In the Bubble with Andy Slavitt: Our Shot

Inside the Three Russian Nuclear Threats (with Senator Tim Kaine)

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Andy gets to the bottom of Vladimir Putin’s escalating nuclear threats with U.S. Senator Tim Kaine and Hans Kristensen, Director of the Nuclear Information Project with the Federation of American Scientists. Plus, Senator Kaine details his personal two-year-long struggle with long COVID and his new bill, the Comprehensive Access to Resources and Education (CARE) for Long COVID Act.

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Andy Slavitt, Tim Kaine, Hans Kristensen

Andy Slavitt  00:18

Welcome to IN THE BUBBLE. This is your host, Andy Slavitt. It’s Monday, March 14th. And nothing could thrill me less than talking to you about today’s topic, which is the nuclear threat that we face, I am 55 years old. Depending on how old you are, you may or may not have grown up during the Cold War, when the topic of nuclear war was on our minds all the time, so was the topic of nuclear accidents, Three Mile Island, Chernobyl, and of all the things that had been in the news in 2018, 2019, 2020, 2021. Now we get a new topic in 2022, which is the very real and present danger of nuclear threat. And we’re gonna talk about that today with an amazing guest on the show. Tim Kaine, the senator from Virginia, you probably know, he ran for vice president in 2016 alongside Hillary Clinton, he won, but he didn’t win. There’s a long story there. And he’s great. We’re gonna talk to him about a number of things. But we’re really going to focus in on some of the briefings and some of the threats that are coming to us, and I want you to understand them better. I understand them a lot better after talking to Tim and some experts. So there’s three categories of nuclear threats. There is the kind of mushroom cloud version, which is a use of a strategic nuclear weapon. This is like the bomb dropped on Hiroshima. This is like the bomb dropped on Nagasaki. And this is what I think many of us think of when we think about nuclear war. The second threat is the use of a more tactical nuclear weapon, a tactical nuclear weapon. What does that mean? That’s a weapon that doesn’t go across continents, but it can be used on a battlefield, they are sometimes less powerful. But as we’re here, they’re not necessarily always less powerful. And that’s the second type. And one, I think you’re increasingly hearing people talk about this use of tactical nuclear weapons.

Andy Slavitt  02:16

And then there’s a third type. The third type is a conversation that I think is under, well, I’d say I didn’t I don’t think we understand it, as well. And it may perhaps even be the most consequential threat to us right now, which is a threat of something happening at one of the nuclear reactors in Ukraine. Ukraine has five nuclear power plants. Russia now controls two of them, including the long defunct Chernobyl plant, which was captured by Russians earlier in the war. The largest one, and in fact, it is the largest nuclear power plant in Europe. It’s called […]`. It came under attack on March 4, it is now under Russian control. The IAEA Director General Rafael Mariano Grossi met with Russian and Ukrainian officials late last week, hoping to reach an agreement to spare the remaining three nuclear facilities. But he came out empty handed. Since March 4, what is going on? What has it been like? Nuclear technicians, it’s […] are being forced to work under gunpoint, according to the head of Ukraine state owned atomic energy firm. This is a situation that I think makes us a little nervous, right people who are needing to do very precise work to protect very precious and dangerous materials, working under the pressure of gunpoint. There are also some 210 technical experts and guards inside the […] nuclear power plant, who don’t have access to medications, cell phones or landline connections based on all reports. They now no longer have electricity, which you may recall and which we will explore is vital to protecting whatever nuclear materials and keeping things cooled. They have been literally around the clock since the Russians captured the plant according to the IAEA. And let me tell you, these folks are reluctant heroes, and the world really is counting on them to keep us safe in a very precarious situation. We’re going to be talking about all three of these threats on the show today with Tim Kaine, but I wanted to invite on an expert Hans Kristensen who’s the director of nuclear information project at the Federation of American Scientists to just get a lay of the land in the streets before we talk to Senator Kaine. And I started by asking him how seriously we should be taking Putin’s nuclear threats?

Hans Kristensen  05:03

I think we should take it seriously in the sense that we are seeing nuclear threats being thrown around in a way that shouldn’t happen. That is disconcerting. And, you know, especially if the crisis continues to evolve. But I don’t think we should be concerned that nuclear weapons are actually going to be used at least the way things look right now. It would take a number of additional steps; I think before things get to that point.

Andy Slavitt  05:31

Can you walk us down that path? And I assume it may be in the answer. Can you talk a little bit about the difference between sort of the tactical use of nuclear weapons versus, you know, what people think of as the mushroom cloud version of nuclear weapons?

Hans Kristensen  05:47

Yeah, I mean, I think that the likelihood of nuclear use increases significantly if the crisis spreads from Ukraine to a direct NATO Russia confrontation, because it is out of a scenario like that you can have a significant buildup of tension and warfighting and what have you, that gets to the point where one of the sides would consider using nuclear weapons. But that’s, that’s a big step from where we are now. And if they did decide, the weapons that would most likely be considered for us first would be sort of tactical nuclear weapons, which is a term for nuclear weapons that don’t have intercontinental range. They have sort of, you know, regional capabilities, and they would probably be the first to use and at first, very few of them probably, to make the other side back down.

