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CNN'S AMANPOUR

Dame Louise Casey on the Desperate Situation Facing Britain's Poorest; Pandemic Brought Emotional Suffering as Wages of Grief and Loss and Isolation Roll Around the World; Coronavirus Not Under Control; Europe Surpassing 250,000 Deaths and U.S. 226,000 Deaths; Dr. Syra Madad, Senior Director, Special Pathogens Program, NYC Health + Hospitals, is Interviewed About COVID-19; Soccer Star and Anti-Hunger Campaigner, Marcus Rashford, Fighting to Feed Poor People; COVID-19 Exposes Inequality Gap with the Poorest; Dame Louise Casey, Former U.S. Government Adviser on Homelessness, is Interviewed About Dickensian Calamity During Pandemic. Aired 3-4p ET

Aired October 27, 2020 - 15:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


(COMMERCIAL BREAK)

[15:00:00]

CHRISTIANE AMANPOUR, CHIEF INTERNATIONAL CORRESPONDENT: Hello, everyone, and welcome to "Amanpour." Here's what's coming up.

COVID-19, the second wave. Epidemiologist, Dr. Syra Madad, tells us why Europe and the United States cannot get a grip on this deadly disease.

And a British soccer star's fight to feed poor children. The U.K.'s former adviser on homelessness, Dame Louise Casey, joins us with her take on the

Dickensian calamity facing parts of this country.

Plus --

(BEGIN VIDEO CLIP)

DR. RICHARD A. FRIEDMAN, NEW YORK TIMES CONTRIBUTING OP-ED WRITER: You know, being lonely and being isolated is very bad for your physical health

and for your mental health.

(END VIDEO CLIP)

AMANPOUR: The doctor will see you now. Clinical psychiatrist, Richard Friedman, talks to our Michel Martin about how this pandemic has impacted

our minds.

Welcome to the program, everyone. I'm Christiane Amanpour in London.

One week until the U.S. election and coronavirus cases are in no way under control. That's on either side of the Atlantic. Europe now has surpassed

250,000 deaths and the United States with less than half the population has 226,000 deaths. With curves spiking, there will be much, much more death on

the horizon. And a new modelling study shows that masks actually do work.

As of September, 49 percent of Americans says, they always do wear mask in public. If the number doesn't budge and social distancing is not observed,

the U.S. could reach a staggering 1 million deaths by the end of February. On the other hand, more than 100,000 lives could be saved during that same

period if 95 percent of Americans wore masks in public. This from the Washington Institute for Health Metrics and Evaluation.

Over here, Europe is now the epicenter. After a good summer, the second wave has hit Belgium so hard it could run out of intensive care beds in two

weeks. France is reporting the most coronavirus hospitalizations since April and the president is about to order new restrictions there. And

Italy, the epicenter of the first European outbreak is again bracing for the worse.

From Northern Italy, Ben Wedeman reports that doctors are literally at war with this virus complete with symptoms of PTSD.

(BEGIN VIDEO CLIP)

BEN WEDEMAN, CNN SENIOR INTERNATIONAL CORRESPONDENT: The intensive care unit is place of total concentration. No small talk. Just the rhythmic

beeping of the machines, the steady breathing of patients on ventilators.

The Ospedale Maggiore di Lodi was in the front line of Italy's coronavirus pandemic earlier this year. And now, the staff is bracing for the second

wave. Dr. Matteo Brambati anticipates another nightmare. It's like the second jump for a paratrooper, he tells me, the first time you don't know

what to expect. The second jump is more problematic because you know what's coming.

At the moment, Italian hospitals are able to deal with the number of patients in intensive care. However, that could change as the numbers

continue to skyrocket. ICU director, Dr. Enrico Storti, regularly gathers his colleagues for a debrief.

DR. ENRICO STORTI, ICU DIRECTOR, MAGGIORE HOSPITAL IN LODI: To evaluate, to better evaluate what we did and how we can now put on the floor and

bring on the table our ideas, our solutions.

WEDEMAN: Gathered in this room are some of Italy's, perhaps some of the world's most experienced soldiers in fight against COVID-19.

Dr. Annalisa Malara diagnosed the first Italian coronavirus patient on the 20th of February.

DR. ANNALISA MALARA, MAGGIORE HOSPITAL IN LODI: We are ready because we learned a lot.

WEDEMAN: But this war, like all wars takes a toll.

DR. MICHELE INTRONA, MAGGIORE HOSPITAL IN LODI: I think I felt like the soldiers during the World Wars. I don't know. I think I experienced what

these young boys experienced at that time when they were going fighting for a war knowing that they could die.

WEDEMAN: The empty beds ready for more casualties.

(END VIDEO CLIP)

AMANPOUR: Our next guest, Dr. Syra Madad, knows all too well the toll the pandemic has taken on doctors. She's an infectious disease epidemiologist

in New York and a member of the COVID-19 Taskforce at the Federation of American Scientists. Mada was featured in the January Netflix documentary

series called "Pandemic: How to Prevent an Outbreak," and that was for the prescient warnings about the risk of a new respiratory virus just around

the corner, and indeed, it happened. And Dr. Madad is joining us now from New York.

[15:05:00]

Doctor, welcome to the program.

I mean, that report from Ben Wedeman in Rome, in Northern Italy actually, really lays it on the table. Can you relate to that feeling of being under

siege of being on the front lines? Is it that bad now in New York?

