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CHRISTIANE AMANPOUR: Hello, everyone, and welcome to “Amanpour and Company.”
Here’s what’s coming up.
(BEGIN VIDEOTAPE)
AMANPOUR (voice-over): Tens of thousand protest Russia’s detention of opposition leader Alexei Navalny, but do they really threaten Putin’s
power? I ask Russia scholar Nina Khrushcheva and former Pentagon official Evelyn Farkas of what new U.S. policy should be.
Then:
JOHN KERRY, U.S. SPECIAL ENVOY FOR CLIMATE CHANGE: We have a president now, thank God, who leads, tells the truth, and is seized by this issue.
AMANPOUR: Is this the year the world turns the corner on climate change? Influential climate scientist Michael Mann offers his plan for how to save
our planet.
And:
DR. RICHARD LEVITAN, EMERGENCY PHYSICIAN, LITTLETON REGIONAL HEALTHCARE: Earlier diagnosis, earlier treatment, supportive care can improve outcome
tremendously.
AMANPOUR: Two emergency room doctors tell our Hari Sreenivasan how early intervention can save the lives of coronavirus patients.
(END VIDEOTAPE)
AMANPOUR: Welcome to the program, everyone. I’m Christiane Amanpour in London.
The Biden administration is already facing a major diplomatic test. Over the weekend, demonstrators in Russia came out in force to protest against
the detention of the opposition leader, Alexei Navalny. And, today, the White House called for his immediate release.
Now, crowds in Russia took to the streets on an unprecedented scale, and they faced a severe crackdown by riot police, as well as mass arrests. The
U.S. Embassy had warned Americans to avoid the demos, telling people where they would be held.
Now, that sparked a backlash from the Russian Foreign Ministry, accusing U.S. diplomats of — quote — “direct interference” in the country’s
internal affairs.
Navalny, who is President Putin’s most high-profile critic, called for the demonstrations after he was arrested on his return from Germany last week.
He was recuperating there from Novichok poisoning, which he has accused Putin of ordering.
Now, the Kremlin denies that. And Navalny knew he’d be in trouble the moment he set foot back in Russia, as he told me before he embarked on his
journey home.
(BEGIN VIDEO CLIP)
ALEXEI NAVALNY, RUSSIAN OPPOSITION LEADER: Well, I don’t think that I can have such a privilege being safe in Russia. But I have to go back, because
I don’t want these groups of killer exist in Russia. I don’t want Putin be ruling of Russia. I don’t him being president. I don’t want him being czar
of Russia, because, well, he’s killing people. He’s a reason why our — the whole country is degrading.
He’s the reason why people are so poor.
(END VIDEO CLIP)
AMANPOUR: Now, how big a threat is Alexei Navalny and his movement to Vladimir Putin’s government? And how should the Biden administration
respond?
Joining me now from Moscow is the Russia scholar Nina Khrushcheva. She is the great-granddaughter of Nikita Khrushchev and she’s a professor at The
New School. Khrushchev, of course, was Soviet leader during the Cuban Missile Crisis. And, from Washington, joining me is Evelyn Farkas, who was
deputy assistant secretary of defense for Russia under President Barack Obama.
Welcome, both of you, to the program.
I’d like to go straight to you, Nina Khrushcheva, in Moscow, because you were at those protests. So, I want to know, from your perspective, how big
a turning point was this weekend’s protests?
NINA KHRUSHCHEVA, THE NEW SCHOOL: Well, thank you very much for inviting me on the program. It’s a great privilege to be here.
It is a turning point, in a sense that, for the first time in many, many years that Alexei Navalny has been an opposition leader or the most
prominent opposition figure in the Russian scene, he is almost equal to Putin in political recognition.
It is a global Navalny that we are witnessing this time around. And I think that’s certainly changed the equation that existed before, because, before,
it was local. He was known, but it was the local opposition. Now we hear that the world is screaming and demanding Navalny’s release.
He’s talking to world leaders. He’s giving interviews. He’s listened to more than he’s listened to Putin. And I think, in this sense, he really
changed the equilibrium of the situation and Russia, for sure became a Putin equal.
The fact that he got arrested just upon arrival and probably is going to be imprisoned for some time, despite all the denials of the Kremlin that Putin
doesn’t care and doesn’t know and he’s just a blogger, really suggests that they do consider him a threat to the regime, and now have to play a very
difficult balance, because either he’s going to be more of a martyr, or he’s going to be some unknown local politician.
And I think that’s what’s going to be playing out in Russia in the next several weeks, if not months.
AMANPOUR: It’s extraordinary to hear you now place Navalny in a much more elevated position than he was us. You said he’s sort of Putin’s equal in
terms of public awareness now and the importance of it. So, let me just turn to Evelyn Farkas in Washington.
When you were in government, Russia was your — Russia was your speciality. And Russia has been a major problem. So, somehow, the United States has not
been able to get its response right, it seems, for nearly 20 years now.
What — now that you have heard how important Navalny is, what do you think the Biden administration should do, as it’s just starting a whole fresh new
page of relations with Russia?
EVELYN FARKAS, FORMER DEFENSE DEPARTMENT OFFICIAL: I mean, I think, Christiane, exactly what it’s doing. I mean, the Biden administration very
clearly has called for the release of Alexei Navalny. He’s not being held under any proper excuse.
I mean, the excuse is that he skipped on his parole for a court case which also was unfounded. And he skipped on his parole because the government of
Russia tried to kill him. They tried to poison him.
