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Subsequent [[neuroimaging]] findings by the University of Pennsylvania team were published in ''JAMA'' in July 2019.<ref name="JAMAJuly2019"/> The [[Retrospective cohort study|retrospective]] [[neuroimaging]] study of 40 affected diplomats studied found that, compared to healthy [[control group]]s, the 40 diplomats in Havana who had reported injury had experienced [[brain trauma]]. Advanced [[MRI]] scans revealed{{efn|Specifically, [[Resting state fMRI|res-fMRI]], multimodal MRI, and [[diffusion MRI]].}} "differences in whole brain [[white matter]] volume, regional [[Gray matter|gray]] and white matter volume, [[Cerebellum|cerebellar]] microstructural integrity, and functional connectivity in the auditory and visuospatial subnetworks" but found no differences in [[executive functions]].<ref name="JAMAJuly2019"/> The study concluded that the U.S. government personnel had been physically injured in a way consistent with the symptoms they described but expressed no conclusion on the cause, source, or clinical importance of the injury.<ref name="JAMAJuly2019"/><ref name="Carey"/> The ''New York Times'' reported: "Outside experts were divided on the study's conclusions. Some saw important new evidence; others say it is merely a first step toward an explanation, and difficult to interpret given the small number of patients."<ref name="Carey">{{cite news|author=Benedict Carey|date=July 23, 2019|title=Were U.S. Diplomats Attacked in Cuba? Brain Study Deepens Mystery|newspaper=[[New York Times]]|url=https://www.nytimes.com/2019/07/23/science/cuba-diplomats-health.html|url-status=live|access-date=July 23, 2019|archive-url=https://web.archive.org/web/20201202142220/https://www.nytimes.com/2019/07/23/science/cuba-diplomats-health.html|archive-date=December 2, 2020}}</ref>
Subsequent [[neuroimaging]] findings by the University of Pennsylvania team were published in ''JAMA'' in July 2019.<ref name="JAMAJuly2019"/> The [[Retrospective cohort study|retrospective]] [[neuroimaging]] study of 40 affected diplomats studied found that, compared to healthy [[control group]]s, the 40 diplomats in Havana who had reported injury had experienced [[brain trauma]]. Advanced [[MRI]] scans revealed{{efn|Specifically, [[Resting state fMRI|res-fMRI]], multimodal MRI, and [[diffusion MRI]].}} "differences in whole brain [[white matter]] volume, regional [[Gray matter|gray]] and white matter volume, [[Cerebellum|cerebellar]] microstructural integrity, and functional connectivity in the auditory and visuospatial subnetworks" but found no differences in [[executive functions]].<ref name="JAMAJuly2019"/> The study concluded that the U.S. government personnel had been physically injured in a way consistent with the symptoms they described but expressed no conclusion on the cause, source, or clinical importance of the injury.<ref name="JAMAJuly2019"/><ref name="Carey"/> The ''New York Times'' reported: "Outside experts were divided on the study's conclusions. Some saw important new evidence; others say it is merely a first step toward an explanation, and difficult to interpret given the small number of patients."<ref name="Carey">{{cite news|author=Benedict Carey|date=July 23, 2019|title=Were U.S. Diplomats Attacked in Cuba? Brain Study Deepens Mystery|newspaper=[[New York Times]]|url=https://www.nytimes.com/2019/07/23/science/cuba-diplomats-health.html|url-status=live|access-date=July 23, 2019|archive-url=https://web.archive.org/web/20201202142220/https://www.nytimes.com/2019/07/23/science/cuba-diplomats-health.html|archive-date=December 2, 2020}}</ref>


In response to a December 2017 State Department request, the U.S. [[Centers for Disease Control and Prevention]] conducted a "Cuba Unexplained Events Investigation."<ref name="buzzfeed2">{{cite news |last1=Vergano |first1=Dan |title=Medical Records Can't Explain "Havana Syndrome," A Buried CDC Report Says |url=https://www.buzzfeednews.com/article/danvergano/cdc-investigation-cuba-havana-syndrome |access-date=May 11, 2021 |work=[[BuzzFeed News]] |date=January 15, 2021 |language=en}}</ref><ref name="CDC">{{Cite book|url=https://nsarchive.gwu.edu/documents/cdc-report-havana-syndrome-medical-mystery-remains-unresolved/CDC%20%2320200983DOS255%20Final%20Report.pdf|title=CUBA Unexplained Events Investigation - Final Report|date=December 3, 2019|publisher=[[Centers for Disease Control and Prevention]]}}</ref> The two-year investigation of the medical records of 95 U.S. diplomats and family members in Havana who reported symptoms resulted in a final report, marked [[for official use only]], dated December 2019.<ref name=BriefingBook>{{cite work|editor=[[Peter Kornbluh|Kornbluh, Peter]]. |url=https://nsarchive.gwu.edu/briefing-book/cuba/2021-02-02/cdc-report-havana-syndrome-medical-mystery-remains-unresolved|title=Briefing Book #739: CDC Report on the 'Havana Syndrome'|publisher=[[National Security Archive]], [[George Washington University]]|date=February 2, 2021}}</ref>
In response to a December 2017 State Department request, the U.S. [[Centers for Disease Control and Prevention]] conducted a "Cuba Unexplained Events Investigation."<ref name="buzzfeed2">{{cite news |last1=Vergano |first1=Dan |title=Medical Records Can't Explain "Havana Syndrome," A Buried CDC Report Says |url=https://www.buzzfeednews.com/article/danvergano/cdc-investigation-cuba-havana-syndrome |access-date=May 11, 2021 |work=[[BuzzFeed News]] |date=January 15, 2021 |language=en}}</ref><ref name="CDC">
*{{Cite book
|url=https://nsarchive.gwu.edu/documents/cdc-report-havana-syndrome-medical-mystery-remains-unresolved/CDC%20%2320200983DOS255%20Final%20Report.pdf
|title=CUBA Unexplained Events Investigation - Final Report
|date=December 3, 2019
|publisher=[[Centers for Disease Control and Prevention]]
}}
*{{cite web |title=CDC Report on the ‘Havana Syndrome’: Medical Mystery Remains Unresolved |url=https://nsarchive.gwu.edu/briefing-book/cuba/2021-02-02/cdc-report-havana-syndrome-medical-mystery-remains-unresolved |website=[[National Security Archive]] |publisher=[[George Washington University]] |access-date=7 May 2022}}
</ref> The two-year investigation of the medical records of 95 U.S. diplomats and family members in Havana who reported symptoms resulted in a final report, marked [[for official use only]], dated December 2019.<ref name=BriefingBook>{{cite work|editor=[[Peter Kornbluh|Kornbluh, Peter]]. |url=https://nsarchive.gwu.edu/briefing-book/cuba/2021-02-02/cdc-report-havana-syndrome-medical-mystery-remains-unresolved|title=Briefing Book #739: CDC Report on the 'Havana Syndrome'|publisher=[[National Security Archive]], [[George Washington University]]|date=February 2, 2021}}</ref>