DR. SYRA MADAD, SENIOR DIRECTOR, SPECIAL PATHOGENS PROGRAM, NYC HEALTH + HOSPITALS: You know, New York is in a much better position than we were as

the nation's first epicenter. So, we've been able to contain the number of cases and hospitalizations, but you can't say that for the rest of the

nation.

And as we know, we don't just have one pandemic here in the United States, we have 50 epidemics playing out differently in each of these states. And

so, for just looking at data, and, you know, the data doesn't lie, and you're looking at multiple metrics. You have majority of the United States

with a lot of viral infection, over 48 states, you know, are kind of in that orange to red zone. It's very, very, you know, distressing to see it.

Not only are we seeing more cases, more infections, but you're also seeing the associate hospitalizations increase as well, and that's a very

troubling sign.

AMANPOUR: So, we're seeing the map that you've been describing, you know, there's only really one green map, one green area which shows going down.

There's only 12 states that are holding steady and the rest are all going up.

And in Europe, we know that, you know, we're seeing this map of a 7-day moving average. I mean, the number of cases has just shot up compared to

earlier this year. When you hear whether it's the U.S. chief of staff saying, we can't get and we're not going to get this under control, whether

it's in France officials saying that it's out of control, those words, out of control, can't get it under control, these are new to me particular in

the second wave. What has happened that has made the second wave seemingly so bad, certainly in Europe?

MADAD: Well, I think it was multiple factors here at play. So, I think the first thing is we have the tools. We have the knowledge to contain COVID-

19. And I think that speaks for the entire world. We know how to contain it. It's these tried and true public health measures that we've used for

multiple different epidemics and pandemics in the past, and this is obviously having a good testing (INAUDIBLE) to find cases, being isolate

them. You know, contact tracing. Being able to provide the support services.

So, it's not, you know, magic. We know how to do it. We know what to do. We just need to invest in the resources behind it. And what you're seeing now

is when you don't have that infrastructure, and on top of that, you're adding onto this contagion of misinformation, disinformation, now following

public health guidance, not allowing people, giving them the right information in a good crisis communication mechanism to constantly wear --

you know, continuously wear a mask, you know, watch their distance, washing their hands, good ventilation.

If you're not articulating that appropriately, you're going to see more cases. And you're seeing that play out across the world, here in the U.S.

as well as in Europe. So, a lot of factors here at play but we have the tools to get this under control. What you're seeing is the white flag go up

and people just saying that we can't control it, you know, this is something that, you know, it's not just possible. But we have examples in

front of us where it is possible.

AMANPOUR: So, what you've said about the United States is because it's 50 different plans, it's not one big national plan like presumably you mean,

should be employed in order to actually get the whole country doing the same thing. Do you presumably agree, because I've seen you talk about masks

and other public health measures, with this latest information, if the majority or almost all the American people, 95 percent were to wear their

masks in public, it would save 100,000 lives up until February?

MADAD: Oh, absolutely. You know, the verdict that we know masks work. Even in the health care setting before COVID-19 started, we put always put a

mask on patients when they're exhibiting signs and symptoms of an infectious disease.

What we know now that we didn't know early on in this pandemic was how prevalent asymptomatic and pre-symptomatic spread of COVID-19 is. And we

know that individuals may not show sign of symptoms are still able to transmit the virus. And that's why it's so important to wear a mask. We

also have better data to now show the different types of masks, just, you know, a cloth-based mask, that's still very effective.

You know, unfortunately, what I often hear is this dichotomy that, you know, the mask is not 100 percent effective, so I'm not going to wear it.

You know, if this false, you know, analogy where if you have, you know, hyper tension and you're at higher risk for various different diseases and

you're giving a prescription medication, that medication is not going to prevent you from a heart attack or from a stroke, it's going to decrease

your risk, and the same thing with a mask. A mask is just one layer of protection. And you want to add on these multiple layers to kind of, you

know, prevent the spread of COVID-19 as well as contracting as much as possible.

[15:10:00]

AMANPOUR: It's obviously not an accident that some of the countries who have dealt with it and are still dealing with it well are in Asia, and

they've been wearing masks for, you know, the better part of the 21st century since first SARS and other such stuff. So, it actually does work.

We know that.

Vice President Biden says he would issue a mask mandate if he was to be elected. And as you say, the misinformation that's coming out from the

president and from a whole range of political opponents to the science was summed up by the World Health Organization director general. This is what

he said about the misinformation.

(BEGIN VIDEO CLIP)

TEDROS ADHANOM GHEBREYESUS, W.H.O. DIRECTOR-GENERAL: There has been political division at the national level. Word that's been blatant

disrespect for science and health professionals, confusion has spread and cases and deaths have mounted. This is why I have said repeatedly stopped

the pollicization of COVID-19. A pandemic is not a political football.

(END VIDEO CLIP)

AMANPOUR: Dr. Madad, is that how you see it being used by and large as a political football? And the second question, I mean, you address it a bit

at the beginning, do you think it's too late to stop this politization of medical facts, public health care and safety measures?

MADAD: So, I think first it's absolutely not too late. You know, you want to make sure that you are starting to provide better risk communication,

better facts, following the science as soon as possible. You know, this pandemic is not going away any time soon. And so, we want to make sure that

we're addressing information based on science, based on data, you know, based on what public health experts are saying.

I think the second part and I completely agree with Dr. Tedros, is we absolutely need to stop this disinformation and misinformation campaign

that's happening at the highest levels of government. It is completely undermining a number of different things. First, not only is it undermining

the information we know to work like wearing a mask, like socially distancing, like providing better ventilation, it's undermining those key

measures. On top of that it's putting more people at risk. It's actually causing more illnesses. It's also causing more deaths because people are

following this information and they are acting upon it. So, their behavior changes as well.