Andy Slavitt  06:46

Can you talk about the damage that a tactical nuclear weapon does? And maybe give us a little if you would mind a little bit of background on what the stockpile that Putin possesses, looks like, and if something like this were to be used, how we will be thinking about the impact and comparing it to, you know, other kinds of disasters that are familiar with?

Hans Kristensen  07:09

Yeah, a lot of people familiar with the destruction of Hiroshima back in World War Two, that was a gravity bomb that was used that had an explosive yield, or power, that was equivalent to what’s called a 15 kilotons of TNT explosives. So 15 kiloton that is actually a relatively low yield nuclear weapon these days. And so you can also have weapons that have less yield down to maybe one kiloton. I mean, they exist in all shapes and forms and they go up from there, there is a misunderstanding in the public discussion about this, that’s tactical nuclear weapons necessarily have very low yield, and strategic weapons, very high yield, there’s a lot of crossover, that’s a lot of blurring between the lines there. So you can find tactical weapons that have a very significant yield as well. But if they were used, of course, a yield of 10 to 15 kiloton would easily devastate an entire city, of course, that’s what we saw in World War Two. And depending on how they would conduct such an attack, it could be more or less dirty in the sense that if a lot of material is sucked up into the atmosphere, and radiated, then you would have a serious problem of fallout, nuclear, or radioactive fallout for a period of time.

Andy Slavitt  08:33

You know, when we think of these accidents in nuclear sites, whether the one in Japan or Chernobyl, would it be the equivalent to something like that, or something even greater?

Hans Kristensen  08:45

No, there’s a lot more nuclear radiation inside a reactor that’s been running for a while, a lot more. And so that’s why, a couple of days ago, when you had the incident in Ukraine, where there was an attack on the outskirts of a large nuclear power plant with six nuclear reactors, it costs a lot of concern, of course, if a reactor was to rupture, or meltdown for other reasons, you could have a release of radiation over Ukraine and most of Western Europe for that matter. That is a much more serious radioactive collusion that could come from that.

Andy Slavitt  09:23

How concerned are you and how concerned should we be about that, given this this state of play and the security of those sites around them?

Hans Kristensen  09:33

I mean, it’s already knocked on our door so to speak. I mean, this was an eerie moment the other day and it fortunately seemed that the Russians were not sort of deliberately targeting the power plant itself. But of course, when you’re in a war situation, when there’s a war raging around you, all sorts of things can happen. And don’t forget also there are people working at these plant that some somewhat crazy to think of them doing their work every day while there countries being blown up, you could imagine, of course, accidents or incidents happening with the power plants where the reactors may not be blown up deliberately. But you could have a disruption of the electricity supply to the plants. So they’re, the coolant system wouldn’t work. And so there are things that can happen if you don’t take great care not to attack this. And it’s very serious. And that’s why attacking nuclear power plants, is a violation of international law explicitly prohibited.

Andy Slavitt  10:31

Well, it’s one of those things that I imagine we get worried about, but don’t know, quite hard to address, other than careful diplomacy in this situation that you know, you’re making me think about some of the brinksmanship here. And for those of us old enough to remember, or at least remember stories of the Cuban Missile Crisis. Can you maybe explain some of the brinksmanship? You know, is it simply that Putin is using the conversation around nuclear weapons as a deterrent to keep the US and the West as a whole from enforcing a no-fly zone? Or at least a partial no fly zone? Is it the boundaries are being drawn at the NATO border? In that we’re just sort of keeping the lines back? And then what’s the appropriate way for the West to respond against these threats? To use their own nuclear weapons as a deterrent, but not an escalate in the situation?

Hans Kristensen  11:28

Yeah. Well, Putin, he has a style of he likes to use big words and threats. This is not something new. We’ve seen this many, many times. I remember explicit Russian threats being issued against NATO countries, going all the way back to 2008, around there, from generals and from ambassadors and what have you, and Putin likes to do this, too. And he has this sort of vision of himself as the commander of Russia’s nuclear forces, and you will see these annual exercises where he sits up the table with big television screens around him. And then he sort of directs the nuclear exercise the launching of the missiles, other than sort of occasional appearances from North Korean leader, we don’t see this from any leader of a nuclear armed state anywhere that nobody else does that kind of a show. So he likes to play that. This is, however, the most serious form of nuclear saber rattling we have seen in Europe since I would say since the Cold War. And it’s explicit because it’s happening, not just in sort of generic terms, but it’s happening around a very violent war going on in Europe at the same time. So it is a new situation. And he like you said he’s definitely using this to tell NATO don’t bother go in, don’t even try. And then you know, do they believe the threat? Well, so far, they think that it’s best not to get involved. They don’t want to risk a wider war in Europe as a result of this. I think it’s actually been a very positive experience on the part of the United States and NATO that they have so far refused to take the bait. They have not played along with this nuclear saber rattling them and sort of said, well, he threatens us, well, we’re gonna threaten you back, something like that. But they have not changed the operations of the nuclear forces in a way to signal to him that, you know, it’s serious and if you do this, then whatever, we’ve even seen the United State cancel a test launch of a ballistic missile, nuclear ballistic missile in the Pacific explicitly on the saying so in public, that they did not want that to be misused in the ramping up of threat. So I think actually, they’ve been very constructive.