So, I think the Biden administration should speak clearly, firmly, stand up for human rights — and Alexei Navalny has human rights, after all — and
for democracy, and then work with the Russian government where it can based on interests, not based on some idea that we’re going to convince Vladimir
Putin and his team to care about the international order.
AMANPOUR: Nina, I want to ask you again, because, up until now, as you have said, Putin’s tactic was to ignore Navalny. And, obviously, he’s
unable to do that anymore.
And I just want to read how some have interpreted what they consider a very clever, almost like a guerrilla warfare of protest by Navalny right now.
So, “The New Yorker” says: “Navalny has managed to force the Kremlin to play his game time and again. Navalny is creating a model of guerrilla
political warfare for the digital age. The Russian state holds all the formal power and can tap virtually unlimited resources to stop the
opposition leader, but he catches them flat-footed all the same.”
Do you agree that he’s caught and he now is catching them flat-footed with some of his recent public — not antics, but publicity games to expose the
regime?
KHRUSHCHEVA: Well, I mean, it’s — his foundation has been exposing corruption for a long, long time.
But let’s also know that this is Russia. And corruption is nothing new to the Russians, nor that they are highly shocked about this. But the more
situation for every Russian, economic situation, especially with coronavirus, especially with Putin being in power for over 20 years,
slightly or not so slightly — depends on what the strata is — deteriorating, but it’s also an incredible Putin fatigue.
And it’s not just from the point of view of the people on the streets, but also, when you’re in power for that many years, the Kremlin is not
necessarily this hip and up-and-coming administration anyway. It was never as such, but now it’s an ossified system. It’s really something that is
getting old. And Putin is getting old.
And Navalny keeps talking about him, the old man, the old toad in the Kremlin. And so — but Navalny is the very new, Internet-savvy, protest-
savvy, because they’re sharpening their skills.
And what we are really witnessing, what I witnessed on Saturday when I went there, it was sort of the old system that does — the old tired thing that
the protesters has become indiscriminately guilty of just being there, being in a position of not supporting the Kremlin, vs. all these other
forms and modes of organization that Navalny was able to introduce to Russia.
For example, something that happened that never happened during the protests before, and they really took it from Alexander Lukashenko from —
the Belarusian leader who refused to leave office in the summer after the rigged elections.
They completely jammed social media, because they already know that those – – this kind of information will be like wildfire. And I was able to post things, and I couldn’t for about two hours.
So, this is something that trying to fight by the very old traditional authoritarian means. And I think what happened, what’s happening now is
that Russia has changed. And with Navalny, it is something that they can actually now put a face to that change, sort of the old broadcasting TV vs.
the Internet, the Internet crowd.
And that crowd, it seems to be winning. It doesn’t mean that Putin is going to go away tomorrow. But Navalny is now — is a very giant headache for
him.
AMANPOUR: That is so interesting, because, before, people, it seemed from polls, were not so enamored of him, Navalny, but definitely gravitated
towards his anti-corruption drive and the like.
And you’re now suggesting that he’s changed into a leader of a movement, an actual real, live head of a movement now.
What do you think the United States should do, or any other of the interlocutors that Russia has abroad, the E.U., the United States, et
cetera?
KHRUSHCHEVA: Well, some of the things that really has been actually victorious for Putin — I know America thinks that more sanctions, the more
lecturing, it’s going to turn around. And it wouldn’t.
I mean, it actually was very well — the point well-taken is that it’s going to be really very strategical, kind of even tactical with Putin.
Certainly, the United States and world leaders should be calling for Navalny’s release. The problem is that, the more Western powers, Western
leaders say to Putin that he’s not doing the right thing, the more he’s going to be doing — not doing that right thing.
So, I think the conversation not on — conversation on a bureaucratic level, on those people — and I really have high hopes for the Biden
administration. Of course, Biden needs to be critical of Putin, but they’re people there working, or should be working, and I’m sure working hard to
deal with things during the Trump years were not even possible.
And I think this could be something that ultimately would get to the top, when smaller things like nuclear agreements, I don’t know, the open sky
agreement, something, or climate change, things can be worked out. That may change generally the political environment.
Navalny may be brought back in into the local opposition, which, of course, it will allow Putin to deal with the international issues, if they release
Navalny.
AMANPOUR: It really is fascinating, because — it really is interesting, because you get a sense that the world is now full of younger people, the
generation of people who are going to tolerate these — as you say, this sort of ossified leadership.
It’s 10 years since the Arab Spring. As you mentioned, in your backyard, the Belarus demonstrations happened.
But let me ask you, Evelyn Farkas, because, clearly, the Biden administration has to potentially toe a pretty careful line. On the one
hand, they want to renew the START nuclear arms control deal, and they’re going to do that. Biden says he will do that for another five years,
because that removes one headache.
But let me just play the view from the White House podium from Jen Psaki, the press secretary.
(BEGIN VIDEO CLIP)
JEN PSAKI, WHITE HOUSE PRESS SECRETARY: Even as we work with Russia to advance U.S. interests, so too we work to hold Russia to account for its
reckless and adversarial actions. And, to this end, the president is also issuing a tasking to the intelligence community for its full assessment of
the SolarWinds cyber-breach, Russian interference in the 2020 election, its use of chemical weapons against opposition leader Alexei Navalny, and the
alleged bounties on U.S. soldiers in Afghanistan.