So, there's a lot that goes on behind bad information and junk science. It definitely puts everybody at increased risk. So, we need to do a better job

of educating the public.

If you look at South Korea and Taiwan, they have done a great job with risk communication. And if you have the trust of the people, they'll listen to

you, they'll know this is what to do, this is whatnot to do. So, we absolutely need that.

AMANPOUR: Yes. Trust from the top and a consistent message from top. So, let me ask you to, you know, project over to here, to Europe. Basically,

Britain started very slow and we have a very, very high death count. It's something like 61,000 here, one of the highest in Europe. But also, Germany

is in a bit of state right now. And Germany was the country -- or there have been others of course in Europe, but Angela Merkel science-based,

fact-base. She had ICU beds, she did contact test and tracing, isolation, all the right things and yet, they are also seeing a spike. We know how bad

it is in Italy and Belgium and Spain and France.

Why do you think it's -- you know, some of these countries that did well in first round are not doing so well now?

MADAD: Well, you know, I think this is something that many of us have said from the beginning, this will be a protracted game of whack-a-mole. So,

this is now where, you know, if you've been able to contain the epidemic and it's not going to come back, we absolutely need to continue to do those

measures that help contain COVID-19. So, we know and we anticipated there were going to be peaks and valleys moving forward until we had better

therapeutics, vaccines, you know, more different approaches in our exit strategy.

So, this is not something that is surprising. But what is surprising is the level of increase that's happening in a number of countries in Europe and

particularly here in the United States. And so, if you don't have good infrastructure that's able to have a hyper local response, as soon as you

see cases, you want to prevent these cases from becoming clusters, clusters from becoming outbreaks. And If you don't have that hyperlocal response

right away, we know that this virus just feeds on (INAUDIBLE). So, it will propagate very, very quickly and can overwhelm a given community at any

given point.

It's really important to invest and have the proper resources to mount an effective hyperlocal response right away. And that's not something that,

you know, we have been seeing here in the United States and in some countries in Europe. So, really important to invest in these resources

right away.

[15:15:00]

AMANPOUR: That's so interesting. And what about what we're seeing, essentially pandemic fatigue, for want of a better term, people are getting

tired but also completely confused by the often changing, particularly in this country, several tiers. You've heard about tier, you know, one through

three and -- I mean, it could be local controls like you're saying but it's confusing people and they don't quite know how many people they should be,

you know, mixing with, where what and all the rest. It's very, very confusing, I have to say, here in the U.K. And winter is coming and the

holidays are coming and people are going to be indoors more than they were since the beginning.

What -- I mean, what is your nightmare scenario, if I could put it that way?

MADAD: You know, I think my nightmare scenario is playing out today. You know, in the United States, we put up a white flag and then you're seeing

in many countries in Europe, you know, it's this uncontained epidemic and we know it's only going to get worse because we have all the factors that

are against us, cold weather, this pandemic fatigue, as you've mentioned, people are so done with, you know, practicing social distance, wearing a

mask, holidays are coming up. These are different factors that are working against us. And so, it's really, really important that we provide ongoing

in laymen's term, you know, what to do and educating the public of why this is important.

You know, when you hear these mixed messages, when hear masks work or they don't work and wear it inside versus wearing it outdoors, it becomes very,

very confusing. So, we need to make sure that we're putting information in very basic terms that people understand. You know, you need to this

cultural competency associated with it, you need to provide trauma informed information. This is, you know, a traumatic event for all of us. And so,

really important of how we communicate this issue.

I think one thing that I'll just also quickly mention is when people look at, you know, number of cases going up, hospitalizations, one thing that

often people say is, well, not a lot of people are dying. Well, we know that hospitalizations and deaths are lagging indicators. And yes, we may be

better equipped to treat patients, we have more tools in our toolbox. You know, we're able to respond faster because we know what to look out for.

Once hospitals become overwhelmed, they go into what we call crisis standards of care. And that ratio to patient and provider dramatically

increases.

And when a hospital is overwhelmed, you may have the best tools and drugs to be able to treat a patient, but if you have that crisis (ph) standards

of care (INAUDIBLE) multiple patients, you're not going to get the care you need. And so, you're going to see an increased number of deaths happening,

you know, in the coming weeks across the board, that's also very, very concerning.

AMANPOUR: Gosh. It is concerning. And perhaps one reason why we heard from Belgium asymptomatic medical professionals, doctors, nurses and the others

have been asked to keep working. How do you diagnose that? I mean --

MADAD: Yes. You know, in New York, that was the same case during our first surge. It's because we have a very limited supply of health care workers.

You don't have a whole lot of health care workers. And so, if there's no doctors and nurses and PAs and the respiratory therapist to be there when

patients need help, then you don't have a health care system.

And so, now, we are putting their lives on the line because we're asking them to come back and work even though they may have been exposed and then

propagating the outbreak. So, it's a very concerning situation. But I think it's a situation that, you know, there's no end to it because, you know, we

need health care workers. And unfortunately, they are taking the brunt of what we're seeing today.

AMANPOUR: So, I just want to play a soundbite from Anthony Fauci, Dr. Fauci, who really has one of the highest trust levels in the United States

and around the world. And when he speaks, people listen. And he's been talking about the virus -- the vaccine rather. This is what he said about

when it may or may not be available.

(BEGIN VIDEO CLIP)

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: Vaccines are proceeding at a very good pace and we should be on

time to get an answer. And I think it will be a positive answer by the end of this year, the end of November, the beginning of December, so that we

can start distributing vaccine to those who are most in need, particularly health care workers and the vulnerable among us in the population.