In January 2021, both [[BuzzFeed News]] and [[George Washington University]]'s [[National Security Archive]] obtained the report, pursuant to [[Freedom of Information Act (United States)|Freedom of Information Act]] requests. (Some material in the released report was redacted for medical privacy reasons.)<ref name="buzzfeed2"/><ref name=BriefingBook/> The CDC developed a "case definition" of the Havana syndrome, consisting of a [[Biphasic disease|biphasic]] (two-stage) syndrome.<ref name=CDC/><ref name=BriefingBook/> The first phase of symptoms (sometimes closely after an [[Auditory system|auditory]] or [[Sensory neuron|sensory]] event) consisted of one or more of the following symptoms: head pressure, disorientation, nausea or headache, [[Vestibular system|vestibular disturbance]], or auditory or visual syndromes.<ref name=CDC/> The second phase of symptoms, occurring sometime later, consisted of [[cognitive deficit]]s, [[Vestibular system|vestibular]] disturbances, or both.<ref name=CDC/><ref name=BriefingBook/> The report concluded, "Of the 95 persons whose medical records CDC evaluated, 15 had illnesses that met the criteria for a presumptive case definition. CDC classified 31 others as possible cases and the remaining 49 as not likely to be a case."<ref name=CDC/> Two years later, six of the subjects in the CDC investigation were still being rehabilitated for their injuries, and four were still unable to return to work.<ref name="buzzfeed2"/> The CDC decided not to conduct a retrospective [[case–control study]] because of the length of time between the event and the onset of symptoms, which could lead to [[recall bias|recall]] and [[selection bias]]es that "could generate misleading or obscured findings."<ref name="buzzfeed2"/>
In January 2021, both [[BuzzFeed News]] and [[George Washington University]]'s [[National Security Archive]] obtained the report, pursuant to [[Freedom of Information Act (United States)|Freedom of Information Act]] requests. (Some material in the released report was redacted for medical privacy reasons.)<ref name="buzzfeed2"/><ref name=BriefingBook/> The CDC developed a "case definition" of the Havana syndrome, consisting of a [[Biphasic disease|biphasic]] (two-stage) syndrome.<ref name=CDC/><ref name=BriefingBook/> The first phase of symptoms (sometimes closely after an [[Auditory system|auditory]] or [[Sensory neuron|sensory]] event) consisted of one or more of the following symptoms: head pressure, disorientation, nausea or headache, [[Vestibular system|vestibular disturbance]], or auditory or visual syndromes.<ref name=CDC/> The second phase of symptoms, occurring sometime later, consisted of [[cognitive deficit]]s, [[Vestibular system|vestibular]] disturbances, or both.<ref name=CDC/><ref name=BriefingBook/> The report concluded, "Of the 95 persons whose medical records CDC evaluated, 15 had illnesses that met the criteria for a presumptive case definition. CDC classified 31 others as possible cases and the remaining 49 as not likely to be a case."<ref name=CDC/> Two years later, six of the subjects in the CDC investigation were still being rehabilitated for their injuries, and four were still unable to return to work.<ref name="buzzfeed2"/> The CDC decided not to conduct a retrospective [[case–control study]] because of the length of time between the event and the onset of symptoms, which could lead to [[recall bias|recall]] and [[selection bias]]es that "could generate misleading or obscured findings."<ref name="buzzfeed2"/>
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===Pulsed electromagnetic energy and ultrasound===
===Pulsed electromagnetic energy and ultrasound===
On February 1, 2022, a declassified US intelligence report (IC Experts Panel on Anomalous Health Incidents) called pulsed electromagnetic energy and ultrasound plausible causes and said that concealable devices exist that could produce the observed symptoms.<ref name="guard">{{Cite news |date=February 2, 2022 |title=Havana Syndrome could be caused by pulsed energy devices – US expert report |language=en |url=https://www.theguardian.com/us-news/2022/feb/02/havana-syndrome-concealable-devices-cia-report |access-date=February 3, 2022}}</ref>
On February 1, 2022, a declassified US intelligence report (IC Experts Panel on Anomalous Health Incidents) called pulsed electromagnetic energy and ultrasound plausible causes and said that concealable devices exist that could produce the observed symptoms.<ref name="guard">{{Cite news |date=February 2, 2022 |title=Havana Syndrome could be caused by pulsed energy devices – US expert report |language=en |work=[[the Guardian]] |url=https://www.theguardian.com/us-news/2022/feb/02/havana-syndrome-concealable-devices-cia-report |access-date=February 3, 2022}}</ref>