(END VIDEO CLIP)
AMANPOUR: So, Evelyn, that is a very long list of issues that the United States has with Russia, not to mention she also added that the U.S. will be
doing a review of this terrible hack that they believe Russia basically organized and conducted called SolarWinds into 10 federal agencies.
Went on for months. Nobody caught it in the United States. So, it’s pretty much a bit of a balancing act. All these things have to be dealt with.
Plus, they don’t really want to go for a — quote — “reset” with Russia.
FARKAS: No, but I think, Christiane, it works, because what we know now about this Kremlin and Vladimir Putin and his cronies is that you have to
speak directly to them.
And you’re not going to make any deals with them that they don’t think are in their national interests or in their regime interest. (AUDIO GAP) the
New START treaty, Putin himself has said, yes, I would like to extend it.
Of course, he said one year, because he would like to have four more years, not the five years that Biden calls for, five-year extension. He’d like
four years of negotiations where he can continue to try to exercise leverage over the U.S. and be in the spotlight.
It doesn’t matter that much. I mean, they can come out at four years, instead of five years, instead of one year. The reality is that, for the
Russian government, they see that as it being in their interest. And if we yell and scream in the United States about human rights abuses in Russia,
that’s not going to change that equation.
And I think we can. And, in fact, what the Biden administration understands is that, if you speak clearly and firmly, and you stand up for your
interests, for your values, the Russian government, this Kremlin is more likely to respect you and understand where the boundaries are, if you will,
and more likely to behave better.
Now, I want to just say a word, though, if I can Christiane, on sanctions, because people oftentimes, I think, fall into a trap of thinking that
sanctions are intended to just change the behavior of the regime that they’re directed towards, in this case, Vladimir Putin and the Kremlin.
Yes, ideally, that would be the outcome. But they also are really important in terms of indicating what Western values are, what is considered
acceptable under international law and what isn’t. They are valuable in terms of exacting a price.
And they also actually helped buoy the opposition. So, I was on a podcast that Greg Feifer had, the former NPR journalist, with one of the opposition
leaders who’s close to Alexei Navalny. And he said: I’m so glad for the sanctions. I don’t think they’re going to change what the Russian
government foreign policy is, but they’re important for us. They’re important so that the world knows what’s right and what’s wrong and that
the West is with us.
AMANPOUR: Well, interestingly, Mikhail Khodorkovsky, who was the last anti-Putin oligarch — he was an oligarch. But, nonetheless he paid, I
think, was it 10 years in jail or however much? He said there should be targeted personal sanctions on Putin and his very closest inner circle,
people who have actual influence on him.
Now, I know, Nina, you have a somewhat different view on that.
But can I ask you about the corruption and how much you think that is going to — the exposure of the corruption is going to actually affect Putin? So,
obviously, as he was being arrested, he ordered his team to release this production they did called the multibillion — what is it called? It’s
called the $1 billion Black Sea palace.
Apparently, 86 million Russians have already gone online to see these allegations of corruption by Putin building himself his massive, phenomenal
palace.
I’m just going to read what — or actually play what Putin said in denial, and then ask you about it.
(BEGIN VIDEO CLIP)
VLADIMIR PUTIN, RUSSIAN PRESIDENT (through translator): I have not seen this movie, simply because of the lack of spare time to monitor such
information. But I had a look at the video compilation my assistant brought me.
I want to answer your question straight away. Nothing named there as my property belongs to me or my close relatives, and never did, never.
(END VIDEO CLIP)
AMANPOUR: So, Nina Khrushcheva, how much of a problem is it for Putin — and, remember, he did it against then Prime Minister Medvedev as well —
the exposure of what he says is corruption and this kind of oligarchy sitting there at the top of power there?
Can — I mean, Putin claims not to care, and obviously denies it. But is it a problem?
KHRUSHCHEVA: Well, I don’t — I actually — I think that this — the palace thing was kind of an interesting entertainment. I don’t think it was
anybody — to anybody’s surprise.
And from my point of view, and people I talk to, it’s the local corruption schemes, when, for example, Alexei Navalny was poisoned in Siberia in the
city of Tomsk, and then was moved to another city by a mere very lucky coincidence.
Those targeted corruption stories of the local officials are much more important for the local officials, because, generally — I’m a Khrushchev.
Khrushchev had a palace. I mean, he didn’t himself have a palace, but it was — they used the czar’s palace in Crimea. Stalin used the czar palace
in Crimea. Yes, they were smaller palaces, perhaps.
But all this opulence really has been around for centuries. It’s not a new thing. I think people watched it because it was a Navalny investigation.
And it was interesting that the first Navalny — this large-scale investigation was about Dmitry Medvedev, who really was much smaller scale
than Putin.
So, if such a tiny thing like Medvedev is rich and powerful — rich, not powerful, but rich, then this country must be in trouble.
So, this was more entertainment than anything. But I think the reason it was such an important release is that, once again, it is a global Navalny
speaking. Navalny who flies regular class and lives in an apartment is a politician who does not have — who does not have those palaces.
So, I don’t think Putin should be afraid. And, I mean, I think this — he probably would take it as a little bite which he doesn’t need to pay
attention to. But these other investigations about Putin’s people around him, these are the ones that they should be very much afraid of and
watching, because these are more dangerous for creating a public negative response.
AMANPOUR: Let me just finally ask you, Evelyn Farkas.
The United States is always looking at the democratic process. And Navalny has said that he can’t run. He’s banned; 2024, he can’t run. But he and his
movement are going to try to challenge Putin’s party, United Russia, in some way and calling for smart voting to try to diminish the that party’s
power in the upcoming Duma, the parliamentary elections.