(END VIDEO CLIP)

AMANPOUR: So, he said much of this before and we all know that it's going to be rolled out in stages for those who need it the most first. How do you

recommend people holiday safely, whether it's Thanksgiving, whether it's Christmas and all the other different religious festivals that take place

over this period?

MADAD: Yes. So, absolutely love to give some comment on how to celebrate the holiday safely. But one thing I'll just quickly point out when it comes

to vaccines is, you know, the operationalizing of these vaccines and the distribution is going to be the biggest, you know, effort of health care

system's lifetime. It is going to require a lot of logistical challenges. And unfortunately, what we're seeing is we're prioritizing vaccines over

therapeutics and we need to make sure we're investing more in therapeutics.

[15:20:00]

When we talk about the holiday season and how to do it safely, you know, we can't have an abstinence only approach. Meaning, you can't tell people not

to get together. We know there's alarming numbers of infection but we want to also make sure people understand, if you are planning on getting

together, we discourage you from doing so. But if you do plan on getting together, you want to make sure that you're looking at who you're planning

on merging your social bubble with. You want make sure you're doing activities outside versus indoors. Limiting the duration that you are with

any individual. You want to wear a mask as much as possible.

We know that these are holidays where you're serving food. And so, because people are going to be eating, you want to see if you can keep these family

units together and then you want to space them out. So, these are a lot. There's number of different considerations that you want to look into. Do

your homework, see how to best, you know, celebrate the holiday safely and effectively.

AMANPOUR: That's really good advice. Thank you so much, Dr. Syra Madad. Thank you so much indeed.

And just a note, before we go onto our next segment, the surgeon general has said that there are more coronavirus cases in the United States. It

truly is up and not just because there is more testing, as the president often claims. So, that's a warning there.

Now, COVID has exposed the massive inequality gap with the poorest, of course, being hit hard and the U.K. is a prime example of this COVID

divide. Children in need now face going hungry as the government opts not to extend program for free school meals during the holidays. Prime Minister

Boris Johnson says he's already supporting families with increased benefits. But soccer star and anti-hunger campaigner, Marcus Rashford of

Manchester United Football Club, has forced Boris Johnson into one U-turn on free school meals and he hopes another one is coming. As the pandemic

shows more unemployment, poverty and misery on the horizon, Britain's former chief scientific advisor, Sir David King, had these words of

warning.

(BEGIN VIDEO CLIP)

DAVID KING, FORMER U.K. CHIEF SCIENTIFIC ADVISOR: It's a false dichotomy to say there's a challenge between managing the epidemic and managing the

economy. But one thing you cannot do is run an economy if you haven't got an epidemic under control.

(END VIDEO CLIP)

AMANPOUR: So, that's, again, incredibly important warning. The government's former homelessness adviser, Dame Louise Casey, warns that

many families must now face destitution if they don't get help. And she's joining me from London.

Dame Louise Casey, welcome to the program.

That is such a dire warning. I mean, destitution and you've said some other things that sound literally Dickensian. How bad do you foresee it getting?

DAME LOUISE CASEY, FORMER U.S. GOVERNMENT ADVISER ON HOMELESSNESS: Well, in a way, that's why I chose that word very, very decisively to try and

convey particularly to the government but to the wider public that I think we are heading into just an extraordinary difficult period. I think at the

beginning of the pandemic, everybody, certainly in the U.K., I was working for the government at that moment, everybody was threatened, certainly on

homelessness, to get everyone off the street and into hotels, to give everybody a chance to self-isolate. We opened up university residence,

these hotels, caravan parks and so on and so forth.

And I think what's happened this time has gone on is I think people keep thinking this is going to be over any time soon, and it's just not, as your

program has been -- I've been listening to it throughout. But clearly what we're looking at is that pandemic continuing.

And I think what happened before the pandemic was, we knew already at that point, as probably the chief former scientific adviser and even your

medical intervention earlier, the doctor, will know that people who live in poor areas, certainly the United Kingdom, are just disproportionately to

live less long and to live a less healthy life.

And what's happened is the pandemic has essentially split the country down the middle with the haves and have notes. And I think that's what's really

concerning me as we head now, not only into Christmas but in actually the whole of our winter here in the United Kingdom.

AMANPOUR: Dame Louise, let me ask you then about the numbers. It's something in the region of nearly two and a half million children who need

school meals, who need to be provided with free meals if they're not in schools during the holidays, while they're at home, they still need the

free meals. And the government is saying no, we're going to add some money into the other benefit area and that should be able to do. But even members

of his own -- of Boris Johnson's own party are beginning to, you know, get very uncomfortable about this. Is he reading the room right? I mean, this

is not something that's going down well with the British public.

[15:25:00]

CASEY: No, it really isn't. I mean, I have worked for five different prime ministers of different political persuasions here in the United Kingdom.

So, I've been in White Hall and in the world of social policy for a long time. And I think that the public know that actually it's right at this

precise moment that we do make sure the children don't go hungry or that their parents have to go hungry so they can feed their children. And I am

already concerned about things like shoes, clothing, coats, all the basics that people need to get through this winter.

And the truth is that the money that they say they handed -- well, they did hand out, 63 million towards this particular effort, they handed that out

and it ran out in August. So, that's hollow really to say that. And I think the other thing is, it shows really that the government is, at the moment,

completely out of step with the British public. Where actually people are supporting the Marcus Rashford's campaign and they're actually, you know,

digging into their own pockets, making extra meals, using supporting food banks.