====Microwaves====
====Microwaves====
In 2018, Douglas H. Smith, the lead author of a [[University of Pennsylvania]] study of 21 affected diplomats in Havana published in ''[[JAMA]] '', said in an interview that microwaves were "considered a main suspect" underlying the phenomenon.<ref name="BroadSuspect">{{cite news|last=Broad|first=William J.|date=September 1, 2018|title=Microwave Weapons Are Prime Suspect in Ills of U.S. Embassy Workers|language=en|work=New York Times|url=https://www.nytimes.com/2018/09/01/science/sonic-attack-cuba-microwave.html|url-status=live|access-date=September 2, 2018|archive-url=https://web.archive.org/web/20200513141918/https://www.nytimes.com/2018/09/01/science/sonic-attack-cuba-microwave.html|archive-date=May 13, 2020}}</ref> A 2018 study published in the journal ''[[Neural Computation (journal)|Neural Computation]]'' by Beatrice Alexandra Golomb rejected the idea that a sonic attack was the source of the symptoms and concluded that the facts were consistent with [[pulsed radiofrequency]]<ref name="pmid33341130"/>/[[microwave radiation]] (RF/MW) exposure. Golomb wrote that (1) the nature of the noises the diplomats reported was consistent with sounds caused by pulsed RF/MW via the [[Frey effect]]; (2) the signs and symptoms the diplomats reported matched symptoms from RF/MW exposure (problems with sleep, cognition, vision, balance, speech; headaches; sensations of pressure or vibration; nosebleeds; brain injury and brain swelling); (3) "[[oxidative stress]] provides a documented mechanism of RF/MW injury compatible with reported signs and symptoms"; and (4) in the past, the U.S. embassy in Moscow was subject to a microwave beam called the [[Moscow Signal]].<ref name=Golomb2018>{{Cite journal |last=Golomb |first=Beatrice Alexandra |date=November 2018 |title=Diplomats' Mystery Illness and Pulsed Radiofrequency/Microwave Radiation |journal=Neural Computation |language=en |volume=30 |issue=11 |pages=2882–2985 |doi=10.1162/neco_a_01133 |pmid=30183509 |s2cid=52162053 |issn=0899-7667}}</ref> The Moscow Signal was inferred to be a Soviet espionage technique that might have also had health effects.<ref name=":0">{{Cite news|title=Long before Havana Syndrome, the U.S. reported microwaves beamed at an embassy|language=en|work=NPR.org|url=https://www.npr.org/2021/10/21/1047342593/long-before-havana-syndrome-u-s-reported-microwaves-beamed-at-an-embassy|access-date=October 27, 2021}}</ref> Neuroscientist Allan H. Frey, for whom the Frey effect is named, considers the microwave theory viable.<ref name="BroadSuspect"/>
In 2018, Douglas H. Smith, the lead author of a [[University of Pennsylvania]] study of 21 affected diplomats in Havana published in ''[[JAMA]] '', said in an interview that microwaves were "considered a main suspect" underlying the phenomenon.<ref name="BroadSuspect">{{cite news|last=Broad|first=William J.|date=September 1, 2018|title=Microwave Weapons Are Prime Suspect in Ills of U.S. Embassy Workers|language=en|work=New York Times|url=https://www.nytimes.com/2018/09/01/science/sonic-attack-cuba-microwave.html|url-status=live|access-date=September 2, 2018|archive-url=https://web.archive.org/web/20200513141918/https://www.nytimes.com/2018/09/01/science/sonic-attack-cuba-microwave.html|archive-date=May 13, 2020}}</ref> A 2018 study published in the journal ''[[Neural Computation (journal)|Neural Computation]]'' by Beatrice Alexandra Golomb rejected the idea that a sonic attack was the source of the symptoms and concluded that the facts were consistent with [[pulsed radiofrequency]]<ref name="pmid33341130"/>/[[microwave radiation]] (RF/MW) exposure. Golomb wrote that (1) the nature of the noises the diplomats reported was consistent with sounds caused by pulsed RF/MW via the [[Frey effect]]; (2) the signs and symptoms the diplomats reported matched symptoms from RF/MW exposure (problems with sleep, cognition, vision, balance, speech; headaches; sensations of pressure or vibration; nosebleeds; brain injury and brain swelling); (3) "[[oxidative stress]] provides a documented mechanism of RF/MW injury compatible with reported signs and symptoms"; and (4) in the past, the U.S. embassy in Moscow was subject to a microwave beam called the [[Moscow Signal]].<ref name=Golomb2018>{{Cite journal |last=Golomb |first=Beatrice Alexandra |date=November 2018 |title=Diplomats' Mystery Illness and Pulsed Radiofrequency/Microwave Radiation |journal=Neural Computation |language=en |volume=30 |issue=11 |pages=2882–2985 |doi=10.1162/neco_a_01133 |pmid=30183509 |s2cid=52162053 |issn=0899-7667}}</ref> The Moscow Signal was inferred to be a Soviet espionage technique that might have also had health effects.<ref name=":0">{{Cite news|title=Long before Havana Syndrome, the U.S. reported microwaves beamed at an embassy|language=en|work=NPR.org|url=https://www.npr.org/2021/10/21/1047342593/long-before-havana-syndrome-u-s-reported-microwaves-beamed-at-an-embassy|access-date=October 27, 2021}}</ref> Neuroscientist Allan H. Frey, for whom the Frey effect is named, considers the microwave theory viable.<ref name="BroadSuspect"/>