Andy Slavitt  13:48

Back to the talk softly and carry a big stick, as opposed to get on TV and do your exercises. To finally wrap up, is there anything in your understanding of Putin in this situation, which would tell you that even if such lines were breached, in his mind, whether it’s a no-fly zone, or, you know, moving advanced weapons in or, you know, Western military, not so much forces, but individuals coming in joining with the Ukrainian forces, that he would hesitate to go first? Or is there still some line between conventional weapons and nuclear weapons that you’d see him being loath to cross?

Hans Kristensen  14:32

No, I think it’s a good question, because, of course, it’s one thing to play this kind of threat game. It’s another thing to consider what would actually happen. And the key question here is, how serious does he think events have to be in Ukraine, for him to even consider using nuclear weapons. I mean, there’s nothing that goes on there that in any way, adds up to the degree of a scenario that would have to be met. According to Russian nuclear doctrine for them to consider using nuclear weapons, I mean, the future of the Russian state is not at stake. It’s may be very dangerous for Putin himself, what’s happening, his future might be a stake, whether that causes him to cross the nuclear line. It’s hard to predict, But I think no, because he would have to assume this as a human, he’s actually still thinking like a rational person, you will have to assume that if you start using nuclear weapons native would, in some shape or form, react to that explicitly. And there’s no way of winning a nuclear war. So the key issue, is there a scenario in which he would think he could pop a nuke somewhere in this war? And he would gamble that NATO would not respond in con, you know, is that the scenario he would think about? That that would have to be required? It seems to me for him to pop in you down there, because otherwise, it would very quickly escalate.

Andy Slavitt  16:00

And we did that hold for the smaller tactical ticket your point that they’re not all small, but so do use of a smaller tactical nuclear weapon? Yeah, I

Hans Kristensen  16:09

Yeah, I don’t think it’s about the […], or the type, it is about nuclear. Any use of a nuclear weapon would be a monstrous decision. I mean, they would break more than seven years of non-use of nuclear weapons ever since World War Two, it would be a huge political and cultural imprint and all these things. And so for him, it would be, it would be that you would really have to have a lot of things at stake for you to take a decision like that. And so we’ll see what happens. But so far, it’s reassuring that US intelligence says they have not seen any steps on the part of the Russians on the ground that indicate they have made any preparations to use nuclear weapons. So that’s the good news.

Andy Slavitt  17:00

Well, let’s hope of course that you’re right, let’s hope that cooler heads prevail. Let’s hope that these nuclear sites stay safe and respected. And of course, over here in the US, it probably feels less imminent or threatening than it does to folks in Western Europe, and certainly Eastern Europe. So our understanding has been advanced significantly by listening to. So really appreciate you coming in the bubble.

Hans Kristensen  17:26

Thanks very much. Have a great day.

Andy Slavitt  18:02

So, Senator, thanks for joining. Thanks for coming in the bubble. You just came out of a hearing in Ukraine. Could you tell us what the latest is and what your latest thinking is?

Tim Kaine  18:13

Well, Andy it’s a real tragic situation. I mean, it the you know, there’s some positive signs first, the incredible heroism of Ukrainians and the fierceness of their resistance. Second, the resolve of Western nations if you know, folks were led to question the viability and value and relevance of NATO or other alliances now they see why alliances are so powerful and why the US leadership and alliances is so necessary for us to have powerful effects as we are and then the other beginning of a bright sign is evidence of real tough opposition in Russia to this war. Protests after protests, Russian citizens making runs on banks and ATMs as the ruble is in a freefall. But the sad reality is, all of these things may not produce an outcome that we would be happy with anytime soon, because Vladimir Putin is deranged. He’s a war criminal. He says he’s going into Ukraine to de-nazify it. When Vladimir Zelensky is one of two Jewish heads of state in the world. There’s 195 countries, and he is trying to invade and topple there have been assassination attempts against Vladimir Zelenskyy Russian missiles have struck the site in Kyiv where 10s of 1000s of Jews were murdered in the early days of World War Two, one of the most gruesome instances during the Holocaust and Vladimir Putin believes this is a war of de-Nazification. It just shows how to arrange the as and why we have to all of us stay resolved to win this but the thing that’s tough right now is it doesn’t seem that there’s a prompt and to this, and that means an awful lot of people are suffering and will suffer.

Andy Slavitt  20:05

What policy options appear to be on the table from the West, either the unity of economic sanctions has been quite strong and quite powerful. And you know, you can just sense that everybody in the US Congress, like people around the country really want to do whatever they can to show support for Zelenskyy and the people of Ukraine, but there are limits. Where do you feel those limits continue to be and how much debate is there?