How much stopped you put on that, having watched Russia and the sort of attempt at civil society emerging?
FARKAS: Important point that you’re making, Christiane, that adds to what Nina said about how Navalny became more popular or more global.
He also became more Russian across the country, again, because he exposed the corruption, but also because he went and he found leaders in local
areas. And he — they started this smart politics campaign, where they decided they were going to — the opposition was going to get together,
regardless of their differences, and back the strongest opposition candidate locally in order to try to get into office.
And it worked for them. It worked for them, and so — out in the east. And so now they’re going to try to do that in many more places. And this was
actually exactly what Navalny was out in Siberia doing when he was poisoned. He was talking to local officials, talking to the opposition
about getting together and supporting some of these candidates.
So, I think the elections will be very interesting, whether Navalny he is in jail or not. He has a lot of people out there in the localities. And,
again, that’s also something that’s different.
One other point I would make is that we haven’t talked much about it; 42 percent, I believe, of the people who are demonstrating now, based on a
Russian sample poll that was taken that was mentioned in “The New York Times” — so, I don’t know how — what the, I guess, accuracy is, but still
that looks like almost half the people who are demonstrating had never demonstrated before.
AMANPOUR: That’s really interesting.
FARKAS: And then, second, Vladimir Putin himself is not very popular, I mean, in the sense that — relatively speaking. His popularity has
diminished.
And I think maybe Nina hinted at that as well. But that also creates a climate that’s more friendly, if you will, towards someone like Navalny.
AMANPOUR: Really interesting.
Evelyn Farkas, Nina Khrushcheva, thank you so much, indeed, for joining us.
Now, a really huge objective for the Biden administration is tackling the climate emergency. The question is no longer, is it real, but, rather, how
long do we have to wrestle with it?
Today, global leaders convened remotely for the Climate Adaptation Summit to share ideas for how to respond to the havoc wreaked by climate change.
John Kerry, who’s President Biden’s special climate envoy, said this to the summit earlier today:
(BEGIN VIDEO CLIP)
KERRY: Some of these impacts are inevitable because of the warming that’s already taken place. But if we don’t act boldly and immediately by building
resilience to climate change, we are likely going to see dramatic reversals in economic development for everybody.
Poor and climate-vulnerable communities everywhere will obviously pay the highest price.
(END VIDEO CLIP)
AMANPOUR: Leading climate expert Michael Mann has some good news to offer on that front.
In his book “The New Climate War: The Fight to Take Back Our Planet,” Mann lays out his battle plan for saving our environment and, in fact, of
course, our world.
Michael Mann, welcome to the program.
So, can I ask you about the title of your book? What is the new climate war, and what was the old climate war?
MICHAEL MANN, AUTHOR, “THE NEW CLIMATE WAR”: Yes, thanks, Christiane. It’s great to be with you.
The old climate war was this assault, a decades-long assault on the basic science of climate change by fossil fuel industry groups, those advocating
for them, advocating for their agenda, an effort to discredit the science, to discredit the scientists and convince the public and policy-makers that
we don’t have a problem.
Well, that’s no longer credible, right, because we can see the impacts of climate change now playing out in real time in the form of unprecedented
extreme weather disasters, floods, heat waves, droughts, wildfires, superstorms.
So, the forces of inaction, the inactivists, as I call them, can no longer claim that it isn’t happening or even that it isn’t due to our activity.
But what they have tried to do is to introduce a number of other tactics in their effort to keep us addicted to fossil fuels. And that includes
dividing the community of climate advocates, deflecting attention away from the needed policies, systemic solutions to individual behavior, and
offering up false promises and false solutions.
These are the various tactics in what I call the new climate war.
AMANPOUR: OK. So, the old one, I mean, you describe what we would call climate deniers. Now you’re talking about the inactivists.
What sort of false solutions are they — give us what they’re telling people as a kind of — to again sort of draw the wool over their eyes,
perhaps, in your view?
MANN: Yes, so deflecting attention, again, away from systemic changes, making it sound like all we have to do is to become vegans, and to travel
less, use more fuel-efficient — fuel-efficient cars, change our lifestyle, that it’s just about lifestyle choice.
And, look, we should do all those things. They decrease our environmental footprint. They often save us money. They make us healthier, happier, set a
good example for other people.
But what we can’t allow is for fossil fuel interests to make it seem like that alone is the solution in their effort to deflect attention away from
the needed policies, because, look, you nor I can’t pass legislation, climate legislation. We can’t build renewable energy infrastructure or
provide subsidies for renewable energy, put a price on carbon.
All of the things that we have to — that we need at the policy level, we can’t do as individuals. We need politicians who are willing to do that.
And the good news, as you noted earlier, is that now, with this new administration, with Joe Biden, John Kerry leading the international
climate effort, there’s real opportunity for meaningful policy action.
AMANPOUR: So, look, that really is very, very encouraging for all of us who believe that our planet or at least our civilization, our human
civilization, is in peril and time is running out.
But are you saying, then — how much can this administration actually do? And, of course, you’re right. It has to be systemic. It has to be
government. It can’t just be us eating vegetables, instead of hamburgers, or just recycling. It has to be everything.
How much damage was done by the by the Trump administration and all the administration’s who, frankly, were inactive for so long before?