In December 2020, a study by an expert committee of the U.S. [[National Academies of Sciences, Engineering, and Medicine]], commissioned by the State Department, released its report, concluding, "Overall, directed pulsed RF energy ... appears to be the most plausible mechanism in explaining these cases among those that the committee considered" but that "each possible cause remains speculative" and that "the report should not be viewed as conclusive".<ref name="pmid33341130"/><ref name="NBCNews">{{cite news|url=https://www.nbcnews.com/news/all/havana-syndrome-likely-caused-microwave-energy-government-study-finds-n1250094|date=December 5, 2020|title='Havana Syndrome' likely caused by pulsed microwave energy, government study finds|first1=Brenda|last1=Breslauer|first2=Ken|last2=Dilanian|first3=Josh|last3=Lederman|newspaper=NBC News|access-date=February 27, 2021|archive-date=March 3, 2021|archive-url=https://web.archive.org/web/20210303165859/https://www.nbcnews.com/news/all/havana-syndrome-likely-caused-microwave-energy-government-study-finds-n1250094|url-status=live}}</ref><ref name="bbc"/><ref name=NatAcademies>''[https://www.nap.edu/catalog/25889/an-assessment-of-illness-in-us-government-employees-and-their-families-at-overseas-embassies Consensus Study Report: An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies] {{Webarchive|url=https://web.archive.org/web/20201209002236/https://www.nap.edu/catalog/25889/an-assessment-of-illness-in-us-government-employees-and-their-families-at-overseas-embassies |date=December 9, 2020}}'', Standing Committee to Advise the Department of State on Unexplained Health Effects on U.S. Government Employees and Their Families at Overseas Embassies, of the [[National Academies of Sciences, Engineering, and Medicine]] (2020).</ref> Chaired by [[David Relman]], the committee included [[Linda Birnbaum]], Ronald Brookmeyer, [[Caroline Buckee]], [[Joseph Fins]], [[David A. Whelan]], and others.<ref name=NatAcademies/> The panel stated that a lack of information and direct evidence (such as medical testing data about affected persons) limited what it could conclude about explanations of the phenomenon.<ref name=NatAcademies/><ref name="buzz071220">{{cite news |last1=Vergano |first1=Dan |title=Scientists Are Slamming A Report Saying Microwave Attacks Could Have Caused "Havana Syndrome" In US Diplomats |url=https://www.buzzfeednews.com/article/danvergano/microwave-attacks-havana-syndrome-diplomats |access-date=April 12, 2021 |work=BuzzFeed News |date=December 7, 2020 |language=en |archive-date=April 12, 2021 |archive-url=https://web.archive.org/web/20210412170516/https://www.buzzfeednews.com/article/danvergano/microwave-attacks-havana-syndrome-diplomats |url-status=live}}</ref><ref name=RelmanNPR>{{Cite news|last=McCammon|first=Sarah|date=October 15, 2021|title=New cases of 'Havana Syndrome' grow as cause remains a mystery|newspaper=NPR.org|url=https://www.npr.org/2021/10/15/1046519741/new-cases-of-havana-syndrome-grow-as-cause-remains-a-mystery|access-date=November 11, 2021|time=5:59}}</ref> In a 2021 interview with NPR's [[Sarah McCammon]], Relman said that the committee identified "microwave radiation that occurs in a pulsed or intermittent form" as "the most plausible" mechanism for the injuries, but that it could not confidently identify any cause given the lack of "direct evidence that this could explain the entire story for sure or even parts of it."<ref name=RelmanNPR/> Relman said the committee lacked information to assess "what the various sources of such pulsed microwave energy might be" but that the facts left the committee "with this very sort of disconcerting notion that it had been produced deliberately by other actors whose purposes we really weren't in a position to fathom."<ref name=RelmanNPR/> Relman said that "the bottom line is that this is still a perplexing story that still needs further investigation."<ref name=RelmanNPR/>
In December 2020, a study by an expert committee of the U.S. [[National Academies of Sciences, Engineering, and Medicine]], commissioned by the State Department, released its report, concluding, "Overall, directed pulsed RF energy ... appears to be the most plausible mechanism in explaining these cases among those that the committee considered" but that "each possible cause remains speculative" and that "the report should not be viewed as conclusive".<ref name="pmid33341130"/><ref name="NBCNews">{{cite news|url=https://www.nbcnews.com/news/all/havana-syndrome-likely-caused-microwave-energy-government-study-finds-n1250094|date=December 5, 2020|title='Havana Syndrome' likely caused by pulsed microwave energy, government study finds|first1=Brenda|last1=Breslauer|first2=Ken|last2=Dilanian|first3=Josh|last3=Lederman|newspaper=NBC News|access-date=February 27, 2021|archive-date=March 3, 2021|archive-url=https://web.archive.org/web/20210303165859/https://www.nbcnews.com/news/all/havana-syndrome-likely-caused-microwave-energy-government-study-finds-n1250094|url-status=live}}</ref><ref name="bbc"/><ref name=NatAcademies>
*{{cite book |editor1-last=Relman |editor1-first=David A. |editor2-last=Pavlin |editor2-first=Julie A. |authors=National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Division on Engineering and Physical Sciences; Standing Committee to Advise the Department of State on Unexplained Health Effects on U.S. Government Employees and Their Families at Overseas Embassies; |title=Consensus Study Report: An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies |url=https://www.nap.edu/catalog/25889/an-assessment-of-illness-in-us-government-employees-and-their-families-at-overseas-embassies |website=[[National Academies of Sciences, Engineering, and Medicine]] |publisher=[[The National Academies Press]] |access-date=7 May 2022 |archive-url=https://web.archive.org/web/20201209002236/https://www.nap.edu/catalog/25889/an-assessment-of-illness-in-us-government-employees-and-their-families-at-overseas-embassies |archive-date=9 December 2020}}
*{{cite web |title=New Report Assesses Illnesses Among U.S. Government Personnel and Their Families at Overseas Embassies |url=https://www.nationalacademies.org/news/2020/12/new-report-assesses-illnesses-among-us-government-personnel-and-their-families-at-overseas-embassies |website=News Release |publisher=[[National Academies of Sciences, Engineering, and Medicine]] |access-date=7 May 2022 |date=December 5, 2020}}
*{{cite journal |last1=Hubler |first1=Graham K. |last2=Hoffman |first2=Stuart W. |last3=Andreadis |first3=Tim D. |last4=DePalma |first4=Ralph G. |title=Pulsed Microwave Energy Transduction of Acoustic Phonon Related Brain Injury |journal=Frontiers in Neurology |date=4 August 2020 |volume=11 |pages=753 |doi=10.3389/fneur.2020.00753 |url=https://www.frontiersin.org/articles/10.3389/fneur.2020.00753/full |access-date=7 May 2022}}
*{{cite web |last1=Teschler |first1=Leland |title=Microwaves and the Havana Syndrome |url=https://www.eeworldonline.com/microwaves-and-the-havana-syndrome/ |website=[[EE World Online]] |access-date=7 May 2022 |date=14 June 2021}}
</ref> Chaired by [[David Relman]], the committee included [[Linda Birnbaum]], Ronald Brookmeyer, [[Caroline Buckee]], [[Joseph Fins]], [[David A. Whelan]], and others.<ref name=NatAcademies/> The panel stated that a lack of information and direct evidence (such as medical testing data about affected persons) limited what it could conclude about explanations of the phenomenon.<ref name=NatAcademies/><ref name="buzz071220">{{cite news |last1=Vergano |first1=Dan |title=Scientists Are Slamming A Report Saying Microwave Attacks Could Have Caused "Havana Syndrome" In US Diplomats |url=https://www.buzzfeednews.com/article/danvergano/microwave-attacks-havana-syndrome-diplomats |access-date=April 12, 2021 |work=BuzzFeed News |date=December 7, 2020 |language=en |archive-date=April 12, 2021 |archive-url=https://web.archive.org/web/20210412170516/https://www.buzzfeednews.com/article/danvergano/microwave-attacks-havana-syndrome-diplomats |url-status=live}}</ref><ref name=RelmanNPR>{{Cite news|last=McCammon|first=Sarah|date=October 15, 2021|title=New cases of 'Havana Syndrome' grow as cause remains a mystery|newspaper=NPR.org|url=https://www.npr.org/2021/10/15/1046519741/new-cases-of-havana-syndrome-grow-as-cause-remains-a-mystery|access-date=November 11, 2021|time=5:59}}</ref> In a 2021 interview with NPR's [[Sarah McCammon]], Relman said that the committee identified "microwave radiation that occurs in a pulsed or intermittent form" as "the most plausible" mechanism for the injuries, but that it could not confidently identify any cause given the lack of "direct evidence that this could explain the entire story for sure or even parts of it."<ref name=RelmanNPR/> Relman said the committee lacked information to assess "what the various sources of such pulsed microwave energy might be" but that the facts left the committee "with this very sort of disconcerting notion that it had been produced deliberately by other actors whose purposes we really weren't in a position to fathom."<ref name=RelmanNPR/> Relman said that "the bottom line is that this is still a perplexing story that still needs further investigation."<ref name=RelmanNPR/>