Tim Kaine  20:34

And you’re right, the effort is multiple. So it’s economic sanctions. It’s things like canceling the Nord Stream two pipeline, which is a big, big deal for Germany that had to do that, but also the effect on Russia humanitarian and military aid to Ukraine to us, granting TPS status to Ukrainian so they can come to the country pressing charges against Vladimir Putin as a war criminal and international courts. There’s multiple things happening. I think the issue that’s right now is that you know, us does not want to be engaged in a war with Russia, Putin kind of wants to turn it into that we want to keep the focus on his illegal invasion of a sovereign nation rather than have it escalated to some kind of more global conflict. So the issue is, how much weaponry can we flow when you get into the military space? President Biden has said US troops are not going to be involved in Ukraine, how much weaponry can you flow to Ukraine to help them defend themselves, that is a deterrent without becoming additional provocation.

Andy Slavitt  21:40

It feels like there’s a number of actions that are punishing to Russia into Putin, but not necessarily deterrent, and that he has been more vocal even then, I think maybe we anticipated about drawing some lines and saying, you know, he will use his deterrence, if we were to put in place, a limited no fly zone and other sorts of things. Whereas the other kinds of things he’s sort of been putting in place without him being that overly provoked, but it feels like we’re dancing around kind of a potential line with that line, for, you know, us as sort of NATO and the boundaries of NATO, and perhaps the use of more advanced weaponry against the citizens of Ukraine. The line for him appears to be no fly zones. Is that the place where you think we’re going to be? Or is there a debate on how to shake this loose? Or, in fact, do you think that maybe diplomacy or some of these other sections will have an impact?

Tim Kaine  22:40

Well, I think frankly, at the end of the day, the only deterrent to Vladimir Putin is his own population, and oligarchs and others around him, they’re watching the ruble plummet, the stock market be closed, interest rates skyrocket, everyday citizens making runs on banks and ATMs. And when you see that happen, that’s not the same as a protest. But it essentially is a protest. So there’s antiwar protests in Russia, and even with mass arrests every day, there’s more protests, and they’re likely to grow. But the citizenry realizing that the ruble is becoming worthless and doing runs on ATMs banks. That is that that is a powerful political statement, eventually, that causes significant unrest. You have China that, you know, right before the Russian invasion, sort of linked arms with Russia and said, we’re a team now China’s is going to suffer very significant reputational damage in the world, by being too close to Russia, they could start to distance themselves from Russia, the US and other nations, stopping oil imports from Russia or joint ventures, getting out of deals with Russian energy producers, these things all produce an internal effect. And I think at the end of the day, the deterrent that will likely have the effect on Putin is the internal deterrent. And I believe that’s going to happen, but I just don’t believe it’s going to be fast.

Andy Slavitt  24:09

Got it. Do you take him in his word when he threatens the use of nuclear weapons, I presume, tactical use of nuclear weapons?

Tim Kaine  24:17

It’s that would be enormous costs to Russians if he were to do that. I mean, if you think of where, you know he would if you use a tactical nuclear weapon in Ukraine first all the Russian speakers in Ukraine that he is supposedly trying to protect but also the fallout risk of using a tactical nuclear weapon even if it’s only a one off and there’s, you know, no response, no escalated response against Russia, just the fallout risk of a tactical nuclear weapon in Ukraine would pose serious challenges for his own Russian population. But we have to take it as a reality. He doesn’t seem to be worried about the kinds of things that others are worried about. So when we you know, so for example, if we’re pressing in international courts to declare him war criminal, we can’t shame him. We can hopefully shame make some Russians ashamed of him. But we’re not going to shame him in this. He, unless he’s brought to heel by China, for example, that might be the one nation in the world that could yank him on a leash and back them up a bit, or more likely breaks or put in his past by growing domestic political opposition in Russia. Right. Again, the sad feeling I have right now is I think we’re assembling the right kind of coalition for the long term, but I don’t think it’s one that’s going to produce the result we want in the near term.

Andy Slavitt  25:50

We’ll keep watching. And it’s really remarkable you and I grew up kind of during this sort of Cold War era. And it’s probably as remarkable to your ears as it is to mine, to hear the threats that Putin has put on the table with regard to nuclear arms and the use of tactical nuclear weapons. And on the one hand, it must be awfully tempting for those of us in the West, to want to put a counter to turn on the table. And on the other hand, you know, I think the Wiser minds and the more experienced minds, including that of the President, you know, probably are mindful of not taking the bait and escalating further. You’ve been doing this a long time, Senator, what’s the right approach here?

Tim Kaine  26:32

Well, I think it’s the approach that the administration has cobbled together over the course of many, many months. And I will say that the key feature of the Biden administration’s approach to this has been let the network of alliances demonstrate its power again, you know, under President Trump, he was repeatedly not only devaluing NATO and questioning its relevance, John Bolton said, had he had a second term, he likely would have pulled us out of NATO.

