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The Situation Room

Flu Outbreak Puts Strain On Hospitals

Aired January 10, 2013 - 17:00   ET


WOLF BLITZER, CNN ANCHOR: And you're in the SITUATION ROOM. Happening now, as a nasty flu bug spreads across the United States, is there still time to get vaccinated? We're going to hear from the nation's point man on infectious diseases.

And what happens when U.S. troops leave Afghanistan? I'll speak with the former U.S. commander there, General Stanley McChrystal. He's in here the SITUATION ROOM.

And new clues may show why the former football star, Junior Seau, committed suicide. Our own Dr. Sanjay Gupta is standing by.

We want to welcome our viewers in the United States and around the world. I'm Wolf Blitzer. You're in the SITUATION ROOM.



BLITZER: But we begin with the growing and, sometimes, deadly flu outbreak gripping almost the entire country right now. Forty-one states are reporting widespread activity and at least 18 children have already died from the virus. Parts of the country are being hit harder than others. The Minnesota Health Department says 27 people have died from flu-related complications.

South Carolina reports 22 flu-related deaths this season compared to one for all of 2011. Pennsylvania is also reporting 22 deaths. Six people are reported dead in Illinois. In Summerville, Massachusetts, near Boston, all 720 doses are free flu vaccine which were supposed to last the entire season have already ran out.

CNN's Mary Snow has been looking at the strain this virus is putting on hospitals. Mary, how bad is it?

MARY SNOW, CNN CORRESPONDENT: Wolf, certain hospitals are taking certain actions. One hospital in Boston, for instance, says it's now going to start screening visitors, asking them to leave if they're feeling sick. Patients will be given masks if they have flu-like symptoms. Here in New York City, some hospitals have set up walk-in clinics for people with flu symptoms.

This as hospitals across the country tried to contain the spread of flu cases and ease overcrowding in the emergency rooms.


SNOW (voice-over): In Boston where a public emergency was declared and ERs are swamped with flu cases, the city plans to offer free flu vaccines this weekend. New York's governor got a vaccine and encouraged others to do the same as health officials report flu cases are running five times higher than a year ago.

In Pennsylvania where one hospital set up a tent to isolate milder flu cases from more serious ones, the state has more than 11,000 confirmed cases, so far. And in Minnesota, some hospitals are imposing restrictions on visitors to stem the spread of influenza.

It's just part of the larger picture across the country where at least 41 states are reporting widespread flu cases weeks ahead of the usual peak flu season with more people landing in the hospital and the message is the same.

DR. ROBERT GLATTER, LENOX HILL HOSPITAL: I still recommend that everyone get vaccinated. It's still not too late to get vaccinated. That's very important to know.

SNOW: Doctors say it takes about two weeks for the shot to take full effect, but, some people who've been vaccinated can still get the flu.

DR. BILL SCHAFFNER, VANDERBILT MEDICAL CENTER: The influenza vaccine is a good vaccine, but it's not a perfect vaccine. It works better in young, healthy people than it does in older persons. It's the best vaccine we have, but there are cases of influenza that occur despite immunization.

They are often of benefit because they can prevent some of the complications. It makes a more serious infection somewhat milder.

SNOW: And health officials say this year's flu vaccine is a good match.

DR. MICHAEL JHUNG, CDC: The exact formulation of the vaccine will change from year to year depending upon what's circulating in other parts of the world. So, scientists have picked the best combination of the three influenza viruses that have been circulating and put them into this year's vaccine.

SNOW: That's the reason why people are told to get vaccinated every year.


SNOW (on-camera): And, Wolf, normally, the flu season peaks in late January and early February. Health officials say there's really no way to predict just how bad this season could get or hopefully may not get -- Wolf.

BLITZER: Mary Snow, thanks very much. Let's dig a little bit deeper and get some important -- critically important information from Dr. Anthony Fauci. He's the director at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.

Dr. Fauci, thanks once again for coming in. Let's get right to some practical questions. People have been e-mailing me questions knowing you're coming in. For example, if you haven't gotten the flu shot but you get the flu and you're dealing with the flu, after you recover, should you still go out and get a flu shot at this late moment? Will that help you?

DR. ANTHONY FAUCI, DIR. NATL. INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: If you really had the flu and, again, you have to get specific diagnosis of that and if it truly is influenza and you're infected with it and recover, then, clearly, you don't need to get a flu vaccine. But you want to be careful that you don't get another mild respiratory infection, think it's the flu, and then, say, well, OK now, I don't need the flu vaccine.

If you've documented flu, you don't need the vaccine. But the point that was just made a little while ago, Wolf, is that it is not too late to get vaccinated, and we are still in the upsurge in many areas of the country. This is an early start to the flu season. We usually see this later in January and in February.