Multiple anecdotes from various Western diplomats stationed overseas, including in Russia, describe mysterious ailments during past decades that might be due to microwave devices.<ref name=Corera/><ref name=":0" /> In 2014, an unclassified NSA report indicated a hostile country in the 1990s possessed a "high powered microwave system weapon that may have the ability to weaken, intimidate or kill an enemy over time and without leaving evidence."<ref name=":0" />
Multiple anecdotes from various Western diplomats stationed overseas, including in Russia, describe mysterious ailments during past decades that might be due to microwave devices.<ref name=Corera/><ref name=":0" /> In 2014, an unclassified NSA report indicated a hostile country in the 1990s possessed a "high powered microwave system weapon that may have the ability to weaken, intimidate or kill an enemy over time and without leaving evidence."<ref name=":0" />

Revision as of 12:11, 7 May 2022

Havana syndrome
The Hotel Nacional in Havana is one of the locations where the syndrome has reportedly been experienced.[1]
SymptomsHearing a sudden loud noise, pain in one or both ears, feeling of pressure or vibrations in the head, tinnitus, visual problems, vertigo, nausea, cognitive difficulties,[2] sleep deprivation/insomnia,[3] fatigue and dizziness.[4]
CausesNot definitively determined[5][6][7][8][9]

Havana syndrome is an alleged set of medical symptoms with unknown causes experienced mostly abroad by U.S. government officials and military personnel. The symptoms range in severity from pain and ringing in the ears to cognitive difficulties[2][4] and were first reported in 2016 by U.S. and Canadian embassy staff in Havana, Cuba. Beginning in 2017, more people, including U.S. intelligence and military personnel and their families, reported having these symptoms in other places, such as China, New Delhi, India,[10] Europe, and Washington, D.C.[11] The cause and validity of the illness have yet to be determined.[12][9]

The U.S. Department of State has referred to the events as "unexplained health incidents",[13][14] while Central Intelligence Agency director William Burns has publicly called them attacks.[15] A 2019 retrospective neuroimaging study of 40 affected diplomats in Cuba published in the medical journal JAMA found evidence that the diplomats had significant brain neuroimaging differences compared to healthy control group members, but it was not able to determine the cause of the observed differences and states that "the clinical importance of these differences is uncertain and may require further study".[16] While there is no expert consensus on the syndrome's cause,[17] an expert committee of the National Academies of Sciences, Engineering, and Medicine concluded in December 2020 that microwave energy (specifically, directed pulsed RF energy[2]) "appears to be the most plausible mechanism in explaining these cases among those that the committee considered" but that "each possible cause remains speculative".[5][7][18] Other potential causes that have been proposed have included ultrasound,[19] pesticides,[20] or mass psychogenic illness.[21]