Tim Kaine  27:14

He was also destabilizing the other alliances, we have by using trade power to, you know, national security waivers to impose trade sanctions against Canada, Mexico, Europe, as if these are national security threats to us when they’ve been allies with us, again, and again and again. And so we went from an administration that devalued alliances, and then cozied up to dictators like Putin, even withholding military aid from Ukraine, in Putin’s favor to try to gain an edge in a political campaign, to an administration that understands of all the elements of American strength, the one where we still have an undeniable, qualitative edge is alliances. Russia and China don’t have that. And that’s why they entered into the sort of manifesto right before the Beijing Olympics saying, okay, we’re partners now, because they can look at what the US does. I mean, even something like an evacuation out of Afghanistan, 76,000 people in a couple of weeks, we can tell from the Chinese reaction while they were counting, see the US is leaving. What they were thinking is how did the US come up with so many allies that were willing to let them use their airfields use their airspace, become lily pads for the hunt, it was 125,000 Afghan refugees 76,000 from came to United States. They’re looking at us and seeing the alliances we put together as the most significant power that we have. And the way NATO plus others have performed thus far has been powerful when you have nations like Sweden and Finland who are not NATO members, who are now starting to think about talk together about joining NATO, who are sending weapons to Ukraine, when Germany that has had a post-world war two policy of not putting weapons into a conflict zone and sending weapons to Ukraine with Moldova, who’s right on the border with Ukraine and because they’re not a NATO ally, is very worried about Russia announces last week we want to join the EU. We’ve seen what Russia will do we want to orient toward the west. When Switzerland traditionally neutral was willing to help us enforce the swift sanctions against Russia’s financial sector. Vladimir Putin is chasing every country into an alliance with other democracies, many because that’s who they want to be and are others because they realize it’s an existential necessity that they link arms with the democracy themselves.

Andy Slavitt  30:33

Are you seeing a unity in the Congress across the aisle now on Ukraine?

Tim Kaine  30:37

Yeah, I am. I think that there’s some details where folks differ. And you’ll still hear some saber rattling, like, you shouldn’t have done this a year ago or, you know, why did Trump do this? Or why did Biden do this? Or Why did Obama do this, but when you get into what we should do now, again, there are some tough, tough questions around, you know, use of aircraft and some hard strategic calls. But in the hearings, we’ve had, we had a classified hearing with Victoria Nuland and then an open hearing today, when you really get into it, we are talking you wouldn’t know necessarily whether it was a Democrat or Republican, asking the question, when you were getting into the, what shall we do now? We really are earnestly looking for answers, that we can reach a bipartisan court on an example how quickly did it become, you know, reality in Congress, we want to ban Russian oil imports, it can raise the price of gas, which is already too high. But Congress got there in a bipartisan way, even before President Biden announced

Andy Slavitt  31:42

Which is really important to cover, because you can imagine a President having to do that and tell Americans you need to sacrifice and suffer the consequences. And the other party exploiting that. So, you know, it is heartening this time to see that, you know, as we switch to talk a little bit about the pandemic, and yes, and you’ve done some really remarkable work there. You know, that’s been an area where I think, at one point, we all thought it hoax, that this would be a kind of nonpartisan response to kind of an existential threat. And it devolved into that. I think and maybe I think we all just shrug our shoulders and say that’s, that’s par for the course, it’s bound to happen. But people like yourself who have, you know, history of working across aisle who come from a state where identity politics is much less pervasive and kind of good, responsible governance. You know, you’ve been everything from a mayor, Lieutenant Governor, Governor, Senator, and then you’ve been in political positions you’ve chaired the Democratic National Party. So it’s not that you don’t get appreciate which side you’re on. But what if you can reflect, as we as we talk about this, like, well, you know, what, what happens to these issues that make them become so partisan? And is there a sense as we move, hopefully, to further states beyond the emergency state of the pandemic, that some of these issues are requests for funding? And we’ll talk a bit about your legislation as part of that, that people can come together and take these out of the political realm and look at them as just simple issues?

Tim Kaine  33:28

I pray that we can and let’s just use the pandemic as an example. I mean, I was governor when George W. Bush was president and we had a potential pandemic H1N1 one that caused a great deal of angst among governors and federal officials at that time, and I remember being on the phone with many governors across the state and then HHS Secretary Mike Leavitt, there was no difference between Democrats and Republicans, you know, who is a very much how can we stockpile enough Tamiflu to provide treatment if this should head, these were completely nonpartisan discussions, and I’ll tell you a sad thing that happened after the attack on the Capitol. A few days afterwards, one of the Capitol police officers after January 6th, 2021 saw me and said, hey, I’m a Virginia resident, can I speak to as a constituent not as a Capitol Police officer he goes, look, I’ve been here for a while. After the attack on the Capitol on 9/11. The attack on the United States. We saw members of Congress standing arm and arm on the Capitol steps Democrats and Republicans and coming together to defend the nation. In the last year we’ve seen a pandemic and we’ve seen a domestic insurrection violent attacking the capitol to disrupt peaceful transfer of power and what we didn’t see after either of those was what we saw after 9/11, democrats, Republicans linking arms and coming together and look Andy, I gotta lay that at the feet of Donald Trump. The difference between the response to 9/11 and the response to both the pandemic and the attack on the Capitol was the character of the nation’s leader who has the loudest microphone in the world and always chose a path of division rather than a passionate path of pulling people together. And that wound is still festering, it’s healing to some degree, but it’s not healed. We’ve survived the stress test so far, but we haven’t yet passed it. And yet, I don’t despair that we could pass it and get back to a place we have done some work in the pandemic that has been bipartisan, the first film, The Cares Act, which we negotiated under very difficult circumstances in March of 2020, as the pandemic was raging, and we were still confused about a lot of it, we had to come up with something fast to try to save a sinking economy and also begin to deal with the health challenge. That was a proud moment of bipartisanship.