So, that's the reason why people are being concerned because it's occurring earlier. And the last time it occurred with this type of an early pattern was in 2003 and 2004, which turned out to be a particularly bad flu season.

BLITZER: Was it an epidemic, then? Was it a pandemic? How would you describe this year's flu breakout?

FAUCI: Well, whenever you get above a threshold of infections, we call that the epidemic threshold. And if you look at the charts that the CDC put out on their website, it clearly has gone above that threshold. So, we are into what would classically be described as a flu epidemic. It's still on the uptick.

And usually, when you're above that baseline in the flu season, you stay there for about 12 weeks. We're right now at about week five or so. So, we still have a way to go even if it peaks. Remember, once it peaks, you still have a considerable amount of time where there's a lot of flu activity.

And right now, it may have peaked, perhaps, in some places, but for the most part throughout the country, it has not yet peaked.

BLITZER: A lot of us remember 2009 when we had the swine flu. How would you compare what's happening now to that?

FAUCI: Well, it's very interesting and a good question, Wolf, is that the 2009 H1N1, it was a different type of flu. This year, it's H3N2 was very widespread, particularly, among children, but in general, it was relatively mild among adults and among senior citizens. Unfortunately, it was more dramatically, clinically difficult among children because they didn't have any prior existing immunity. So, they're comparable in some ways, but in some ways, they're not. It was more widespread. A real explosion. It occurred very early. You might remember, Wolf, it actually occurred during the fall season right as children were going back to school at the end of August and the beginning of September and we had seen activity in the prior April.

So, it was a different pattern. But, in general, that flu from 2009 was widespread but not particularly severe, particularly, in adults.

BLITZER: Why are we seeing so many cases now?

FAUCI: Well, that's the way flu goes. I mean, we're getting a lot of attention appropriately so to this right now. And you're seeing cases now because this is the pattern of how flus occur. We usually would be seeing this sometime later in January into February. The characteristic about flu this year is that it ticked up earlier than usual.

And in general, if you compare it to 2002 -- excuse me, 2003 and 2004, when you have that kind of early click, that doesn't necessarily mean it's going to go way up, but it looks like it's following the pattern of what we saw in 2003 and 2004, which comparatively speaking was a bad year.

BLITZER: Does it have anything to do with the coming about during the holiday travel season?

FAUCI: Well, whenever you have people who are congregated together, that is always a condition that would make the breakout of a respiratory-borne virus like influenza is to be -- more likely to be transmitted in crowded places.

So, the fact that it started in the beginning of December, the very end of November and people congregated together, that certainly could have been a factor when you see breakouts among families, children who get infected, give it to the elderly individuals. That is not an unusual pattern for influenza. So, there's nothing particularly peculiar about this. This is the way influenza goes.

BLITZER: And one important question, if you have the flu, you think you have the flu, at what point do you go to the hospital?

FAUCI: Well, if you start to really feel seriously ill and have significant respiratory symptoms, you should see a doctor, but not just for sniffles or a mild cough when you go to bed.

One of the things I want to emphasize, Wolf, is that when you have influenza, which can potentially be a serious disease, if you get very sick or you're hospitalized or you're a member of a group that's at risk for complications like pregnant women, very young children, elderly individuals, individuals with chronic conditions, physicians should treat these individuals with anti-flu medication like Tamiflu.

You shouldn't wait when you have someone at a high risk for complications to get back a definitive diagnosis of flu. You should treat them right away, those individuals that are at higher risk for complications.

BLITZER: Dr. Fauci, thanks so much for joining us. I suspect we're going to be continuing this conversation in the days to come. Appreciate it.

FAUCI: You're quite welcome.

BLITZER: He's being called a tough dude. President Obama names trusted adviser, Jack Lew, to be his next treasury secretary, but why are some critics up in arms?

And should the U.S. stick to its phase withdraw from Afghanistan or cut its losses and get out now? I'll speak with the former U.S. commander there, retired general, Stanley McChrystal. He's here in the SITUATION ROOM.


BLITZER: Only weeks removed from a heated fight over the fiscal cliff, President Obama and Congress will soon go head-to-head soon once again over the budget and the debt ceiling. Today, the president announced he wants the man -- announced who he wants as his man in his corner, nominating his White House chief of staff, Jack Lew, as the next treasury secretary.

Lew served as a budget director for both Presidents Obama and Clinton. The president praised Jack Lew for being, quote, "a low-key guy" and hinted to Congress he wants Lew to get started as soon as possible.


BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Jack has my complete trust. I know I'm not alone in that. In the words of one former senator, having Lew on your team is equivalent as a coach of having the luxury of putting somebody at almost any position and knowing he will do well. And I could not agree more. So, I hope the Senate will confirm him as quickly as possible.


