as much as I admire the effort and as I much as I admire the progress against poverty, I am worried that the sheer scale is going to crowd out our doing what we need to do to compete with China, to build back better the president's principal aspiration.

And I'm very worried that this is going to lead us to difficulty down the road as inflation picks up and the Fed has to respond.

ZAKARIA: Paul, you know, you've described this as a different from a stimulus, more like war-time spending. And I was wondering, how you would respond to that, which is it was the war-time spending of the Vietnam War at least the conventional wisdom holds that led to the runaway inflation of the 1970s.

KRUGMAN: Yes. I think, first of all, that there were a lot of other things that happened in -- to lead to that inflation. And it also took many years of sustained irresponsible policy to get us to the stagnation of the '70s which we all think we remember, although a lot of that is more of a myth than the reality.

But in a way the closes analogy would be the Korean War, which was a brief huge expansion of spending, which did lead to a fair bit of inflation for one year. And -- but not to sustain inflation. So it wasn't actually -- it turned out not to be a big problem and I think there are a lot of reasons to think that this won't be nearly on that scale. So for what it's worth, there is a lot of other people who are actually in the business of making forecasts who think that this is a -- this is a big bill.

And there is a lot of stimulus even if it is mostly about stimulus but it's not something that's going to cause a massive overheating. They could be wrong, I could be wrong, Larry could be right, but the consensus view is not one that is raising alarm bells about the scale of this bill.

ZAKARIA: And Larry --

SUMMERS: I'm not so sure, Paul. I'm not so sure, Paul. First of all, interest rates in the first quarter of this year, current trends continue, will have risen by more than the first quarter of any year in the last century except for 1980. So markets are sending a pretty clear signal of concern. Second, you cut things off in the fourth quarter. If we've got an economy that's rapidly growing and is above potential, the inflation could well materialize in 2022.

Third, look at the -- look carefully at the magnitude of this stimulus. We're talking about something that's on the order of 14 percent of GDP, and people like you, people like me, most economists until very recently thought that when you have a dollar of stimulus, it added about a dollar or more to GDP, and if that works out, any time in the next two or three years, we're going to have a problem which is what markets are recognizing.

ZAKARIA: So, Paul, let me ask you just about the size because it's not just this bill, right? If you add the two previous bills that were passed under the Trump administration, we're at something like 30 percent of GDP? I mean, is there some point at which you would get worried?

KRUGMAN: Like I say is, look, if this was designed as a stimulus, if this had been designed to get maximum bang for buck, then we would be getting numbers that might be a concern. But it wasn't. And my take on it is that Biden is going to be in a position to say, hey, look, we got a blooming economy. A bunch of you have gotten checks. It's a -- look, government could do lots of good and that he'll be in a strong political position to do what needs to be done to invest in the future.

Larry's view is, it's going to be inflation has taken off, oh, my god, big government is a villain, Biden is the reincarnation of Jimmy Carter who is still alive, but still, they -- and that that's going to be the problem. Of course, Larry could be right. But that is not what my numbers say is likely to happen. It's not what the private forecasters think are going to happen. And, you know, we'll just -- unfortunately, pretty much, you know, this is a done deal. So now we're just going to see what really actually happens.

ZAKARIA: Next on GPS, does this new law represent the most important piece of domestic policy legislation since the New Deal or the war on poverty?

[10:15:06] The debate continues when we come back.


ZAKARIA: And we are back with Paul Krugman and Larry Summers talking about the $1.9 trillion relief bill that became law on Thursday.

Larry, do you worry that the infrastructure bill will not happen because in a sense we'll have -- Biden has used up all of his political capital for this one?

SUMMERS: I don't think he used up a lot of economic space and political space, but particularly economic space on this bill.


It just defies belief that you can commit $2 trillion to a program that contains no public investment and not have less capacity for public investment than if you had not made a commitment of that magnitude. I just don't find it plausible. And I think we're taking very substantial risks.

It would have been much better to have talked about large sums like this, but to have talked about things that would help us compete with the Chinese, that would talk about things that would help us prepare children for the 21st century.

That would help us save the planet, rather than what we've done here which is make transfer payments in virtually every direction. And, yes, when we do that to the poorest people, that is exactly right. But some of the transfer payments we've made I think are quite misguided.