This is the United Kingdom, we're the fifth or sixth richest country in world. You know, we shouldn't have to be doing there. And I think the

government has pulled this one wrong.

AMANPOUR: Well, I want to play a bit of an interview that Marcus Rashford, again, the Manchester United soccer star, who's made, you know, child

poverty and hunger his cause and that he's changed the government action on it during the summer, as we said, and he's trying to do it again now.

You know, Prime Minister Johnson has said, I understand. We don't want to let people to go hungry. But Rashford is saying that he doesn't think

members of the government actually either have the experience of what it means to be hungry and to be raised in that kind of situation or what is

actually going on in households that can't make ends meet. This is what he said.

(BEGIN VIDEO CLIP)

MARCUS RASHFORD, MANCHESTER UNITED SOCCER STAR: People have opinions and whether or not they understand fully what is going for is another

conversation. But because of that it's easier for me to sort of dismiss a lot of the people that are making opinions because, you know, I know for

sure that a lot of them speak in the way they are speaking is so insensitive about the issue and they've definitely not been through it

themselves and --

(END VIDEO CLIP)

AMANPOUR: Do you disagree that it's insensitive? I mean, Boris Johnson talks about pumping, you know, a thousand pounds into the already social

welfare, a thousand pounds per year per household. I mean, does that even come close to meeting the need?

CASEY: Well, firstly, I have looked carefully at that thousand-pound claim and I can't see where that's coming from. To be fair to the government,

they have been putting these jobs support schemes in place. They have increased a tiny bit, what we call the universal credit, which is the main

welfare benefit to people here in England.

The issue is, it doesn't come close to it. So, essentially, the government, since 2010, has taken close to 27 billion pounds out of our welfare benefit

budget and some individuals and families that are needing welfare support are on less money now than people were in 1991. So, proceeding the

pandemic, things were pretty tough. And I think that's what gets hard. The public understandably think, well, we're paying our taxes. There's a

welfare benefit system. People can get universal credit.

But, you know, the architect of universal credit, who was a conservative -- who is a conservative and brought it in during the conservative era, he

himself, Iain Duncan Smith, says that actually they didn't get the amount of money they had expected from universal credit. And one of the reasons

universal credit being so difficult was actually the money was removed by the chancellor.

So, I think what's happening amidst of all of this is people are just forgetting one thing, which is we're a decent country and actually most

Tories are decent, most Labour MPs are decent. Most people go into politics to try and make a difference, to actually make a more cohesive and better

society. And they can come at that slightly differently. I worked for different prime ministers that have different reasons as to why they help

poor people.

But at the end of the day, we're a country with a very, very long history, right back to the Dickensian era of actually reaching out and helping poor

people. And I think that the support that Marcus Rashford's family got, his mom got, knowing that her son would be on preschool meals, we know from a

health perspective that four square meals minimum a week, twice a day, are going to keep kids where they are.

[15:30:00]

Free school meals, interestingly, were created in this country during the Boma war period, by generals in the army because they weren't out. They

couldn't actually recruit people, enough men as it was at the time to carry a rifle because they were so malnourished.

So I think we have a long history and a long church and faith history here as well of supporting the poor. And I really hope that the government

really wakes up and thinks, you know what, we're sorry, we don't want to have this fight.

This is not the fight for COVID. We're not going to Penny pinch, we're not going to be unkind. We don't want to be called the nasty party. I don't

think that they do. I genuinely don't.

And so, I hope that this splits and this almost politicization of children and their families goes away and goes away and time for us to make sure

every family gets that this Christmas.

CHRISTIANE AMANPOUR, CNN INTERNATIONAL HOST: And yet, I mean, you know, I was just, I mean, you completely shocked when I heard you make these

incredible statements about the dramatic situation right now. You said, are we going to watch parents choose between food and putting shoes on their

children's feet? And then even worse, you said, are we going to be prepared to see, I guess so many mothers, prostitute themselves in order to put food

on the table for their children? I mean, that's catastrophic.

CASEY: Well, that's partly what's so important right now about conveying the message into the Cabinet Office, into 10 Downing Street, and actually

into all of the MPs that at the moment are not in the right place on supporting families.

I cannot convey strongly enough the incredible effect. So our biggest problem in this country is working poor. So these are people that are poor,

but they're in work.

If you take their income down, they're already in poverty. We accept as a country in our own indices and all the evidence that the government would

accept that we have this patriarchal (ph) record working poor.

So if you're working poor and you remove 20 percent, or 27 percent, or 30 percent of their income, how are they supposed to find the other third for

their rent, for their food?

We already know in the northeast from the significantly understated charity called Changing Lives that used to be called Tyneside Cyrenians long

history in faith and in the church. They have themselves said that women during the course of this pandemic have started to prostitute themselves in

order to make to put on the table. So it is happening here.

And, you know, I think the problem always with people is that if you don't live with it, if you don't come from it, if you don't feel it, you don't

see it, that is pretty easy to stigmatize people like Marcus Rashford's mother, and pretty easy to stigmatize the people who we see sleeping out on

our streets who are homeless. And that's where I think --

AMANPOUR: I mean --

CASEY: -- that prove this one wrong.

AMANPOUR: Yes. Well, by the way, so do the other constituent parts of Great Britain, Scotland, Wales, Northern Ireland will give their children free

school meals, only England will not. This is what the prime minister said.

(BEGIN VIDEO CLIP)

BORIS JOHNSON, BRITISH PRIME MINISTER: I totally understand the issue of holiday hunger is that we have to deal with it. The debate is, how do you

deal with it?