BLITZER: The president may not necessarily get his wish for a quick confirmation. Lew is publicly classed with Republicans over the budget. The "Wall Street Journal" editorial page referred to him as a yes man. CNNs chief business correspondent, Ali Velshi and I spoke with editorial writer, Stephen Moore, about why his newspaper is no fan of Lew's.


STEPHEN MOORE, THE WALL STREET JOURNAL: We were very critical of him in our editorial this morning, Wolf, for a couple of reasons. One is, look, we kind of were hoping that this would be kind of a new start for the president, that this second term might be a departure from some of the policies of the first term, and this suggests that it's going to be kind of more of the same.

And when you heard the discussion about how many Republicans really just don't get along with this guy, they don't agree with this philosophy. They think he's really hard to deal with the negotiations. I think that could presage some real big fights to come. But I wanted to mention one other point if I could, wolf.

One other things that bothers me about the president's cabinet in his first term and the one that's coming forward in the second term is you just don't have the business experience. And you've heard that complaint by business men and women around the country that, you know, where are the people who understand how business works, who know how to, you know, meet a payroll?

And Jack Lew does have private sector experience at Citi, but he's never really run a company, and I think that's a shortcoming not just of Jack Lew but the entire cabinet.

BLITZER: He did run two divisions at CitiGroup during the years when President Bush was in office.

MOORE: Right.

BLITZER: So, he did spend a few years up on Wall Street. Let me bring Ali Velshi.

MOORE: Hold on, Wolf. Let me just say one --

BLITZER: Go ahead.

MOORE: Can I just say one thing about that?


MOORE: Yes, but, you know, look at his performance at Citi. I mean, Citi actually needed a huge government bailout when he was there and, by the way, by many reports, the division that he ran lost billions of dollars. So, I'm not so sure that's a real star for him.

BLITZER: And you're right. Ali, hold on a second. But in the story I read today on the front page of the "Wall Street Journal," steve, it did point out, it did make the argument that even, as you point out, he did run those two divisions, one of which got into real serious trouble in 2007, 2008.

He wasn't the guy who was making those investment decisions that really caused such severe heartburn. I read that in the "Wall Street Journal" today.

MOORE: OK. Well, that may be -- look, I don't know all the facts about it, Wolf, but I will say this. He was in charge of the operation and it lost money, whether he was making the specific calls on investments, I don't know. But certainly, you know, you don't look at that reference and say, gee, this really makes him, you know, qualified to be the treasury secretary for the United States.

BLITZER: All right. Let's let Ali weigh in. You got a question, Ali.

ALI VELSHI, CNN CHIEF BUSINESS CORRESPONDENT: Hey, Steve, good to see you. Listen, I'm not sure there's anybody who Obama would ever nominate for treasury secretary that the editorial pages of the "Wall Street Journal" would be in favor, but maybe there is. Who knows?

But I would have thought you would have liked this, and I'll tell you why, because your history is one of a tax fighter, right/ You've been a tax fighter forever. You're founder of the Club for Growth.

MOORE: Right.

VELSHI: You've got the same DNA as Grover Norquist and Pat Toomey and guys like this.


MOORE: Right.

VELSHI: And this guy knows budgets, right? Jack Lew understands every detail about budgets. He's run the OMB twice. So, whether or not you agree with where he comes from, the fact is this is a guy who can speak the right language when the biggest crisis, you and I agree, the biggest crisis in Washington right now is the fact that there's an absence of a budget.

MOORE: Yes. OK. So, Ali, that's a great point. Let me address that because when I heard you talk about this before, it was the one thing you said I kind of disagreed with. What I'm saying is, look, we have a fiscal crisis on our hand. We have a debt crisis.

And if you look at his performance in the last few years in terms of running the budget office and being the chief of staff for the president, the debt crisis has gotten much worse. So, again, I don't look at that reference and say, gee, this is a guy who's going to really fix the problem.

And I do think what we need in Washington is some new thinking. And I'm kind of tired of this (INAUDIBLE). He's been in Washington in and out of government for 25 years, and I guess, my philosophy is, why not bring in some new faces granted they're going to have the president's philosophy but maybe looking at new approaches to bringing this enormous debt down.

BLITZER: Steve, do you remember his record at OMB during the four years, last four years of the second term of the Bill Clinton administration? How that budget thing worked out?


MOORE: I knew you were going to bring that up, Wolf. And look, I'll give him high marks for his record as Clinton's budget director, but I'm going to give him an F for his performance as budget director under Barack Obama because we took the deficit up to a trillion dollars, levels that, Wolf, you and I and Ali, I don't think we ever would have seen in our lifetime. So, look, the president is going to get his choice. He's going to be confirmed. I just don't think this is a guy who's going to really build bridges with the Republican Party, which I think all three of us think is desperately needed right now if we're going to get out of this crisis.