For example, I believe strongly in unemployment insurance, but I do not believe in a program where the majority of unemployment insurance recipients are getting considerably more money than they got when they were working.

I think full insurance is enough. Insurance past that point is too much. And that in a way is emblematic of why I'm concerned about what this program is going to do to the economy.

ZAKARIA: Paul, I wanted to ask you, there was an interesting column by Steve Pearlstein, you know, "The Washington Post" economic columnist, I think it was his final column and he said that he -- I think he's a pretty straightforward liberal but he said, I worry a lot about a new liberal orthodoxy that says deficits don't matter, debt doesn't matter, you can borrow as much as you want. Spending always pays for itself.

And I think he was suggesting it was a kind of mirror image of the kind of view that you've often criticized Republicans as having, you know, the tax cuts always pay for themselves. Is it -- I mean, can one just borrow unendingly? Is there -- you know, are you not worried?

KRUGMAN: No. Is it possible to have a spending program that is too big? I mean, are the things that Larry is worried might happen as a result of this plan? Are those things that can happen? Definitely. If I'm OK with $1.9 trillion, but if someone had come along and said, let's do $4 trillion this year, then I would say, oh, that is inflationary. That's too far.

But the really important thing I think, if we're trying to think about this future, is that this is a short-term, this is a crisis response. It is a rescue plan. It's very front-loaded.

ZAKARIA: Larry, you get the final word.

SUMMERS: Here is the irony, Fareed. There is a lot that's good in this program. But I think it is advocates try to have it both ways. On the one hand, when a concern about inflation is raised, they explained that it's mostly temporary and transient and just a relief program, and really just a special one-year thing. On the other hand, most of the time they're explaining how it's the most fundamental revolution in American policy since the New Deal. And you can't really have it both ways.

You can either have long-term transformation or you could have temporary action. And what I would have liked to see more is a program of this scale or larger, that was paid for and was focused on investment and contained the necessary relief. This program goes vastly beyond, as my unemployment insurance example illustrates, what was necessary to provide relief and it doesn't, with the exception of the childcare anti-poverty thing, which is very important.

It doesn't really do much that either represents a revolution in social investment, on social policy, or revolutionary investment in the future of our country. And I think that's something we're going to look back on and regret. Not that we did something. But that we weren't more careful and calibrated in the design of what we did.

ZAKARIA: All right. We are going to have to leave it at that and obviously we will watch what happens and perhaps have the two of you back to do a midterm analysis.


Thanks very much, Paul Krugman and Larry Summers.

SUMMERS: Thank you.

KRUGMAN: Thanks.

ZAKARIA: Next on GPS, China is worried President Biden might be forming an exclusive clique with the leaders of three nations he met with on Friday. What is all this about? We'll tell you in a moment.


ZAKARIA: Top officials of the Biden administration have spoken out often about China in the last 50 days since inauguration. But we're now in between two big opportunities for them to act on their rhetoric. On Friday, President Biden met with the leaders of India, Japan and Australia. [10:30:04]

Collectively they're known as "The Quad," and their collective focus is countering China.

At the end of this week, Secretary of State Blinken and National Security Adviser Sullivan will meet with their Chinese counterparts face-to-face for the first time in Alaska.

Joining me now to talk about results and expectations is Susan Thornton. She was acting assistant secretary of state for East Asia and Pacific Affairs under Secretary of State Rex Tillerson.

Welcome. Let me ask you, the United States, Japan and Australia have been meeting and have had security cooperation for a while. The big new development appears to me to be that India is taking a much more active role and at a much higher level.

Does this signal that India has finally decided to join a kind of explicitly anti-Chinese, or countering-Chinese, camp?

SUSAN THORNTON, FORMER ACTING ASSISTANT SECRETARY OF STATE FOR EAST ASIA AND PACIFIC AFFAIRS: Well, I think it's interesting, Fareed, that India has finally stepped up and shown more willingness to engage with this so-called "quad" grouping of countries. It's been reluctant in the past to join with the group because of its pretty explicit symbolism against China.

I think now, of course, with the border clashes that we saw between India and China, they have stepped up. And I also think that there's more wherewithal for this group to cooperate on things that are substantive, going forward.