Tim Kaine  36:03

And we did some other things in those early phases. But you know, the continued pushing of an anti-science message by President Trump even as Republican leaders in Congress when you’re trying to work together on some things. The fact that President Trump was pushing this anti-science message just caused enormous confusion. And I will say if I’m going to be critical of President Trump, I feel duty bound to say some positive things, the warp speed development of the mRNA platform vaccines truly was remarkable. They did a poor job on the communication side, they didn’t have much of a deployment plan when they left office, but the development of those vaccines, I give the Trump team credit, and my only question is, why didn’t he go out and just be the biggest salesman in the world and take credit for this thing, which he deserves credit. He wouldn’t do that he got vaccinated, privately wouldn’t tell anybody got vaccinated finally, a year later, he’s willing to acknowledge that he got vaccinated which was a mystery to me. But my hope is, now we’re working on a pandemic preparedness bill in the HELP Committee, Senator Burr, who as you know, has had a real interest in pandemic preparedness going back a number of years and who’s retiring it you’re in, is working with Senator Murray. And you know, there’s kind of a HELP Committee tradition is, you know, if a chair or ranking is on their way out, we usually try to do something important to them. We did that with Mr. Alexander in his last year, like what is important to you, you’ve been a great part of this committee, let’s try to do things that matter to you and this pandemic preparedness bill is something that I think we can do, that will be bipartisan, and that will position us in a better way for future pandemics, but also just health crises more generally, our public health data system in this country, isn’t what it should be. I appreciate that, as a mayor and a governor in a senator that often the local health departments don’t talk to the State Health Departments and neither talk that well, at the federal level. And the absence of really inter operable information with confidentiality protection obviously, means that we don’t spot trends fast enough, we don’t get the best data on, you know, cures, or efficacy of treatments, and then side effects of treatments, all these things would be much better off if we are better connected. And I think we’re gonna come up with a pretty good bill on that score.

Andy Slavitt  38:30

Well, it’s great. I don’t have ever told you the story. When I was in the White House at the pandemic response. There was a big debate internally about, you know, should trump get credit? Should Trump not get credit, and I went out on the North Lawn and did Fox and Friends, which not a lot of folks in the white house wanted to do. Yeah. And they jumped at me friend out of the gate and said. So you would tip your hat to Operation warp speed? Now, what had happened is immediately before that, the hosts have been talking to each other and they said, I’m going to trap this guy. I could hear. And so I was basically trying to talk to conservatives about why they should get vaccinated. So I said, of course, you should get credit. I said, I would absolutely tip my hat. I mean, this is a scientific process that actually began more than a decade ago, with scientists inside the NIH and inside BARDA creating this mRNA vaccine. I think the Trump administration made sure that we got in record time, a vaccine up and out, I take my headphones on I walk out of the North Lawn, my phone flashes with a Politico headline. Slavitt praises Donald Trump, as I walk back into the West wing. And I’m like, I don’t think I’m gonna walk into the West wing, right? They might give it and I think I rented a claim in plain sight. Don’t worry about it. Just don’t worry about it.

Tim Kaine  39:52

But Andy, if Donald Trump had really leaned in to the vaccines, our vaccination rate wouldn’t be 67 or 68% it could easily have been 85%. I mean, you have nations like Ireland where it’s 97% or 98%. Now we had an anti Vax culture that was both left and right. preexisting code.

Andy Slavitt  40:12

And anti-science and antiestablishment culture was even stronger.

Tim Kaine  40:16

Yes, right. Anti-science, antiestablishment. I don’t trust authority that is a venerable American, don’t tread on me. You know, that’s the kind of people we are. So we weren’t going to get to Ireland levels or the levels of some other nations. You know, I’m intrigued by you know, I’ve been visiting a lot of African refugees in the United States, they came in to eight military bases, as they were processing to resettle in communities. You know, ask the base commander. So what’s the vaccination percentage? It’s 100%. I said, well, is that because you’re required to goes well, yeah, we do require it, but we never really have to require I mean, they, they’re desperate to get vaccinations. I visited Latin America with a bipartisan delegation last July. And you know, Ecuador, Colombia, Guatemala, Mexico, and you got a lot of people who don’t want to get vaccinated, send us more vaccines, our folks want to get vaccinated. So it’s a little bit of a tragedy, one of our personality quirks. It’s kind of a tragedy of our life, because we’re going to pass a million deaths before Easter. I mean, we’re at about 960,000 deaths to COVID. Now, we’re going to pass a million deaths before Easter. It didn’t have to be this way.