The U.S. intelligence services have not reached a consensus on or a formal determination of the cause of Havana syndrome, though U.S. intelligence and government officials have expressed suspicions to the press that Russian military intelligence is responsible.[22][23][24] In January 2022, the Central Intelligence Agency issued an interim assessment concluding that the syndrome is not the result of "a sustained global campaign by a hostile power". Foreign involvement was ruled out in 976 cases of the 1,000 reviewed.[25][26] In February 2022, a panel of experts assembled by the Biden administration released an executive summary stating that stress or psychosomatic reactions could not explain some of the incidents of Havana syndrome it had reviewed, and that radio waves could have caused some of the injuries of the C.I.A. officers and diplomats.[27]

Cuba

The U.S. Embassy in Havana, Cuba

In August 2017, reports began surfacing that American and Canadian[28] diplomatic personnel in Cuba had experienced unusual, unexplained health problems dating to late 2016.[29][30] As of June 2018, the number of American citizens experiencing symptoms was 26.[31]

Events

The original 21 events in Cuba were characterized as starting with strange grating noises coming from a specific direction. Some people experienced pressure, vibration, or a sensation comparable to driving a car with the window partly rolled down. These noises lasted from 20 seconds to 30 minutes and happened while the diplomats were either at home or in hotel rooms. Other people nearby (including family members and guests in neighboring rooms) did not suffer the same symptoms.[32]

Impact on American diplomats

Some U.S. embassy workers have experienced lasting health problems, including an unidentified diplomat who now needs a hearing aid.[33] The U.S. State Department declared that the health problems were either the result of an attack or due to exposure to an unknown device[34] and declared that it was not blaming the Cuban government and would not say who was to blame.[35] Affected people described symptoms such as hearing loss, memory loss, and nausea.[34] Speculation centered around a sonic weapon,[36] with some researchers pointing to infrasound as a possible cause.[37]

In August 2017, the United States expelled two Cuban diplomats in retaliation for perceived Cuban responsibility.[29] The next month, the U.S. State Department stated that it was removing non-essential staff from the U.S. embassy and warned U.S. citizens not to travel to Cuba.[38] In October 2017, President Donald Trump said he believed that Cuba was responsible for the occurrences,[39] calling them a "very unusual attack".[40]

In response to the incidents, the U.S. State Department announced in March 2018 that it would continue to staff its embassy in Havana at the minimum level required to perform "core diplomatic and consular functions"; the embassy had been operating under "ordered departure status" since September 2017, but the status was set to expire. This announcement served to extend the staff reductions indefinitely.[41]

U.S. government investigations

In January 2018, the Associated Press reported that a non-public FBI report found no evidence of an intentional sonic attack.[42] A November 2018 report in the New Yorker found that the FBI's investigation into the incidents was stymied by conflict with the CIA and the State Department; the CIA was reluctant to reveal, even to other U.S. government agencies, the identities of affected officers because of concern about possible leaks. Federal rules on the privacy of employee medical records also hindered the investigation.[43]

In January 2018, at the direction of Secretary of State Rex Tillerson, the State Department convened an accountability review board,[44] which is "an internal State Department mechanism to review security incidents involving diplomatic personnel."[45] Retired United States Ambassador to Libya Peter Bodde was chosen to lead the board.[45]

Impact on Canadian diplomats

In March 2018, MRI scans and other tests taken by a chief neurologist in Pittsburgh on an unspecified number of Canadian diplomats showed evidence of brain damage that mirrored the injuries some of their American counterparts had faced. In early 2018, Global Affairs Canada ended family postings to Cuba and withdrew all staff with families. Several of the Canadians who were affected in 2017 were reported to still be unable to resume their work due to the severity of their ailments. The lack of knowledge of the cause of Havana syndrome, as of February 2019, had made it challenging for the Royal Canadian Mounted Police to investigate.[46]

In 2019, the Canadian government announced that it was reducing its embassy staff in Havana after a 14th Canadian diplomat reported symptoms of Havana syndrome in late December 2018.[47] In February 2019, several Canadian diplomats sued the Canadian government, arguing that it failed to protect them or promptly address serious health concerns.[48][49] The government has sought to dismiss the suit, arguing in November 2019 that it was not negligent and did not breach its duties to its employees. In court filings, the government acknowledged that several of the 14 plaintiffs in the suit suffered concussion-like symptoms but said that no definitive cause or medical diagnosis had been ascertained.[50] In a November 2019 statement, Global Affairs Canada said, "We continue to investigate the potential causes of the unusual health symptoms."[50]

Cuban government reactions

After the incident was made public, the Cuban foreign minister accused the U.S. of lying about the incident and denied Cuban involvement in or knowledge of the cause of the health problems the diplomats experienced.[51][52]

The Cuban government offered to cooperate with the U.S. in an investigation of the incidents.[53] It employed about 2,000 scientists and law enforcement officers who interviewed 300 neighbors of diplomats, examined two hotels, and medically examined non-diplomats who could have been exposed. NBC reported that Cuban officials stated that they analyzed air and soil samples and considered a range of toxic chemicals. They also examined the possibility that electromagnetic waves were to blame, and even looked into whether insects could be the culprit, but found nothing they could link to the claimed medical symptoms. The FBI and Cuban authorities met to discuss the situation; the Cubans stated that the U.S. neither agreed to share the diplomats' medical records with Cuban authorities nor allowed Cuban investigators access to U.S. diplomats' homes to conduct tests.[54] In 2021, a panel of 16 scientists affiliated with the Cuban Academy of Sciences and convened by the Cuban government reported that "the narrative of the 'mysterious syndrome' is not scientifically acceptable in any of its components." The panel addressed the microwave hypothesis directly, writing, "No known form of energy can selectively cause brain damage (with laser-like spatial accuracy) under the conditions described for the alleged incidents in Havana."[55]