ZAKARIA: One of the things that has happened, in an awkward bit of timing, the quad talks a great deal about democracy, about being free and open. This week you have had two major international institutions, Freedom House and the V-Dem Institute in Sweden, downgrade India essentially to a non-democracy, or to partly free, to an electoral autocracy.

Is this reminiscent of the Cold War, when the United States overlooked the democratic decay of some of its allies because it wanted them to be part of the anti-Soviet camp?

THORNTON: Well, I think this does present a little bit of a problem for the quad members because they want to portray the organization as a grouping, a so-called "diamond of democracies," as it's been called.

But I think that it's not exactly like the Cold War. Because there are things that the group can do together. And part of the whole impetus behind the quad, frankly, has been an effort to try to get India to be more active in the East Asia region, a bigger contributor to global public goods.

So I think the quad can work on those issues. Of course, India is a democracy, even with problems. I think we can probably allow that a lot of countries have problems even though they be democracies.

And so I think these will present some tensions that will need to be worked around. But it shouldn't -- it shouldn't come into some kind of conflict overall with the efforts of the group to work on the issues that they spelled out in their meeting on Friday, which are really about kind of transnational issues.

So the public face of the quad wants to be about, kind of, attacking these transnational issues, climate change, the pandemic, technology issues. The hidden symbolism, of course, is against China. And I think they'll be able to work that balance going forward.

ZAKARIA: And finally, let me ask you, we don't have a lot of time, but have you been struck by the fact that, on China, the Biden administration's policies seem more a continuation of Donald Trump's than a significant departure from -- from them?

THORNTON: It's not unexpected, I would say. You know, they're, kind of, trying to assess where they want to go on China. We have this meeting coming up next week between Tony Blinken and Jake Sullivan and their counterparts in China. And I think that will be basically an airing of frustrations, for sure, on both sides.

But what we've really got to do is restart diplomatic communication. President Biden has talked about coming to China from a position of strength. And I think, now that they've met with this quad grouping -- Tony Blinken, of course, will be meeting (inaudible) allies in Northeast Asia, Japan and Korea before this meeting with the Chinese, which is a good diplomatic sequence to come to this meeting.

And I think, although there will be some airing of frustrations, what we really need to do is, sort of, look to a future, you know, road map or way of sitting down and looking at, sort of, the issues of problem areas and the issues of cooperation, and working out how we're going to start up communication and actual practical work with China on some of these irritants that have been plaguing the relationship.


And I think the Biden administration is going to be able to make this shift. There's so many issues on the plate, and a lot of them are very thorny so it's taking some time to iron them out.

But of course, the relationship with China is going to continue to be quite contested and quite competitive. But I think the Biden team is looking to, kind of, balance that out a bit with, you know, constructive cooperation on areas that are really challenging and where we need China to be at least collaborating with the rest of the world.

ZAKARIA: Susan Thornton, pleasure to have you on. Thank you.

THORNTON: Thank you.

ZAKARIA: When we come back, Walter Isaacson on the next great scientific revolution. (COMMERCIAL BREAK)

ZAKARIA: Just over a year ago, on March 11th, 2020, the WHO declared COVID-19 a pandemic.


Only nine months later, a British grandmother became the first person to get the Pfizer vaccine outside of clinical trials.

The biotech revolution is one of the main factors that allowed scientists to move at that kind of warp speed. Walter Isaacson's previous books have focused on the likes of Steve Jobs and Albert Einstein. Now he sets his sight on modern-day wonders of science in "The Code Breaker: Jennifer Doudna and Gene Editing, and the Future of the Human Race."

Welcome, Walter. You talk about...

WALTER ISAACSON, AUTHOR, "THE CODE BREAKER": Thank you, Fareed. Thanks for having me.

ZAKARIA: ... the three great scientific -- pleasure.

You talk about the three great scientific revolutions that have taken place, really, in the last 100 years, the first one, the quantum revolution, where Einstein and people like that help us understand what's underneath the atom; the second, the information revolution, that helps us organize all information into bits and bytes; the third, the biotech revolution.

Explain what -- what that means, and what is -- will it be as far- reaching as the first two?

ISAACSON: I think it will be definitely more far-reaching than the first two because it means we can code molecules the way we code microchips. We can code things like telling a molecule, "Hey, create this facsimile of a spike protein in this human cell so we can have an immunity against a coronavirus."