BLITZER: I agree with the need for building bridges, working together, compromise that is critically important. I know Ali does as well. Steve Moore, as usual, thanks very much for joining us.


A legal battle over photos showing the body of Osama Bin Laden. A federal appeals court considering whether to take action. Stay with us. You're in the SITUATION ROOM.


BLITZER: A federal appeals court weighing whether to demand the release of photos of Osama Bin Laden's body. Lisa Sylvester is monitoring some of the top stories in the SITUATION ROOM right now. What's happening in this one, Lisa?

LISA SYLVESTER, CNN CORRESPONDENT: Wolf, at issue, dozens of images of the late al Qaeda leader including his burial at sea. The conservative group, Judicial Watch, argues the freedom of information act requires releasing the pictures. That's been debated since the May 2011 raid which killed Bin Laden. The White House said at the time that it's not in the U.S. national security interest.

And shock and outrage in Paris after the apparent assassination of three Kurdish women political activists. The French interior minister says they were executed, but there's no claim of responsibility. One woman was a founder of the Kurdish worker's party, PKK, which has waged a war with Turkey and is viewed by the U.S. as a terror group. The ethnic Kurdish population covers parts of Turkey, Syria, Iran, and Iraq.

And, we're less than two weeks into 2013, but gauging by the number of jobless claims. The job market still has a long road to recovery. Claims rose during the first week as 371,000 people filed first-time claims for unemployment benefits. That is up 4,000 from the previous week.

And while there has been improvement over the last four years, claims idled in the 350,000 to 400,000 range for most of 2012.

And history takes center stage at the second inauguration of President Obama who will take the oath of office publicly with Martin Luther King Jr.'s traveling bible used for his speeches and sermons as well as the Lincoln bible on loan from the Library of Congress. And the president will use the first lady's Robinson family bible.

That has been around since the 1950 for the official swearing in. That is Sunday, the 20th. We are all looking forward to that. My understanding that is new, actually, on Sunday, Wolf. BLITZER: On Sunday, that's the official swearing, very private low key. But the big one, Monday, the January 21st on the steps of the U.S. Capitol.

SYLVESTER: Yes. For those of us in the news business, it's very thrilling and exciting because we get to do it twice.


BLITZER: I'll be working Sunday and Monday. Happy to do so. Love these historic moments. Thanks, Lisa.

So, what happens in Afghanistan after all U.S. troops leave? Just ahead, I'll speak with the former U.S. commander there, retired general, Stanley McChrystal is here in the SITUATION ROOM.


BLITZER: The Afghan president, Hamid Karzai, is now making the rounds in Washington with the shopping list. He's meeting with secretary of state, Hillary Clinton, this hour. He'll see the president, President Obama tomorrow. But he's already held talks on Capitol Hill and over at the Pentagon.

At issue, the U.S. troop withdrawal and Afghanistan's future security. Let's bring in our Pentagon correspondent, Chris Lawrence. He's working the story for us. All right. Chris, what's the latest?

CHRIS LAWRENCE, CNN PENTAGON CORRESPONDENT: Wolf, some people say that the White House put out this whole notion of zero troops in Afghanistan after 2014 ahead of President Karzai's visit is sort of a negotiating ploy to win some concessions on some other points. But I've got to tell you, it is a number that has raised a lot of eyebrows here in the building.


LAWRENCE (voice-over): The White House floated the possibility of pulling all troops out of Afghanistan. Now, the Pentagon is pushing back, saying it could jeopardize any negotiating power with the Taliban.

LEON PANETTA, DEFENSE SECRETARY: The stronger position we take in showing that we are going to continue to complete this mission, the better the chances we have to ultimately achieve political reconciliation.

LAWRENCE: The Pentagon was only the beginning of the Afghan president's visit to Washington.

PANETTA: Our meeting, I believe, helped -- will help lay the ground work for President Karzai's discussions tomorrow with President Obama.

LAWRENCE: Sources say President Karzai and his defense minister brought a wish list to the Pentagon, drones, helicopters, and hardware to support their security forces.

GEN. MARTIN DEMPSEY, JOINT CHIEFS CHAIRMAN: What we talked about yesterday was, you know, let's move beyond a wish list of equipment.

LAWRENCE: The U.S. wants assurances terrorists won't set up shop in Afghanistan as American troops leave. Karzai agreed.

PRES. HAMID KARZAI, AFGHANISTAN: (INAUDIBLE) to provide security to these people and to protect (INAUDIBLE).

LAWRENCE: But a recent Pentagon report reveals the Afghan border patrol relies on the U.S. for even its most basic needs, food and water. It's rife with illiteracy, lack of accountability, and corruption, and these conditions are expected to endure beyond 2014. But every troop in Afghanistan costs the U.S. government about a million dollars a year.