MANN: Yes, and I’m glad you put it that way, because look, the inaction the part of the Trump administration really provided an opportunity for
other nations who had been active on this front to sort of back off in their efforts, China, for example, Australia, which has now become sort of
an outpost of climate change denialism, in response to the space for inaction that was created by Trump.
And so I would say the single greatest damage that was done by Trump and the Trump administration was the damage to our reputation on the world
stage, the fact that we were no longer leading the effort. In fact, we were the only country to actually back out of the Paris accord. It set a
terrible precedent. It sent just the wrong example to the rest of the world.
So, the most important thing that this administration can do is what they’re already doing, signaling to the rest of the world that we are ready
once again here in the United States to lead on this issue, because, as you allude to, there is a lot of damage that needs to be undone.
We need to restore all of the critical regulations, restrictions on methane emissions, stopping building new fossil fuel infrastructure, like the
Keystone XL pipeline, which Biden has said will no longer be supported now. We have to undo the damage that was done. We have to reestablish our
reputation the world stage.
But we have so much lost ground. Four years of lost opportunity means that we have to work even harder now.
AMANPOUR: Michael Mann, I just want to come to some of the solutions. You talk about some of the real solutions, like carbon pricing and the green
stimulus.
So, let me just run through a few. As we know, the bipartisan spending plan in December was with Democratic and Republicans support for $35 billion of
green stimulus. We know that the E.U. is using more renewables and fossil fuels. It did during 2020.
New York City’s largest pension funds have voted to divest their portfolios of an estimated $4 billion of securities related to fossil fuel.
And hopeful that Democrats and Republicans have agreed to the spending stimulus?
MANN: Absolutely. I think that signals, you know, that there is the possibility of sort of bipartisan corporation. Look, we’re not going to win
over the hardcore climate change deniers that are in the pay of the fossil fuel industry from fossil fuel states, but there are a handful, maybe a
dozen or so moderate Republicans who, look, they don’t want to be on the wrong side of history.
And after everything that has happened over the past few weeks, I think that they are re-evaluating their collective political souls, and maybe
there is a reservoir of goodwill among enough of them to come over to join with Democrats and pass meaningful climate legislation.
Look, I don’t harbor, you know, any misconceptions here. We are not going to see an expansive green new deal like legislation or set of bills pass
split 50-50 Senate, but there is an opportunity for some legislative action on climate which will complement the executive actions that we’re seeing
across the board with the incoming administration.
AMANPOUR: Well, you mentioned Australia, and you know critics say Australia, whether it is the government or the opposition, they are all in
hock to the fossil fuel industry there, we know the Murdoch papers have just like — you know, they have just come and crashing down on the head of
anybody who talk about climate change. It’s really hard in Australia.
But also, there’s this thing that you’ve pointed out, and that is, you know, how we are bamboozled by some language like carbon capture. You know,
even Elon Musk has talked about giving — what did he say, offering $100 million for carbon capture technology. But somebody like Janet Yellen, the
secretary treasury says, we cannot solve the climate crisis without effective carbon pricing. President does support an enforcement mechanism
that requires polluters to bear the full cost of the carbon pollution that they are emitting.
Do you think these fossil fuel people, the industry, I mean, will come to the view that carbon pricing is a must?
MANN: Well, they may come kicking and screaming, right. But I think what, you know, the environmental progressives have done a real service to our
public discourse and our political discourse. The Green New Deal, as I said, probably won’t pass a 50-50 Senate in anything like its current form,
but it sends a signal that there is a lot of passion and energy within the Democratic Party for meaningful action.
And look, conservatives, if you don’t get on board with some sort of the solution, you may end up getting stuck with what you view as a heavy handed
very large expansive climate approach. And so, I think it is broadening some moderate conservatives to the table, and I think carbon pricing is one
of the tools in the tool box that needs to be on the table and actually, it does bring along some moderate conservatives who believe that we can solve
this problem, you know, using market mechanisms in addition to all of the other tools that we have.
AMANPOUR: So, again, it is really interesting because the big behemoths, the BPs and so many others have given so much money to so many politicians
that it is a hard fix to break, a hard addiction to break.
But I just want to ask you how you feel about this potential evolution. So, in 2005, BP popularized the term carbon footprint, is essentially putting
the onus on individuals to limit our individual carbon footprints and deflecting, you know, the need for big structural change. But then when I
spoke to the then-former CEO, John Browne, I talked to him in 2019, and he had come to the idea of carbon pricing. Listen to what he said.
(BEGIN VIDEO CLIP)
JOHN BROWNE, FORMER CHIEF EXECUTIVE, BRITISH PETROLEUM: We absolutely, in order to get the temperature into a range that is acceptable in some way,
we have to charge for carbon, and we must have a carbon tax. Then we can deploy the technologies, and we will not, we will still use hydrocarbons,
because we don’t have the means whereby to replace them yet, but they will be cleaner and cleaner and cleaner. This is what we have got to do.
(END VIDEO CLIP)
AMANPOUR: So, what do you make of that and how influential could that be?
MANN: Yes. So, you have to listen carefully to messaging there, there’s a little bit of a suggestion that, hey, we can use cleaner fossil fuels, and,
you know, a fossil fuel can’t be the solution to the problem created by fossil fuels. Fundamentally, we have to get off of fossil fuels.
But what you see there is some repositioning, is a recognition that the people in the United States, and elsewhere around the world, including
Australia, I spent a sabbatical down there, they’re good folks and they know they’ve got a problem, and they want their government to do something
about it.