Andy Slavitt  41:27

Well, yeah. And in some of this is a function of, and look, you are very much in the middle of this in the presidential campaign, of a whole bunch of people feeling disaffected, and not having a lot of opportunities to express it. And when they have those opportunities, they just don’t trust any of us. They don’t trust me. They don’t trust you. They don’t trust the pharmaceutical companies. They don’t trust the president. They don’t, you know, and as you said, Donald Trump tapped into that he didn’t have an answer for it. Except he was good at tapping into it. But you know, when it came time to say, hey, let’s all get vaccinated, the message of hate. Let’s do it, because it’s good for all of us. There’s about 50% to 60% of the people that, that that works for. There’s another 20% of people who I think were persuaded that yeah, maybe this, this works. But there’s another 20% of people that you know, you could have been handing out free checks. And I think if it was coming from the government coming from certain realms, it just made it more difficult. By the way, I just want you to note my amazing skill at transitioning from a conversation about Ukraine, to one about pandemic, I think that was one of the most seamless.

Tim Kaine  42:41

It was so seamless, I didn’t notice.

Andy Slavitt  42:43

Wasn’t it good? I reached the audience is basically, how does he do this? You didn’t even notice it just happen. But you, Senator are made a little bit of news by doing something that I really appreciate, which is you told a little bit of your own story, around your lingering symptoms from COVID-19. And for those who didn’t see that, could you could you talk a little bit about that?

Tim Kaine  43:17

You know, I’m glad too Andy, so I’ll tell you my story, but I’m gonna tell you why I decided to talk about it because I didn’t for a while, but so I got COVID when we were passing the Cares Act in March of 2020. But my symptoms were non-standard. So at that time, at the very beginning of COVID, the common symptoms were loss of taste, or smell respiratory problems, I didn’t have any of that. What I had was, it felt like a blizzard of allergic reactions, you know, pinkeye, skin rashes, nerve tingling. And it was kind of when hey, you know, pollen was on your part of me, this is just like a really bad […]. So, but I then went home and I gave COVID to my wife, and then she just got the very standard case. Okay, this is COVID. We got to antibody tests; it was COVID. There wasn’t even good testing at the time. We didn’t get our antibody tests, oh, you know, four or five weeks after. But by mid-April, we were both fine, except I have these two little symptoms. And I say little because people are really suffering. I’m gonna get into that in a minute. But when I got COVID It was like, every nerve ending in my body just started to tingle. Like, it’s, you know, I kind of describe it as like, every nerve ending had five cups of coffee, and it’s just like 24/7 and it just was instantaneous one day and it hasn’t gone away.

Andy Slavitt  44:31

Is it sporadic? You feel it right now?

Tim Kaine  44:36

I feel absolutely right as I’m sitting here, never goes away. It’s not painful. And it’s not even like when your leg falls asleep. That’s like really annoying. It’s not that bad. It’s about halfway to that.

Andy Slavitt  44:49

Oh, it’s a pins and needles kind of sensation?

Tim Kaine  44:52

Yeah, pins and needles tingling. The other thing is that I was getting rashes that would pop up and disappear and instead of that, that went away. But instead of the rash is what I get. It’s I call it like a heating pad phenomenon where I’ll just feel like somebody put a heating pad on my lower back or in my arm, turned it on for 20 minutes, and then it fades away. And that is not unpleasant at all. But I’ve sometimes like what’s going on. Anyway, after a number of months of this, I did go to a neurologist and he said, look, you know, viruses sometimes have these neurological after effects. I got an MRI and other neurological testing, I was fine, I can work I can exercise I can sleep; it’s not getting in my way. He said, though, the reality of some of these neurological after effects is the good news is he said they usually don’t get worse. They can subside over time, but sometimes they don’t, they just stay. And it’s now been two years. But my symptoms are not debilitating. So I wouldn’t really talk about them, because some people are really suffering. But then I started to talk to people who had long COVID symptoms, who were telling me and I told my doctor and my doctor didn’t believe me. Or I’ve been to a physician, and they said, Oh, you know, it’s probably anxiety or depression. So let me prescribe anti-anxiety medication or something like that. And they’re like, that’s not what this is. This is a physical change. You know, my former governor, Ralph Northam, had COVID. And a year later, he has no sense of taste or smell. This is not anxiety or depression; it is a change in your physiology. And so I decided probably about five or six months ago, that I was going to start sharing my story, just so that people who are dealing with it, and it could be 15% to 20% of people that COVID who were having these long symptoms that they you know, would realize policymakers believed them, you know, and that we’re actually and we get this, this is real, don’t let somebody fob you off and tell you your experiences aren’t important.

Tim Kaine  46:54

And so that’s why I’ve started to do it. And I’ll tell you Andy the response of people, the first time I did it at a hearing couple months back with Fauci, Dr. Fauci, and Walensky, got a lot of outreach, introduced this bill, so a lot of people reaching out to me, including look, including colleagues here on the hill, who are having the same experience, but I don’t want to talk about it yet. And there’s that, hey, thanks for putting that bill in. Because this is real. And look, when COVID is completely in the rearview mirror, I don’t know when that’ll be. The two things that won’t be in the rearview mirror are the combined mental health impacts of a million deaths and job losses and businesses closed, kids missing the prom and homecoming to graduation, adults being isolated, because their kids can’t visit them. So the mental health impacts will keep going. And then this long COVID piece will keep going and in order to, you know, have a healthcare system, we can feel good about using that label for the healthcare system, we have to deal with these mental health pieces. And we have to deal with the long COVID reality.