So, even leaving a small force adds up. 3,000 troops would cost $3 billion every year they're deployed. The question of how many troops remain is secondary to what they will do. Defense officials say Karzai prefers any remaining U.S. troops to focus on training his forces.

He's opposed to foreign troops conducting raids. That's a part of counterterrorism whereas trainers would patiently teach Afghan forces.


LAWRENCE (on-camera): Now, remember, the U.S. left no troops in Iraq, but that was due in part of the Iraqi government's demand that any remaining American forces be subject to Iraqi courts and laws. I spoke with a senior defense official who says he doesn't see that same sort of inflexibility with Karzai's administration.

He said, although, sovereignty is extremely important to the Afghan government, they see it more in terms of worrying about Afghan prisoners being held in U.S. military jails in Afghanistan more so than being very, very strict on providing maybe some legal flexibility for remaining U.S. troops, Wolf.

BLITZER: We're just getting video, by the way, Chris, of Hillary Clinton, the secretary of state, with Hamid Karzai over at the State Department right now. There you see it.


BLITZER: Getting back to that shopping list that the Afghan leader came to Washington with for weapons, who's going to pay for all those weapons for Afghanistan?

LAWRENCE: It's a good question, Wolf. I mean, when you look at just providing for the army that the United States has helped build there, it's going to cost about $4 billion a year of which the Afghans can only contribute about 500 million. So the U.S. will be on the hook for $2 billion of that. They'll try to get some international partners to pay another part of that. But, again, yes, the Afghan government simply does not have the revenue to buy, you know, big pieces of equipment.

So, again, that would be something that the U.S. would have to sort of try to find a way to finance to help support their forces.

BLITZER: Yes. Billions more. And we don't know what the end result of those weapons are going to be, good or bad for the U.S.

Chris, thanks very much.

So how tough will it be for U.S. troops to get out of Afghanistan? What sort of situation will they be leaving behind?

Let's hear now from a former commander of U.S. forces in Afghanistan.

And joining us now, retired U.S. Army General Stanley McChrystal. He's got a brand new book entitled, "My Share of the Task" that has just been released.

Congratulations, General, on this excellent new book.


BLITZER: Let's talk about Afghanistan right now. There are still, what, 66,000 U.S. troops on the ground in Afghanistan. Troops are supposed to remain there throughout this year, throughout next year. They are all supposed to be out by the end of 2014.

Here's the question. Does it really make any difference if they are pulled out more quickly or if they wait until the end? Is there going to be a real difference in the result in Afghanistan as far as the timing of the withdraw?

MCCHRYSTAL: Well, Wolf, I would leave the specifics to the commanders on the ground. But what I would say is the most important thing is the minds of the Afghan people and that's communicating that we're not deserting them, in fact, that we are going to live up to the strategic partnership that President Obama offered them in the fall of 2009. And I think it's essential to them having the confidence to carry the burden themselves in the future.

BLITZER: Well, we've been there, General, for more than a decade already. This has been the longest war in U.S. history. How much more time do the Afghans really need to get their act together?

MCCHRYSTAL: When I arrived in the spring of 2002, they had been at war for 23 years. The country was torn apart physically. They were psychologically traumatized as a nation. They need a long time to put things back right again culturally and physically, and now it's been 34 years. So I think it's understandable. I don't think we need to carry the major load now. They do. But they need a partner. They need a friend. BLITZER: So has the mission become one of going after al Qaeda in the aftermath of 911 which the U.S. obviously has done and done well to a mission of nation building in Afghanistan?

MCCHRYSTAL: Well, if you think back, we went to Afghanistan not on an Afghan invitation but instead to meet our requirements to unseat the Taliban to push al Qaeda out or to kill or capture al Qaeda. I think we took on a moral responsibility to help the Afghans sort things out after we'd overthrown the government. I think we also have a geo strategic interest in Afghanistan because regionally Afghanistan is very important, of course, nuclear armed Pakistan is key for that region and the world.

BLITZER: Because General James Jones, former national security adviser, retired Marine Corps commandant, NATO Supreme Allied commander, he said a few years ago there were, what, less than 100 actual al Qaeda operatives, terrorists, inside Afghanistan right now. Is that a number that's consistent with the information you had when you were the commander there?

MCCHRYSTAL: It is. In fact, I might have said on most days a little bit less than that but a lot more just across the border and, of course, we know if Afghanistan, when we revert to under governed or ungoverned territory, they're likely to find safe haven.

BLITZER: As we're peaking right now, General, Hamid Karzai, the Afghan president, is here in Washington for talk with the president, the secretary of state, the secretary of defense. Is this a man we can really trust?

MCCHRYSTAL: Well, I think you need to put President Karzai in context. In my book, I think I give a unique view of President Karzai in the role that he has to play. They don't have normal political parties in Afghanistan. He's been -- he's had his life attacked or attempts on his life three times. He operates in a very difficult political environment and he has an insurgency going.