Studies regarding injuries

At the request of the U.S. government, University of Pennsylvania researchers examined 21 affected diplomats posted to Cuba, and the preliminary results were published in the Journal of the American Medical Association (JAMA) in March 2018. The report "found no evidence of white matter tract abnormalities" in affected diplomats beyond what might be seen in a control group of the same age and described "a new syndrome in the diplomats that resembles persistent concussion."[56][57] While some of those affected recovered swiftly, others had symptoms for months. The study concluded that "the diplomats appear to have sustained injury to widespread brain networks."[56][57]

Subsequent neuroimaging findings by the University of Pennsylvania team were published in JAMA in July 2019.[16] The retrospective neuroimaging study of 40 affected diplomats studied found that, compared to healthy control groups, the 40 diplomats in Havana who had reported injury had experienced brain trauma. Advanced MRI scans revealed[a] "differences in whole brain white matter volume, regional gray and white matter volume, cerebellar microstructural integrity, and functional connectivity in the auditory and visuospatial subnetworks" but found no differences in executive functions.[16] The study concluded that the U.S. government personnel had been physically injured in a way consistent with the symptoms they described but expressed no conclusion on the cause, source, or clinical importance of the injury.[16][58] The New York Times reported: "Outside experts were divided on the study's conclusions. Some saw important new evidence; others say it is merely a first step toward an explanation, and difficult to interpret given the small number of patients."[58]

In response to a December 2017 State Department request, the U.S. Centers for Disease Control and Prevention conducted a "Cuba Unexplained Events Investigation."[59][60] The two-year investigation of the medical records of 95 U.S. diplomats and family members in Havana who reported symptoms resulted in a final report, marked for official use only, dated December 2019.[61]

In January 2021, both BuzzFeed News and George Washington University's National Security Archive obtained the report, pursuant to Freedom of Information Act requests. (Some material in the released report was redacted for medical privacy reasons.)[59][61] The CDC developed a "case definition" of the Havana syndrome, consisting of a biphasic (two-stage) syndrome.[60][61] The first phase of symptoms (sometimes closely after an auditory or sensory event) consisted of one or more of the following symptoms: head pressure, disorientation, nausea or headache, vestibular disturbance, or auditory or visual syndromes.[60] The second phase of symptoms, occurring sometime later, consisted of cognitive deficits, vestibular disturbances, or both.[60][61] The report concluded, "Of the 95 persons whose medical records CDC evaluated, 15 had illnesses that met the criteria for a presumptive case definition. CDC classified 31 others as possible cases and the remaining 49 as not likely to be a case."[60] Two years later, six of the subjects in the CDC investigation were still being rehabilitated for their injuries, and four were still unable to return to work.[59] The CDC decided not to conduct a retrospective case–control study because of the length of time between the event and the onset of symptoms, which could lead to recall and selection biases that "could generate misleading or obscured findings."[59]

The CDC concluded, "The evaluations conducted thus far have not identified a mechanism of injury, process of exposure, effective treatment, or mitigating factor for the unexplained cluster of symptoms experienced by those stationed in Havana."[60]

Theories regarding cause

Since the first reported case, various scientific studies and reports have attempted to theorize a potential cause for the symptoms reported in association with Havana syndrome. Study methods have included neuroimaging[16] and blood markers taken from patients, which were collected and analyzed systematically for the first time in 2021.[8]

Pulsed electromagnetic energy and ultrasound

On February 1, 2022, a declassified US intelligence report (IC Experts Panel on Anomalous Health Incidents) called pulsed electromagnetic energy and ultrasound plausible causes and said that concealable devices exist that could produce the observed symptoms.[62]

Microwaves

In 2018, Douglas H. Smith, the lead author of a University of Pennsylvania study of 21 affected diplomats in Havana published in JAMA , said in an interview that microwaves were "considered a main suspect" underlying the phenomenon.[6] A 2018 study published in the journal Neural Computation by Beatrice Alexandra Golomb rejected the idea that a sonic attack was the source of the symptoms and concluded that the facts were consistent with pulsed radiofrequency[2]/microwave radiation (RF/MW) exposure. Golomb wrote that (1) the nature of the noises the diplomats reported was consistent with sounds caused by pulsed RF/MW via the Frey effect; (2) the signs and symptoms the diplomats reported matched symptoms from RF/MW exposure (problems with sleep, cognition, vision, balance, speech; headaches; sensations of pressure or vibration; nosebleeds; brain injury and brain swelling); (3) "oxidative stress provides a documented mechanism of RF/MW injury compatible with reported signs and symptoms"; and (4) in the past, the U.S. embassy in Moscow was subject to a microwave beam called the Moscow Signal.[63] The Moscow Signal was inferred to be a Soviet espionage technique that might have also had health effects.[64] Neuroscientist Allan H. Frey, for whom the Frey effect is named, considers the microwave theory viable.[6]