And we're very proud of the support that we've given. I've said repeatedly throughout this crisis, that the government will support families and

businesses, jobs and livelihoods across the country. We're going to continue to do that.

I just repeat my single point, my most important point, we don't want to see children going hungry this winter, this Christmas, I certainly not as a

result of any inattention by this government and you're not going to see that.

(END VIDEO CLIP)

AMANPOUR: OK. He says you're not going to see that. Where's the plan? What is the plan, as far as you know? Because as we've discussed, the

supplemental benefits, all the things you've talked about, do not even amount to a drop in the ocean.

CASEY: So I think that's where they just need to listen to people who have worked in this area, who are not politically driven. I'm not a member of

any political party, their own Children's Commissioner in Longfield who was their Children's Commissioner.

The really important thing here is that free school meals become incredibly important because they are a slam dunk way that you can make sure you can

get food to children and thereby making sure that their parents could be to serve the mechanism of free meals is really straightforward.

[15:35:03]

The second thing here is, to be fair, I don't think the Prime Minister does understand what holiday hunger is. Instead of just defending a position,

which he's now done over a week, he actually says this and we've got this one wrong, let's try and figure out how we do make sure kids don't go

hungry at Christmas.

The obvious way to do hunger during -- in the school time is to get meals on the table to kids. They could do and other ways. They could fund local

government more. Because, you know, this -- the money they've allocated ran out, it was only for 12 weeks. So it's pretty hollow to then say, what

they've got 62 billion. And as I said, none of this touches the sides, really.

And I think the main thing for me, and my worry is that everybody gets in their political trenches. So what you happen -- what we've had in the last

week, because we've had a very loud yell from the Labour men of Greater Manchester about homelessness, about the fact that COVID significantly

affects deprived areas more than other areas, all true and then everybody got into their bunker. So then Labour called an opposition debate. That

meant the government decided to go tribal.

And you know, some of the people that are conservatives both -- in both houses, both the House of Lords and the House of Commons, really, really

don't want this, they are charitable one. The conservatives not want to be part of the nasty party.

And, you know, despite everything, this is a country that actually, you know, we are good at charity, we believe in charity, we believe in it, and

we want to help people. And not just for Christmas.

AMANPOUR: Yes.

CASEY: You know, my point here is --

AMANPOUR: Yes.

CASEY: -- we least another six months here of this pandemic, but we need to manage all families and give them a helping hand.

AMANPOUR: They really do. I mean, look, we've just had seen a letter signed by 2000 pediatricians backing Marcus Rashford's, you know, food for these

kids. Every day, they say, we see the impact of malnutrition and hunger in our surgeries.

You know, you know this government, you know the others, do you believe there will be another U-turn that this government will allow children not

to go hungry will give free food to children over the holidays? Will they make that vital U-turn do you think?

CASEY: Well, I mean, I can only hope so. I think they're politically --

AMANPOUR: OK.

CASEY: -- in the wrong place. I also think, the invidious side last week of people actually having a go at Marcus Rashford was really, really not on.

They need to leave that guy alone.

He is standing up for doing what he believes is the right thing. He is the role model of role models in Great Britain right now.

And it wasn't pleasant to sound very British and understated to see MPs in particular using language about him that I think made us all even more

angry than we were before. So, you know --

AMANPOUR: Yes. Well, let's see.

CASEY: -- they need to find a way out of this. And they should do because, you know, kids are what matter, old people, vulnerable people and children.

That's what we exist to support in any society.

AMANPOUR: That's right. Dame Louise Casey, thank you so much for your knowledge and your perspective.

Now, the pandemic has brought with it also a season of emotional suffering as waves of grief and loss and isolation roll around the world. My next

guest says it's our aversion to uncertainty that's fueling this anxiety as difficult questions remain over if and when life will return to normal.

Dr. Richard Friedman is a professor of clinical Psychiatry at the Weill Cornell Medical College who specializes in mood disorders. And here he is

speaking to our Michel Martin about the importance of mental health as we navigate this virus in a tense election cycle as well.

MICHEL MARTIN, CNN HOST: Thanks, Christiane.

Dr. Friedman, thank you so much for visiting with us.

DR. RICHARD A. FRIEDMAN, PROF. OF CLINICAL PSYCHIATRY, WELL CORNELL MEDICAL COLLEGE: My pleasure.

MARTIN: You know, you hear people talk all the time about how stressful these last couple of months have been. And I do wonder if there's just some

data about that, that says that this really has been a particularly stressful period.

FRIEDMAN: Sure. I mean, there are plenty of data about just what the impact of COVID has been and all the other events in people's lives in the last

couple of months. And they all show generally that the level of distress, psychological distress and anxiety and depression has gone up

significantly.

So if you look at all the surveys together, you just sum them all up, it looks as if the rates of anxiety and depressive symptoms have tripled or

quadrupled, you know, post COVID compared to periods before COVID, which is You know, very alarming.

[15:40:02]

MARTIN: And so let's talk about that, the general population, what's been the worst of it?

FRIEDMAN: I think probably psychologically the worst aspect of it is confinement, is the lockdown. Because the lockdown essentially means you're

cut off from your daily routine, and you're cut off from other people, except the people you actually happen to be living with. And that's

enormously stressful, because we're social animals.

And psychological, you know, being lonely and being isolated, is very bad for your physical health and for your mental health. And it's extremely

immersive.