So I think if you put all of those factors in play suddenly you get a better measure of the kind of task he has facing him. I'm not saying that President Karzai is a perfect leader. But what I'm saying is we should try to understand that context and I think it can allow us to deal better with a leader like him.

BLITZER: In your book, "My Share of the Task," you write this about the Afghan president. You say, "Hamid Karzai was a man of strong emotions and loyalties rubbed raw sometimes to cynicism by long years in politics. He was slow to trust but committed to relationships."

You traveled with him. You spent a lot of quality time with him. Bottom line right now, is he doing what he needs to do?

MCCHRYSTAL: Well, I'm not on the ground to judge the current activities but I think he's doing what he thinks he has to do, and that is navigate a Western coalition that is very skeptical of the mission and desirous of pulling out, dealing with a Taliban insurgency and then internal politics. So I think if you really look at his challenge, he's walking a tight rope in a stiff wind.

And just because he doesn't do everything we want doesn't mean he's not doing what he has to do to survive in that world.

BLITZER: Here's what really worries me. After more than a decade of U.S. troops in Afghanistan, billions and billions of dollars, we're still spending about $100 billion this year in Afghanistan, maintaining the U.S. and NATO troop presence there, U.S. troops basically can't even trust Afghan troops to go out on the same combat missions because there have been so many casualties, so many Americans who've been killed by supposedly friendly Afghan troops.

Explain what's going on.

MCCHRYSTAL: Well, I'm sure there's no single answer for each of the green-on-blue killings but clearly what you've got is an army that has grown very fast, a population that has a tradition of xenophobia, concern about foreigners, you've got deeply held cultural and Islamist feelings and in many cases when you get young people together, again like President Karzai, feelings get rubbed raw, there can be mistakes made, there's probably some Taliban influence in that but I think it's a -- it's a very disturbing trend but I don't think it's one that can't be worked through.

The feedback I get from most people is that while as bad as that is, it's overshadowed by the tremendous cooperation of many other locations.

BLITZER: The hunt for Ayman al-Zawahiri, the formerly number two al Qaeda leader, now the number one now that bin Laden has been killed, that's been going since 9/11 with no success.

Do you have any idea where this guy is hiding?

MCCHRYSTAL: Well, not current intelligence but I would assume in western Pakistan. He always had the requirement to do more operation, more operations that UBL did. We didn't see UBL, we didn't see glimmers of UBL or even shadows from UBL, but what we would see is indications that Zawahiri was moving around communicating. We had several times, when I was involved, when we felt we had a good location for him, that was never true for UBL.

My sense is that by doing that he will make himself more vulnerable over time and of course he's very dangerous to the Pakistanis, the West. Many people would like to get him and I think they eventually will.

BLITZER: Basically I'm -- when I'm hearing your criticism of the Pakistanis the U.S. really can't trust what's going on in Pakistan right now. Is that -- am I correct in my analysis.

MCCHRYSTAL: It's great you -- used the word trust because just for context if you were to put on a Pakistani lens and look back at the United States, back from their founding in 1947 with a very difficult history, they would argue that they haven't been able to trust the United States consistently. They helped Dr. Kissinger go to China. We had a treaty that they thought required us to come to their aid if they went to war and twice they went to war against India, tried to invoke that treaty and we did not think that it applied. We pulled out of the region essentially after the Soviets left Afghanistan. And of course invoked the Presser Amendment.

I'm not an apologist for either side. I'm simply saying that it's really important that we understand Pakistanis approach us with a lot of mistrust, a lot of concerns that we won't be a steadfast, consistent partner, and I think we've got equally legitimate complaints about their performance.

I think what we've got to do is continue to engage -- I don't agree with disengagement or pulling away. I agree with it's a constant effort to try to build a trust-based relationship over time.

BLITZER: General Stanley McChrystal's new book is entitled "My Share of the Task: A Memoir."

General McChrystal, thanks very much for joining us and of course thanks so much for your service to the United States.

MCCHRYSTAL: Wolf, thank you for having me.

BLITZER: The government's new Consumer Financial Protection Bureau just laid down some new rules for getting a mortgage. You're going to find out what's changing, whether it will help or hurt your chances of buying a home.


BLITZER: New rules could make it harder than ever to buy a home but that might be a good thing. They could help stave off another housing crisis.

Lisa Sylvester is joining me now.

Lisa, what are these new rules all about?

LISA SYLVESTER, CNN CORRESPONDENT: Well, Wolf, you would think that it's in the bank's best interest to not give a mortgage loan to someone who can't repay that loan. And you would think it's in a person's interest not to sign an IOU on a house that they can't afford, yet both happened during the housing bubble. And now there are new rules to keep that from happening again.