Or we can code a molecule to say, "Hey, cut DNA at this spot so we can get rid of a genetic disease." And down the road, we can say, "Hey, let's edit in some DNA we want so we can design our children to have certain traits that might make them safer or healthier," or go down a path that we may not want to go down, which is enhancing our children in ways that harm the species.

So these are going to be moral issues we have to face, but it's also a beautiful story of adventure about the wonders of nature.

ZAKARIA: At the center of the story -- I mean, I know the hero is Jennifer Doudna, who has been on this show many times, but is really RNA, the -- the somewhat neglected sibling of DNA.

Explain why RNA -- which is really the way human life began, the replication -- why is it so important? And maybe use COVID-19 and the -- and the messenger RNA to -- to help, you know, explain to viewers?

ISAACSON: Yes. When Jennifer was a young girl in sixth grade, she got "The Double Helix," which is Jim Watson's account of DNA. And she went on to say, "OK, I'm going to do the same with RNA."

Now, as you say, DNA is the famous sibling, the one that gets on the magazine covers. But RNA, you know, like, sort of, the siblings of famous siblings, is the one that does the real work.

What RNA does is it goes into the nucleus of the cell, gets that genetic information, and acts as a messenger to bring it to the outer region of a cell, where we create proteins, or every other cell in our body.

And so, with that messenger function, it's the one that says, "Hey, build this hair follicle or this neuron or this hormone." So it actually does real work. It doesn't just sit there in the nucleus curating information.

And that's how we put it to work in order to do the Pfizer-BioNtech and the Moderna vaccines, whole new types of vaccines. I mean, we've never seen vaccines like this. But they just reprogram the RNA and said, "All right, tell ourselves to build a tiny fragment of this spike protein that the coronavirus has." That makes it really safe, really fast.

And here's a really important thing. It means you can recode it. If the coronavirus tries to evade us by mutating or having variants, as it's doing, and it gets much different, you just type in a new code, just as if you were, you know, cutting and pasting a document or reprogramming a website.

ZAKARIA: So in a sense, what it has done is it has taken the making of vaccines, which used to be a kind of bespoke, artisanal process, right -- you had to find a weak strain of the vaccine or a little piece of the spike protein and put it in, and it's turned it into -- essentially, what it's doing is sending an e-mail into the body and saying, "Hey, this is what you should be looking for to fight?"

ISAACSON: Exactly, Fareed. That's why we call it messenger RNA. And as you say, instead of having to, sort of, create in vats weakened forms of a virus and take six, seven, eight years, and there's safety issues there, you can just do this by typing in a new code.

They did it in really three or four weeks when BioNtech, Moderna and Pfizer were working together on it. And it shows that what Jennifer Doudna has done throughout her life is to say "This miracle molecule of RNA can do two or three things. It can act as a messenger," as you just said, an e-mail telling ourselves to build this protein, "it can act as a guide, where you can attach it to an enzyme and say cut the DNA right here."


And that's called the CRISPR system. We borrowed that from bacteria. They've been fighting viruses for more than a billion years.

And there's just so much more we can do to fight cancer, to fight genetic diseases, and to do detection technology so that we'll have these home kits that use this CRISPR technology to say, "No, no, you don't have coronavirus; you have a strep throat, or, "Yeah, the cancer cells are resurging," or even, "You're eating the wrong type of yogurt; your gut microbiome isn't doing well."

And that will bring biology into our homes. And Jennifer Doudna and her companies are working on this. It will bring biology into our homes the way the personal computer brought microchips into our homes.

ZAKARIA: A Chinese doctor tried a very ambitious strategy with gene editing, where he decided he was going to take a pair -- twins -- and make sure that they never got AIDS. What was wrong with that idea?

ISAACSON: What he did was he crossed a line that we've been reluctant to cross. Because the edits I've talked about that CRISPR can do in the human body, like stopping sickle cell anemia, if you do it in reproductive cells, like early-stage embryos or sperms or eggs, they become inheritable, which means that not only the patients have it but it's passed down for generation to generation and edits the human species.

And we've tried to draw the line, until the Chinese doctor did that. And so people were appalled. But as you said, now that we've been hit with the coronavirus, there are people saying, "Well, wait a minute, what's wrong with editing our species so we're less susceptible to viruses?"