There is enough collective willpower out there that it is bringing the fossil fuel industry to the table and there’s going to be some hard
bargaining that needs to be done. We can’t make — you know, give them all of the concessions they are asking for here because they want an easy way
out. It’s not going to be easy. We fundamentally need the fossil fuel industry to disappear, but it has to do so on a scheduled timeframe makes
this transition manageable and fair and equitable.
AMANPOUR: I mean, it came up in the — it’s really — you know, I’m sure many who work in that, the ordinary people who work in it, not the — you
know, the very rich people who have become very rich on fossil fuels are very concerned about the jobs being phased out. It was a big part of the
election, Joe Biden talked, you know, about phasing things out, whether it was fracking or whatever it was.
And I just wonder what you think of, should the government stop paying these massive tax incentives to the fossil fuel industries and instead give
them to the green technology?
MANN: Yes, absolutely. And so, one of the first things we need to do it to stop, you know, these subsidies for the fossil fuel industries. It’s crazy,
right? The market incentives need to work in a way that makes renewal energy more competitive because it is not doing this damage to the planet,
and instead, we have these perverse incentives, you know, under the past administration and other past administrations where we’ve actually been
incentivizing the bad behavior, the fossil fuel industry.
And so, we need to level the playing field so that renewable energy can compete fairly against fossil fuel energy, and that means pricing carbon in
some way, that means subsidies and stimulus for green energy and renewable energy, that means meaningful regulation, that means international
diplomacy to make sure that we get our other global partners on board. There is no one tool in the tool box that’s going to solve this problem
alone. We use — we need to use every tool in the tool box if we’re going to do this.
AMANPOUR: Well, Michael Mann, it’s interesting and heartening to hear you have a more hopeful view. You’ve been in the trenches, you know, at war
with the climate deniers for so much of your career. So, thank you very much indeed for joining us.
MANN: No, thank you.
AMANPOUR: Now, hovering above all of this, the ongoing COVID pandemic. Here in the U.K., a harsh national lockdown continues amid pressure to
perhaps impose stricter new border controls. And in the United States, 25 million cases now have been reported.
The vaccines have provided the only light at the end of this tunnel, but supply is now an issue everywhere. Two E.R. doctors on the frontline tell
our Hari Sreenivasan more must and can be done to save lives through earlier diagnosis.
Dr. Caputo works at the Lincoln Medical Center in New York. And Dr. Richard Levitan at Littleton Regional Hospital in New Hampshire.
(BEGIN VIDEOTAPE)
HARI SREENIVASAN: Thanks, Christiane. Dr. Caputo, Dr. Levitan, thanks for joining us.
Dr. Caputo, I want to start with you. You are in a unique position to be able to work at public hospitals and through kind of private concierge
service, break it down for me. I mean, how many of the patients that you are treating in the Bronx have negative outcomes or die versus the patients
that you are treating in the concierge medical service?
DR. NICHOLAS CAPUTO, ATTENDING EMERGENCY PHYSICIAN: Right. So, we actually just published a paper in the journal of Internal Medicine on our outcomes
for the time period of the pandemic surge. And depending on the co-work you fell into really dictated your risk of poor outcome.
Overall, mortality for that six-week time period we covered, which is about 12,000 COVID positive patients was about 30 percent. So, you know, if you
got COVID in New York City during the time of the pandemic surge in the public system, the mortality was around 30 percent for the overall
population of patients that were admitted to the hospital. Now, these were highly acute, highly ill patients that came in.
So, to me, that number is actually quite good. Just when you breakdown the subgroup analysis to that, if you were on renal replacement therapy or you
were intubated, your risk of fatal outcome really shot up to above 80 percent, above 90 percent. So, your high-risk of having a poor outcome if
you had severe illness on top of COVID as opposed to — at Solace, in the concierge service, it was less than 1 percent.
Now, why was this? It really had to do with our ability to deploy things such as fingertip pulse oximetry at home, Telehealth at home, doing daily
check-ins with patients. And I’m talking early, I’m not talking this was just initiated like two or three months ago. We really initiated this back
in late March, early April and it really was to the credit of our leadership over at Solace.
And so, I think those interventions early on really helped us to, you know, find those patients that were at highest risk earlier in their course of
the disease which, you know, led to better outcomes.
SREENIVASAN: So, Dr. Levitan, we recently have he the president saying we’re looking at possibly 500,000 people dead by the end of February. Have
things changed enough where we can bring the number down by doing things, intervening after people have a diagnosis of COVID but before they get to
the hospital?
DR. RICHARD LEVITAN, EMERGENCY PHYSICIAN, LITTLETON REGIONAL HOSPITAL: We have learned incredible amounts of stuff about COVID over the last 10
months. We have learned that the amount of virus you get exposed to can affect your outcome. Obviously, we’re learned that comorbidities, age,
diabetes, heart disease, there’s a myriad of things that we know now are associated with worse outcomes.
But after 10 months, the fundamental thing we have learned about this disease is that the sooner you come in, the earlier you get diagnosed with
COVID pneumonia, the earlier we can detect it and the earlier we initiate supportive care, we can modify disease outcome.
So, 10 million Americans over the next few months, 10 million Americans despite the best efforts of Biden administration, which I hope they are
very successful of getting out the vaccine out, but 10 million Americans are going to be infected with COVID and they cannot adjust their age, they
can’t adjust their viral load, they can’t adjust their diabetes status or their race. And we know that Hispanic and black patients are at greater
risk of serious outcome.