SYLVESTER (voice-over): The federal government wants you to know about Henry. A California man who bought his $500,000 home at the market peak. His lender approved the loan even though his annual salary was less than $50,000. Henry not surprisingly is now on the verge of losing his home.

There are many Henry's out there. The result of the free wheeling easy days of credit leading up to the housing market crash.

RICHARD CORDRAY, CONSUMER FINANCIAL PROTECTION BUREAU: The great praise from that era is the ninja loan, no income, no job, no assets but you could still get a loan and many borrowers did. The underwriting standards really deteriorated over that period that you're describing from 2000 to 2008. By the end of it there really was very sloppy, irresponsible lending.

SYLVESTER: Today the government agency looking out for consumers' financial interest issued a new rule on the ability to repay. Banned are no document and low document loans. A lender must consider the borrower's credit history, income, ability to pay, monthly payment and other factors. A lender can't use a teaser rate to mask the true cost of the mortgage. And there are new built-in protections for consumers and lenders under qualified mortgages.

No excess, upfront points or fees. A borrower's ratio of debt to income can't be greater than 43 percent and only in limited circumstances can lenders issue loans where the borrower is surprised with a huge balloon payment at the end of the lending term. And for the lenders, there's something key. There's legal protection from being sued by borrowers who default.

The Mortgage Bankers Association responded to the news cautiously optimistic, quote, "The rule was just issued and we must examine it carefully. Nevertheless, we applaud the bureau for offering a legal safe harbor to lenders when they originate loans that meet the rigorous qualified mortgage standards in the rule."

But will the new rule mean an even further tightening of credit for would-be buyers? Julia Gordon is at the director of Housing Finance and Policy at the Center for American Progress.

JULIA GORDON, CENTER FOR AMERICAN PROGRESS: Lenders have been waiting for the rules of the road to be cleared. They are clear now so lenders can start making more loans and giving more people mortgages.


SYLVESTER: Not many lenders have tightened underwriting standards on their own since the housing market collapse, but now these rules are mandatory for lenders and brokers and they will have a year until January 14th, 2014 to comply with these rules.

BLITZER: Important information for people who want to buy a house.


BLITZER: Thank you very much.

The results are in from a group studying the brain of the former NFL star Junior Seau. What it discovered may explain why he committed suicide.


BLITZER: New clues about the former football star Junior Seau, why he may have committed suicide. Researchers who studied his brain found that he suffered from a neurodegenerative brain disease, which could have occurred from repeated hits to his head.

Joining us now is CNN's chief medical correspondent, Dr. Sanjay Gupta, who spent a lot of time studying these concussions, these brain injuries from playing football.

First of all, Sanjay, what do we know about what was found in Junior Seau's brain?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, they were specifically looking for evidence of something known as chronic traumatic encephalopathy. And what this specifically means is certain proteins and tangles, if you will, that are found throughout the brain.

I'll tell you what. A lot of people that are familiar with Alzheimer's disease, it's in some ways a very similar process to Alzheimer's, except that's something that happens to people in their seventh, eighth decades of life. Junior Seau was 43 years old.

Wolf, let me just show you quickly if I can on this model of the brain. They look -- again, this is a little bit hard to talk about, Wolf, because I -- you know, I knew Junior Seau playing and it's just hard to talk about him in this way, but they found, specifically, in areas in this part of the brain, where some of the memory stores are, as well as some of the emotional centers of the brain, deposits of these proteins and tangles, and the concern was and the question was, could this be explaining some of the behavior that he had around the time of his death. Depression, impulsivity, and forgetfulness, was what was described. And the connection or an association seems to be there.

Really quick, Wolf, sometimes a picture is worth a thousand words. Let me show you specifically what we're talking about, a normal -- what a normal brain sort of looks like versus a brain with CTE. The top, you can see, Wolf, you don't see any of these dark brown sort of stains as you see on the bottom. It's those dark brown stains that represent those proteins and, again, they say, is associated with these behavioral changes that Junior Seau exhibited, Dave Duerson, and so many football players before them -- Wolf.

BLITZER: So the bottom line, does CTE explain Junior Seau's suicide? Is there a direct cause and effect, in other words?

GUPTA: No, I don't think you can say that. And I will also add to that that establishing cause and effect is what everybody wants in medicine and science, but it can take a long time to get that sort of data. What we're talking about here, Wolf, is still a relatively new science. It's still emerging. Thirty-five football players that have been examined at one particular laboratory in Boston, of them, 34 did have evidence of this CTE. But keep in mind, Wolf, that these were also players for -- that for one reason or another, their brains were being studied. So there was already some concern. It's going to take more study to sort of establish that connection, but one thing the researchers did tell me is that CTE, they have not found anything else that causes it, except for repeated blows to the head.