It's interesting, especially with Tony Blinken and Jake Sullivan meeting with the -- their Chinese counterparts on Thursday, that the Chinese have now been working in this international group of scientists, with Europeans, Americans, the British, and they've put that doctor in jail; they've made it so we don't do inheritable edits, and they're all working together internationally, especially the Chinese and the United States, on rules of the road for gene editing.

So when Blinken and Sullivan are there meeting their counterparts, they're going to have a whole list of things that we're going to have to fight over. But it's nice, also, as you said, Fareed, to have a list of places you can cooperate. That's the way detente worked during the Cold War. And scientific cooperation on gene editing should be the top of that list.

ZAKARIA: We've got 30 seconds. I want you to give the last word to David in your book, who had sickle cell anemia, and was asked would he like his genes to be edited? And -- and tell us what he said.

ISAACSON: You know, it's a provoking -- thought provoking thing. He's doubled over with sickle cell, a 17-year-old boy named David Sanchez, whenever he plays basketball. And they say, "We can cure it in future generations. Your kids won't have it."

And he said, "That's great." And then he says, "But maybe that should be up to the kid." And they say "Why?"

He says, "Well, sickle cell, it helped forge me. It made me more compassionate. It made me more persistent. I had empathy for other people because I went through it."

And so when we start fiddling with the human race, we have to make sure we keep those compassion and empathy and that we don't, sort of, say, "All right, we're going to end all diversity in society."

I was so touched by that 17-year-old. I think he's the best bioethicist in my book.


ZAKARIA: Walter Isaacson, always a pleasure to read anything you write. We will be right back.

ISAACSON: Thank you. Thank you so much, Fareed.



ZAKARIA: And now for our "What in the World" segment. This week marked a full year since many Americans first went into lockdown, a year since I last saw the "GPS" team in person.

A year ago COVID-19 was already well on its way to becoming the greatest public health emergency faced in decades. But behind closed doors, another public health crisis was growing mostly unnoticed, the opioid epidemic.

You remember that this was one of the glaring problems in pre-pandemic America. Well, it got much worse during COVID. Take a look at this chart from the CDC.

As we know, overdose deaths have been high over the past few years. But the rate accelerated when COVID-19 began sweeping the nation. Unlike the virus, the opioid crisis was not isolated to just a few hot spots. According to O.D. map, these deaths have gone up in 40 states since lockdowns began. At one Virginia hospital, overdose cases were reportedly up 1,000 percent.

Here is an astonishing way to look at it. There are some places like San Francisco where more people died last year from opioid overdoses than from COVID-19. What in the world is going on?

Some of the causes may be obvious. According to Harvard physician Michael Barnett, the pandemic was a perfect storm for substance abuse. The lockdowns, no surprise, increased feelings of isolation and despair. These stressors are some of the key triggers for substance abuse.

Economic downturn has also proven to exacerbate mental health crisis. What's more, social isolation means that people are using drugs alone. So in the event of an opioid overdose, there is no one to administer the antidote drug Nalaxone, or to call 911.

There are also more structural causes for the spike. Lockdowns and recessions don't just trigger substance abuse in individuals; they also restrict the programs designed to help those suffering.

Across the board, states have cut budgets for social services, from treatment centers to medical training.


In a September survey, 52 percent of community mental health organizations reported that demand for their services had increased but at the same time, 26 percent have had to lay off staff and 54 percent have had to shut down programs.

Now Trump's CARES Act of March 2020 and the COVID relief bill that Biden signed this week together allocated a few billion dollars for mental health and substance abuse programs. But experts say they don't begin to fill the gaping hole created by the recession.

There are some small measures of hope. First, the new COVID relief bill incentivized further expansion of Medicaid, which the Kaiser Family Foundation reports is responsible for 40 percent of all opioid addiction treatments. Further, the medications to treat these addictions have become easier to access thanks to looser restrictions and expanded telehealth.

Many medical experts hope that these changes will last past the pandemic, that even when life returns to normal, drug treatments will have shifted forever.

But my worry is that the new normal in America has become an increased use, dependence and abuse of these dangerous drugs. It is one more of the deep and long-lasting scars left by the pandemic and the lockdowns.

Thanks to all of you for being part of my program this week. I will see you next week.