But the one thing they can do which was shown by Donald Trump, which was shown by Boris Johnson and which, you know, Nick Caputo is speaking to
about the Concierge Service is that earlier diagnosis, earlier treatment, supportive care can improve the outcome tremendously.
CAPUTO: Let me just jump in real quick. This is actually — we are starting to see this in the literature. You know, there’s evidence out of
Italy as well as the Midwest in the United States where they are showing the patients who were discharged from the emergency department that were
COVID positive, that were sent home on a home monitoring program with fingertip pulse oximetry and daily checks, had a lower revisit rate and had
lower rates of intubation and poor outcome.
So, the evidence is starting to come out. So, you know, it’s nice to be ahead of the game just a little bit but the evidence is starting to catchup
with what we’re seeing on the frontlines.
SREENIVASAN: And, Dr. Levitan, the pulse oxis that I see at my local pharmacy, these are maybe $25 or so, maybe $30, maybe less. Is this
something that hospitals and the state health agencies should start distributing?
LEVITAN: I absolutely believe so. These oximeters are tiny, they are small. This one is $20 from Walgreens. And what we now know is that they
will show lung injury before the patients feel it.
So, you know, this past week, I had a handful of patients who were being monitored with these pulse oximeters, and the only reason they came in was
because their oxygen fell. One woman who went to bed at night with a normal oxygen woke up and it had gone from 95 percent, 94 percent down to 78.
Now, she is morbidly obese, a cancer patient, she has stents and diabetes. She came in with a pulse ox that had dropped overnight significantly. And
she was shocked when I told her that her x-rays showed a small pneumonia, the beginnings of COVID pneumonia. And she was surprised when I said, we
have to hospitalize you. We can get ahead of this and we can make sure you have a good outcome. And she looked at me and said, but I feel fine, and
that is exactly the challenge of COVID.
The challenge of COVID is that the patients do not realize they are developing lung injury early on. And when they finally come in, because it
is clear they can’t breathe, when we shoot the x-rays of those patients who come in at eight days, 10 days after the diagnosis of a COVID positive
test, when they come in, their lungs are severely injured and they have a high-risk of landing on the ventilator and landing in the ICU.
And so, just by comparison, this week I had a 29-year-old who fell into the category. She had been diagnosed 10 days earlier, did not get home
monitoring and she came in when she was out of breath and had severe lung injury, wound up in the ICU and, you know, wound up on ECMO, which, you
know, our last thing we do to try to keep these patients alive, by putting them on a heart/lung machine.
So, I believe early treatment results in better outcomes, significantly better outcomes. It is important to note that this is not my idea. You
know, this is now adopted universally at the Mayo Clinic. If you are diagnosed with COVID, you are monitored with pulse oximetry. The Mayo
Clinic is one of the finest institutions in this country. The best institutions in this country are doing this on all of their patients.
Nick can speak to the fact that New York City recently deployed 200,000 of these pulse oximeters. NHS in England also recently deployed 200,000
oximeters to high-risk patients.
So, to the Biden administration, over the next two months, you know, great. Let’s get the vaccines going, but let’s help as best we can the people who
will get diagnosed with COVID so that have their best chance of survival.
SREENIVASAN: So, Dr. Caputo, what is happening in New York? What are you finding with the deployment of these?
CAPUTO: You know, I think part of the problem was the messaging that we put out. So, you know, basically, what we told people was it, if you have
COVID, stay home. But if you get sick, you should go to the hospital.
But as Richard was saying, with this disease that causes silent hypoxia, it is difficult to navigate that situation because you don’t know when you are
actually going hypoxic, right.
SREENIVASAN: Is that because our bodies are compensating in some way or I mean, am I —
CAPUTO: That’s what we believe. We believe that it is a slow progression to hypoxia. And so, it is not a sudden onset. So, you’re not all of a
sudden out of breath. It’s slowly — your o2 levels are slowly dropping over time. And so, you are not really noticing it. And so, that is a major
issue right there.
You know, one of the spectrums, we’re saying, you have COVID, stay home, isolate, quarantine and one the other end, I’m saying, if you get sick,
come to the hospital. Well, as Richard was saying, when people start to feel sick, they’re short of breath, they’re dyspneic, we’re already way
behind the eight-ball, because these were the people that were showing up in March, April and May that had, you know, pulse oximetry’s in the 60s,
70s but they were sort of short of breath. At that point, it was — you know, they were on the fence.
You know, so what the city basically did, because, you know — and New York City Health and Hospitals treats the population, you know, as truly diverse
as the city itself, you know, not all of the patients speak English or have smart phones. And so, we needed a solution that would work for everybody.
And you know, the HH Program that was developed, and, you know, I have to give credit because it is due by a good colleague and a friend of mine,
Gabe Silvestre, who is an (INAUDIBLE) doc here at New York City Health and Hospitals.
It’s a program that does daily checks and provides a pulse oximeter to patients who are diagnosed with COVID and discharged from the hospital to
determine the early signs of deterioration, and really give them the means to have a meaningful visit by phone or FaceTime or Zoom or whatever it has
to be with an emergency medicine provider to determine the proper course of action.
Now, anecdotally, what I have seen is much less severity coming through the doors or the emergency department here at Lincoln and as well as in other
emergency departments that I work at, but more of a volume of the COVID positive patients. So, the volume is going up but the severity is coming
down and I think that is in part as to what Richard was saying due to what we have learn and how the treat the disease. And really, how to detect it
early on.