And by the way not just concussions, Wolf, but even what are known as sub-concussive hits. The kind of hit that you see a player -- they take a hit but they get right back up, seemingly nothing wrong? Those can accumulate according to some of these researchers and cause some of these problems later on down the line.

BLITZER: Which players, Sanjay, are at the highest risks for CTE?

GUPTA: We're not entirely sure. I mean, we do know that the more hits, the worse off you are. So if you start football early around in life and then play all the way through, you're going to accumulate a lot of these both concussive and sub-concussive hits.

I've seen evidence of this CTE myself in someone as young as 17 years old. So we know that it can happen pretty early on in life. And what you're seeing there, Wolf, is that that blow and the sort of swelling and sometimes the inflammation that can occur in the brain, that might be a precursor to CTE.

But, Wolf, your question is a good one. There may be some people who are more genetically pre-disposed to developing this. And we don't know who those people are right now.

BLITZER: Sanjay, thanks very much. And thanks for all the work you've done, all the research you've done on this problem. It's a growing problem.

GUPTA: Thank you, Wolf.

BLITZER: Lisa Sylvester is monitoring some of the other top stories in THE SITUATION ROOM right now.

Shooting -- another shooting incident and heroics by a teacher?

SYLVESTER: Yes, we have that story as well as a story about Syria.

Syrian Foreign Ministry official says the point man for the U.N. is biased and has deviated from his mission. In a recent interview, the U.N. diplomat said the government's political plan to end violence is just more of the same from a family that's been in power too long.

Meanwhile, the British foreign secretary promised today that all options are on the table to ramp up help for opposition, hoping to speed a political transition.

And as Wolf mentioned, a 16-year-old student armed with a shotgun walked into a California high school classroom this morning and took aim at two of his classmates. Sheriff's officials say one of those, a 16-year-old boy, was critically wounded. A gunshot toward a different boy missed. The shooter was taken into custody.

And tales of truck hijacking, smuggling, and underground production highlight a new report that find 60 percent of the cigarettes sold in New York are illegal. The problem, the highest cigarette tax in the country. A rate of $4.35 a pack, which is even higher in New York City. By contrast, Missouri's cigarette tax is only 17 cents a pack.

And a huge sendoff today. The governor of South Carolina, she watched her husband leave for the war in Afghanistan. Governor Nikki Haley's husband is a captain in the Army National Guard. He left for a month of training before his expected yearlong deployment. In a statement, the governor said she has a proud military family who understands the sacrifices of serving the country.

So he is going to be in Afghanistan for a whole year -- Wolf.

BLITZER: Yes, that's the nature of this. They go for a year.

SYLVESTER: Yes. We wish them the best to --

BLITZER: Of course.

SYLVESTER: All of our men and women in uniform.

BLITZER: We certainly do. Thank you.

Has a group of killer whales managed to escape a deadly trap beneath the ice? That's next.


BLITZER: We've been following a life-or-death drama in Canada's frozen Hudson Bay. Now a group of killer whales that had been trapped in a small space beneath the ice may, may be free.

Let's bring in our meteorologist Chad Myers.

Chad, what's the latest?

CHAD MYERS, AMS METEOROLOGIST: Well, what the wind was doing to the ice flow up there was pushing it all against the eastern shore of the Hudson Bay, way up here, up into northern Canada, up into Quebec. That area here, as it was pushed up against there, was trapping the whales up against the shore. And as the wind kept blowing in one direction, right here to this town in northern Canada, a very small little village, they found that this pod of whales, you can see the pictures there, so very dramatic, they couldn't get out.

Well, just, in the overnight hours, the winds last night blew dramatically from the northeast, making the ice that had right all the way up against these islands, let that ice crack away, move away from the islands, and the orcas were allowed to swim out. And so they haven't been seen now for about 24 hours. That's the good news. They do believe that they got out of there, and the ice is still not back to the shore because the winds are not blowing from the west just yet.

So some good news for those. Just dramatic pictures of those whales, coming up for air in a box not much bigger than a swimming pool.

BLITZER: Is the ice we see, Chad, early for the season or what other reason could they get trapped?

MYERS: Yes, that's a good question. In fact, what they believe is that the water is still warm, that's why they're there, but then this is free ice. We're talking about ice such as floating around in chunks, that ice that's floating around in chunks got pushed by the wind up against there.

So kind of two things. Yes, the ice is early, but the warm water to leave is late. And so that got these guys in a little bit of trouble.

BLITZER: Chad, thanks very much.

MYERS: Sure.

BLITZER: Happening now, flu vaccine and drug shortages. The National Rifle Association at the White House gun meeting. I'll talk to the NRA president this hour.

Diversity questions about the Obama Cabinet. Where are the women? And growing momentum for a $1 trillion coin.

I'm Wolf Blitzer. You're in THE SITUATION ROOM.