MARTIN: I know you just recently wrote a piece about, that talk a little bit more about why that is, because I think, you know, some people might

think, well, you know, it's boring, or it's a bummer. But what you're saying it really is harmful to your health. Tell me a little bit more about

why.

FRIEDMAN: So there are two aspects to it. One is that people when they're confined are locked away from the world. And so we don't have exposure to

all the sort of unexpected events that we are privy to in our daily lives. So you go outside on the street and you see people you don't know, you've

experience this. All kinds of unexpected experiences, all day long, they're stimulating.

And so you're stripped of that. So you're not free to roam around the world and have those experiences. And that cuts us off from a level of

stimulation. And we need a certain amount of stimulation or social stimulation. And so, you know, that's one aspect of it.

The other is that you're lonely, because you can't see your friends and much of your family, except virtually, either the way we are by Zoom or by

telephone. And so it cuts people off socially, and it increases stress and increases anxiety and makes people feel sad and lonely.

MARTIN: We're about to enter into a kind of a heavy holiday period. I guess that these virtual experiences, it really you and I are having one right

now and, you know, it's fine. But why is it that these virtual experiences don't feel as satisfying?

And I had a Zoom, you know, dinner with my family, but it just, it just doesn't feel the same? Why is that?

FRIEDMAN: Right. A Zoom turkey doesn't taste the same.

I think in part, well, first of all, we assume that's the case, right? We assume that all these virtual connections are not equivalent to in person,

in face connection.

And I think that that might be true, but we actually don't have good data to prove that that's the case. But there are reasons to assume that it

might not be for one, we're tactile, we like to touch each other. And we get all kinds of information by being with somebody in the flesh, you can

smell them, you can see them, you can hug them, you can touch them, it's hard to do that.

I mean, I remember the first time I went out and broke isolation and had dinner with friends who also had been isolated, it was so stimulating, and

so exciting to see them in person, although I've been looking at them on the screen for weeks. It was clearly very different.

It may be the case that for people you already know and you have a connection with, talking, you know, virtually suffices, it may not be the

equivalent, but it's much better than nothing. To be able to see their face, to be able to hear their voice that actually provides something that

helps with isolation.

So I don't mean to knock virtual connection. I think it's critical, it's really important. But it may not be the same thing.

And all the studies that are done up to this point, looking at the effects of social isolation measure, you know, social connection by in person

meetings. So, we don't actually know whether virtual connections will count in quite the same way as in person connections, when you look at, you know,

future studies on the impact of social isolation.

MARTIN: And for people who are already before COVID, before the shutdowns, we're experiencing anxiety or depression, what are the particular sort of

vulnerabilities for them?

FRIEDMAN: So they're much more likely when they're socially isolated to develop clinical levels of anxiety and depression and have a relapse of

their preexisting problem.

So if you have a history of depression, let's say, we know social isolation is particularly hard, and stress and worry. So, you know, one of the things

about COVID is, you know, people are cut off from their friends and from work and they have all kinds of economic pressures.

People have lost their jobs. They're worried they can't make ends meet. They're not sure if they get sick, they're going to have care, they might

die, who's going to take care of them.

So if you're somebody with a history of depression going into that reality, it's particularly stressful. And so, we look at those people and say they

were at higher risk of having a recurrence of their depression.

[15:45:04]

MARTIN: Are you seeing that yourself? I mean with your peers and your practices, with just in terms of your professional work?

FRIEDMAN: You know, initially I wasn't. And I think it was because of -- it was because of the effect of time. I think now as it's going on, and the

lockdowns have no end in sight in a way, where we may experience a second wave, so there's uncertainty, now people are getting more anxious and more

depressed. And obviously, I have a biased sample, because I'm a psychiatrist, and I treat people with those problems. And it's very

challenging for them now.

And I think the one thing that we don't talk a lot about is how aversive uncertainty is.

MARTIN: Tell me more about that?

FRIEDMAN: Well, we don't really know what's going to happen to us. I mean, people, though it's -- COVID is an invisible microbe, right? I mean, you

can't know whether you're safe in any setting. There are things that you can do, you're not powerless, you can wear masks, you can socially

distance, you can do all kinds of things to protect yourself. But in the end, there's a certain degree of uncertainty.

We can use the good news, we can use the bad news, good situations, bad situations, as long as you know what they are. But it's very hard to get

used to an uncertain one.

And in part, it's because I think we've evolved, we've been hardwired by evolution to, you know, detect danger in our environment, that's what saves

us. And uncertainty means, you know, hey, right around the corner, there could be something that's dangerous or threatening to, and that means

you're vigilant and anxious.

And so uncertainty produces a state of constant anxiety and stress. You know, we know this early on from HIV studies, from genetic testing studies,

people who would go in and get an HIV test in the early days, when, you know, there were no treatments available. And this was, you know, a

uniformly almost fatal diagnosis.

People were asked beforehand, they were much more anxious, much more dysphoric depressed. When they got the results and they were positive or

negative, their mood was better and their adjustment was better than during the waiting period. So the uncertainty was really corrosive in a way that

certainty, either positive certainty or negative certainty isn't, because I think you can adjust. You can accept something that's very stressful, but

you can adjust to it, you can learn to live with it.

MARTIN: You know, health care workers have experienced a lot of trauma, you know, depending on where they are. And in some places, I mean, the, you

know, the working conditions have been horrific. They've been exposed to, you know, way more suffering than many of them even the best trained and

the most experienced have ever experienced. And I'm interested in your thoughts on, you know, how they move forward.