So, again, early detection leads to early treatment, leads to better outcomes.
SREENIVASAN: Dr. Levitan, someone listening to this and say, well, at what cost, right? But I am assuming that even if you paid the retail price for
every one of those 200,000 pulse oximeters and you had, I don’t know how many dollars spent on the people that were on the phone, checking up on
those patients, that is still less money, I am imagining than what the hospital system is spending per patient when they get in or, of course, the
loss of life which is kind of incalculable?
LEVITAN: Absolutely. So, let me just give you a sense of the significance of this in terms of the system impact. Currently in Southern California, as
you are well aware, ICUs are overwhelmed. What many people don’t realize about COVID patients who develop what we call the critical illness, ICU
level care intubation, ECMO, these patients are in the hospital for not, you know, three days, five days, they’re in the hospital for 2, 3, 4, 5, 6,
weeks if they live. We’re talking patients who land in the hospital and they don’t move through the system.
Now, the patients who I have seen, and I we’ve had much experience with this now since we started doing pulse oximetry back in early April, the
patients that I have seen who come in the moment their oxygen dropped, they’re in and out of the hospital in a floor bed, not an ICU bed, on a
floor bed in four to five days, just like our former president.
They get some steroids, they get oxygen, they get put on a proning cushion, it’s a way to make them more comfortable so they can breathe. But the
things we’re doing, simple early things, have led to them to going in and out of the hospital quickly. And so, you know, even in this past week, I
had a dialysis patient, diabetic, getting treated for cancer and he came in with early, you know, oxygen that had just dropped overnight, and he was
only 88 percent, but he was high-risk patient. And we gave him Dexamethasone, we gave him Remdesivir, he wound up in the hospital. He was
out of the hospital in four days, even though he had every risk factor you can imagine for a bad outcome.
So, while there are increases in work that Nick talks about, proving Telehealth, providing, you know, access to these oximeters, getting, you
know, the dollars and putting this into place, what we are saving on the backend in terms of patient days in ICU is extraordinary. And every one of
those critical illness cases, I mean, just think about this for a moment, every critical illness case of COVID is in excess of $1 million. Easily.
It is staggering to think about the resource utilization that is happening because of the delayed care and severe presentation that we could avoid.
SREENIVASAN: So, Dr. Caputo, if the data is coming back from places like Italy, if cities like New York are rolling out this plan, what’s to stop
the rest of the country? Why is there still such a gap?
I mean, because for me, what’s odd is being a New Yorker, it wasn’t like we didn’t let the world know what we were going through, right? I mean, we —
everybody knew what was happening in New York. Yet, here we are 10 months later, and it is happening again in Los Angeles. So, my question is what is
it going to take for other hospital systems, other health care systems, insurance companies to try this?
CAPUTO: This is the million-dollar question. You know, I don’t have an answer as to why the response in the rest of the country hasn’t been, you
know, more optimal knowing that the lessons of New York were not — you know, they weren’t sealed in a vault, we didn’t work in a silo.
You know, I took part in many webinars and WhatsApp groups and Facebook groups just imparting information on what we were seeing in the frontlines
during the surge, during the pandemic, what was working, what wasn’t working. Now, I do have to say on the other end of that is that the
mortality rate is not like what it was in March, April and May. So, obviously, people were listening, those interventions that Rich was talking
about are being applied.
And so, though the volume is up ticking, the mortality is not. And so, you know, that gives me comfort that, you know, the lessons of New York and the
tragedy that happened in March, April and May, the really tough lessons were taken to heart in terms of individual patient outcome, but the overall
lessons in terms of preparation and prevention seems like, I don’t know if they were glossed over or, you know, there were other bureaucratic issues
involved that prevented optimal logistical preparation for it, but it’s a hard question to answer.
LEVITAN: Let me just give you my two cents on this. This past week, when I had this critically ill person who was not given monitoring, who was not
given a pulse oximeter and who came in 10 days later, I actually reached out to the testing center where she had her COVID test. And I asked them, I
said, why don’t you guys do the pulse oximetry monitoring. And the person who was familiar with her care, who was familiar with me said to me, I’ve
been reading your stuff, Rich, but the CDC does not recommend it yet. There’s no recommendation from the CDC on this. So, we don’t do it.
I think, you know, Biden administration is looking at what it can do to prevent deaths over the next few months and obviously as fast as they can
deliver the vaccine, let’s do it. But for the 10 million Americans facing down a COVID diagnosis over the next few months, for the 100 to maybe
200,000 who may die, this is short-term reduction in resource utilization, but also improvement of the patient outcome. And the one thing that I think
can make the most traction to reduce mortality in the short-term.
SREENIVASAN: All right. Dr. Richard Levitan and Dr. Nicholas Caputo, thank you both.
CAPUTO: Thank you.
(END VIDEOTAPE)
AMANPOUR: Gosh. Let’s hope that message is broadcast loud and clear, far and wide.
And finally, this is what black excellence looks like, that is how UCLA gymnastics described the incredible performance by this student, Nia
Dennis, this weekend. The 21-year-old homage to black culture included hits from Kendrick Lamar, Beyonce and others.
As you can see there, she earned kudos from the reigning gymnastics queen, Simone Biles, who tweeted, this was so fun to watch. Keep killing it.
Dennis scored 9.95, helping UCLA clinch victory over Arizona State. Now, that is flipping amazing.
And that is it for our program tonight. Thank you for watching “Amanpour and Company” on PBS and join us again tomorrow night.