Andy Slavitt  48:03

You know, it’s interesting, because we’ve had some advocates for long COVID on this program before. And I heard from a few of them after you made your announcement. And I almost got like the biggest exhale, that I think I’ve heard from a group like this quite a while, because I think they felt like nobody well known is saying that this is a problem. And if that’s the case, people are gonna have a tough time believing it, this has got to be a problem for some well-known people. And finally, I think they feel like a great burden. And pressure is lifted on them. Now my son who’s 20 has a still has symptoms almost a year and a half later, from COVID. And I guess I put him in your category where they’re not preventing him from doing the things that he needs to do in life. But he’s aware, you know, he’s had tachycardia, his limbs are ice cold and blue, his fingers in his toes, his are intermittent. He gets these rashes that are incredibly painful, and then they go away. And of course, like a lot of people, he doesn’t want to put too much of this on COVID because he doesn’t know. Just so strange things are happening to his body. And they’ve happened since he had the original case of COVID.

Tim Kaine  49:21

Well, Andy if I could just playing just playing down the road for your son. So your son’s a young person, right? So he’s got a long life at, if you have these symptoms after COVID. And then particularly if they’re severe, and not only, you know, may, is there some chance that as you describe them to others, they’re like, oh, I don’t know about that. Maybe that’s not COVID. But you yourself are dealing with the reality of how long is this going to go on? I mean, is there going to be a treatment for it? Am I going to live with this the rest of my life? And the answer is we don’t know the answer to these questions. So what we’re trying to do with this bill that I introduced is first have a registry where we could get as much the patient kind of symptoms data into the registry so that we can really understand all the nuances of this. Because for some, it’s cardiac for some, it’s neurological, for some, it’s I’m super fatigued. For some, it’s I have a respiratory problem, or it’s showing up in my bloodstream. So we want to document protecting people’s confidence, obviously, as much as we can, then secondly, we want to do research into causes, but also into treatment. So for example, maybe it would be hard to really identify the cause. But if people like me who have nerve tingling, well, there have already been some treatments that people use for this neuropathy and nerve tingling. And even though that might not have been related to COVID, well, maybe that treatment might work for the people who have what I have. And there may be other treatments out there that weren’t created because of COVID. But that might have some efficacy. So we need to research all that. And then the final thing we need to do and our bill is about this is disseminate information enough to patients and providers, and then also provide support services, like, how, what do you need to show about long COVID In order to get a disability determination or to go to an employer and say, hey, I’d like an accommodation at work, because I have this, we’re gonna have to figure all that out. And that’s, you know, that’s kind of what we’re trying to do with this bill.

Andy Slavitt  51:24

Well, it’s a great bill, I hope people support it. We could, there’s a lot more we could talk about, but I have it on very good authority that you have to vote. And we don’t want to get in the way of that. So all I could do, thank you for coming on in between your hearing and your votes. We’ll have you back on if you’re willing to talk more about this and other things. It’s just a real pleasure to connect with you again, thank you for all you’re doing.

Tim Kaine  51:45

Andy Slavitt, you’re a hero to everybody cares about health care policy. So I’ll be glad to do this again. Okay, take care, guys. Appreciate it.

Andy Slavitt  52:04

Okay, thank you. Tim Kaine. I also want to say thank you to Hans Kristensen. And because I’m not going to have an unlimited amount of time to do it. I want to thank Chris EPS once again, who is my partner on this show. She’s been really being incredibly resourceful in these last few shows, reacting very quickly getting amazing guests, bringing you the information you need to hear. I’m just incredibly grateful. Let me tell you about the upcoming shows on Wednesday, Roh Khanna, who is on the Armed Services Committee, very smart. We will be talking about a number of things with Roh, you will want to listen to this. He is probably a gang of one in the Congress as someone who is highly progressive, and a major capitalist. We’re gonna hear about that, but we’re also going to hear what he’s hearing in the latest new creative course. And then on Monday, we are going to go in depth on the promise of the mRNA platform. Can it cure cancer? Yes, it can. Can it help fight pandemics? Yes, it can. Can it change the way science works on a number of fronts? Yes, it can. It’s pretty fascinating. Pretty amazing. And I’ve been wanting to do this show for some time. So I think you’re going to really, really get a kick out of it. You’re gonna geek out. That’s it for now. We’ll talk to you on Wednesday.

Andy Slavitt  53:41

Thanks for listening to IN THE BUBBLE. Hope you rate us highly. We’re a production of Lemonada Media. Kryssy Pease and Alex McOwen produced the show. Our mix is by Ivan Kuraev and Veronica Rodriguez. Jessica Cordova Kramer and Stephanie Wittels Wachs are the executive producers of the show, we love them dearly. Our theme was composed by Dan Molad and Oliver Hill, and additional music by Ivan Kuraev. You can find out more about our show on social media at @LemonadaMedia. And you can find me at @ASlavitt on Twitter or at @AndySlavitt on Instagram. If you like what you heard today, please tell your friends and please stay safe, share some joy and we will definitely get through this together.

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