FRIEDMAN: Oh, yes. I mean, as a group, if you talk about a group that's been traumatized, it's the medical providers, the heroes and the heroines

in this whole pandemic. And, you know, I mean, I know, for my colleagues and working in the hospital, that they were on the front lines. And these

are, for the most part, young healthy people who saw death, sorry, on a level that they had never seen before, even though they were physicians,

and sometimes saw their own colleagues get sick and take care of their colleagues and that the trauma of sometimes seeing their young healthy

colleagues die from COVID.

So, the rates of depression, anxiety and PTSD is much, much higher, I think, in this medical population. And I'm very worried about that. I mean

the rates are sometimes reported as high as 40 percent, 50 percent, of doctors who were on the front lines who have significant enough depression.

This was true in China, that they had trouble going back to work.

And what are we going to do if we have a second wave?

MARTIN: Well, I have a political layer to this, if I may, because on top of this, it's in the middle of a very contested election, people seem to feel

the stakes are really high. And I was interested in your take on whether the politics of a moment kind of add to this stress?

FRIEDMAN: Oh, certainly. I mean, you've got -- essentially, if you think of the country in a way like a brain, you know, this is a time of high

expressed emotion, fear, anxiety, you've got a president who thrives on stress and tension and racial division, and is a very angry person. And so,

he is essentially signal to everybody that he's going to rile up his base. He's going to rile up with the country.

And instead of calming things down and saying, as a moral leader could, you know what, this is a very scary moment we're in. We're facing a pandemic,

but I know that we can get through this because we have science and good public health measures that we can take to protect ourselves, like wearing

masks and social distancing, and figure out intelligent ways to deal with this problem.

[15:50:22]

Instead, you had somebody who basically said, in effect to the country, you're on your own. I wash my hands of it, I'm not responsible.

So, what does that do to people? Well, the country looks to its leader to calm them and say, you know, it's a difficult moment, but we're going to be

OK. We're in this together. And we're going to use the prestige, the power, the science, the, you know, the force of, you know, the federal government

for good to do something to help you feel safe.

If you take that away, you make people much more anxious, much more frightened. And then if you look at the political situation, in which there

is violence in certain areas and terrible tension and highly polarized groups of people, those, you know, who are Republicans and those who are

Democrats, I can't remember a time where the country has ever been so polarized.

So the emotional state, the high emotional temperature of the country makes it hard for people to take a step back and calm themselves down.

MARTIN: And if you look at the debate, the last the second and final presidential debate, which was held Thursday night, in their closing

remarks, they were asked to speak to -- both candidates were asked to speak to people who did not vote for them. And President Trump painted this very

dire picture of what he said the outcome of would be for the country if former Vice President Joe Biden is elected.

And former Vice President Joe Biden had a very different message. He said, I'm going to be the president for everyone, and not just the people who

voted for me.

And you know, it's just hard to talk about this without feeling like you're making a partisan statement. But these are very different types of leaders.

And President Trump is making very is delivering very specific messages, which are that it's, you know, it's going to be terrible if I'm not the

president. And I just wonder if that does stoke a certain anxiety.

FRIEDMAN: It's not a partisan question. It's a question about psychology. Trump's message essentially is, if I don't win, you will all suffer. The

country will go down in flames, terrible things will happen, the suburbs will vanish, America will be overcome by Carnage, which, of course, is

ridiculous. It's a message designed to make people feel frightened.

And given the fact that, you know, until election on one side is going to lose. So you're voting -- someone is going to vote for the losing team,

right. And if you view this as a sports metaphor.

We know what happens when teams lose, fans feel terrible, they feel depressed, they feel dejected, they're anxious, they're stressed. And you

know, there's a fair amount of literature on this. They actually are at risk, medical, and emotional risk of losing.

So, one candidate is basically saying, you know, what, if I'm president, I'm all of your president. I'm president for all of you, which softens the

blow for the losing team. Whereas Trump's message was, if you lose, boy, you're really going to suffer.

So, I think that psychologically, you know, it's a valid question. It's not a partisan question. It's a psychological questions of two different --

very, very different approaches to an adversarial process, an election. Someone's going to lose, someone's going to win.

Of course, the President is basically saying, you know, I can only lose if people cheat and has undermined the integrity of the election from the

start.

MARTIN: The election is soon upon us. How does the country go forward after this? And how did people go forward psychologically?

FRIEDMAN: Right. So I've been thinking about this recently and having discussions with friends and colleagues. Some of them are pessimistic and

say things to me like, you know, we will never be able to trust one another again. We've lost something.

And how will we ever regain a sense of normalcy in the country after these four years of strife and tension and discord? In my view is a lot more

optimistic. And the reason is, I think people essentially, most people, essentially, are very flexible and decent human beings and are uniquely

susceptible to the influence of leadership.

So if you have a benign leader, who cares about people and signals that he wants harmony, and wants to include people, I think you will see very quick

turnaround in the national sort of emotional temperature.

The damage that's been done to institutions and all kinds of things that, you know, your pundits can talk more intelligently about than I can, they

may take a long time to normalize and recover.

[15:55:03]

But I think emotionally when you're talking about how people feel, I think that we're very, very susceptible to the tone of our leader, and the

direction of a leader. And that can change very quickly, positively or negatively. We're malleable.

MARTIN: Dr. Richard Freeman, thank you so much for talking with us today.

FRIEDMAN: My pleasure. Thank you for having me.

AMANPOUR: Indeed. And how often does it come from the top?

That is it for now. You can always catch us online on our podcast and across social media.

Thank you for watching and goodbye from London.

(COMMERCIAL BREAK)

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