In December 2020, a study by an expert committee of the U.S. National Academies of Sciences, Engineering, and Medicine, commissioned by the State Department, released its report, concluding, "Overall, directed pulsed RF energy ... appears to be the most plausible mechanism in explaining these cases among those that the committee considered" but that "each possible cause remains speculative" and that "the report should not be viewed as conclusive".[2][18][5][7] Chaired by David Relman, the committee included Linda Birnbaum, Ronald Brookmeyer, Caroline Buckee, Joseph Fins, David A. Whelan, and others.[7] The panel stated that a lack of information and direct evidence (such as medical testing data about affected persons) limited what it could conclude about explanations of the phenomenon.[7][65][66] In a 2021 interview with NPR's Sarah McCammon, Relman said that the committee identified "microwave radiation that occurs in a pulsed or intermittent form" as "the most plausible" mechanism for the injuries, but that it could not confidently identify any cause given the lack of "direct evidence that this could explain the entire story for sure or even parts of it."[66] Relman said the committee lacked information to assess "what the various sources of such pulsed microwave energy might be" but that the facts left the committee "with this very sort of disconcerting notion that it had been produced deliberately by other actors whose purposes we really weren't in a position to fathom."[66] Relman said that "the bottom line is that this is still a perplexing story that still needs further investigation."[66]

Multiple anecdotes from various Western diplomats stationed overseas, including in Russia, describe mysterious ailments during past decades that might be due to microwave devices.[8][64] In 2014, an unclassified NSA report indicated a hostile country in the 1990s possessed a "high powered microwave system weapon that may have the ability to weaken, intimidate or kill an enemy over time and without leaving evidence."[64]

Some scientists, including physicist Peter Zimmerman, bioengineers Kenneth R. Foster and Andrei G. Pakhomov, and UCLA neurologist Robert Baloh, consider the microwave hypothesis implausible; Baloh called the National Academies conclusion "science fiction".[67][65][68] Cheryl Rofer, a former chemist at the Los Alamos National Laboratory, said that there were no microwave experts on the NAS committee and that "No evidence has been offered that such a weapon has been developed by any nation." Rofer also cited a 1978 study that found no adverse health effects from the Moscow Signal.[69]

In 2021, a panel of 16 scientists affiliated with the Cuban Academy of Sciences and convened by the Cuban government addressed the microwave hypothesis, writing that "No known form of energy can selectively cause brain damage (with laser-like spatial accuracy) under the conditions described for the alleged incidents in Havana."[55]

Ultrasound

In March 2018, Kevin Fu and a team of computer scientists at the University of Michigan reported in a study that ultrasound—specifically, intermodulation distortion from multiple inaudible ultrasonic signals—from malfunctioning or improperly placed Cuban surveillance equipment could have been the origin of the reported sounds.[70][71][72]

Cricket noises

In 2017, some U.S. personnel in Havana made audio recordings during incidents associated with Havana syndrome, one of which was obtained by the Associated Press.[73] In January 2019, biologists Alexander L. Stubbs of the University of California, Berkeley and Fernando Montealegre-Z of the University of Lincoln analyzed the recordings and concluded that the sound was caused by the calling song of the Indies short-tailed cricket (Anurogryllus celerinictus) rather than a technological device. Stubbs and Montealegre-Z matched the song's "pulse repetition rate, power spectrum, pulse rate stability, and oscillations per pulse" to the recording.[74][75] Stubbs and Montealegre wrote, "the causes of the health problems reported by embassy personnel are beyond the scope of this paper" and called for "more rigorous research into the source of these ailments, including the potential psychogenic effects, as well as possible physiological explanations unrelated to sonic attacks."[75] This conclusion was comparable to a 2017 hypothesis from Cuban scientists that the sound on the same recording is from Jamaican field crickets.[74][76][77][78]

In 2018, JASON, a group of physicists and scientists who advise the U.S. government, analyzed audio recordings from eight of the original 21 incidents of Havana syndrome and two cellphone videos taken by one patient from Cuba. It concluded that the sounds in the eight recordings were "most likely" caused by insects and that it was "highly unlikely" that microwaves or ultrasound beams were involved, because "No plausible single source of energy (neither radio/microwaves nor sonic) can produce both the recorded audio/video signals and the reported medical effects."[79] The group determined with "high confidence" that the two videos were sounds from the Indies short-tailed cricket, and also noted a "low confidence" hypothesis that the noises may have been from a concrete vibrating machine with worn bearings.[79] The report's findings were first reported by Reuters in July 2019.[80] Parts of JASON's report were declassified in September 2021.[79] While biomedical engineer Kenneth Foster (an opponent of the microwave theory) cited the findings as evidence against the theory, biomedical engineer James Lin (a proponent of the microwave theory) said that the recordings the JASON report analyzed could not represent actual cases of Havana syndrome, since typical sound recorders cannot record microwaves.[79] The JASON report also concluded, "It cannot be ruled out that while the perceived sounds, while not harmful, are introduced by an adversary as deception so as to mask an entirely unrelated mode of causing illness."[79]

Pesticides or infectious agents

A 2019 study commissioned by Global Affairs Canada of 23 exposed Canadian diplomats, completed in May 2019, found "clinical, imaging, and biochemical evidence consistent with the hypothesis" of overexposure to cholinesterase inhibitors (a class of neurotoxic pesticide) such as organophosphates (OPs) as a cause of brain injury; the embassies and other places in Cuba had been sprayed frequently as an anti-Zika virus mosquito control measure.[81][82][83] The study concluded that other possible causes could not be ruled out.[81]

The 2020 National Academies study found that it was unlikely that "acute high-level exposure to OPs and/or pyrethroids contributed" to the illnesses, due to a lack of evidence of exposures to those pesticides or clinical histories consistent with such exposure,[7]: 23  but the study committee "could not rule out the possibility, although slight, that exposure to insecticides, particularly OPs, increased susceptibility to the triggering factor(s) that caused the Embassy personnel cases."[7]: 23  The National Academies study committee also found it "highly unlikely" that an infectious disease (such as Zika virus, which was an epidemic in Cuba in 2016–17) caused the illnesses.[7]: 23–24 

Psychogenic origin

After the initial reports of the incidents in Havana, the FBI's Behavioral Analysis Unit visited the city and came to the assessment that the individuals were suffering from a mass psychogenic illness.[84] The Behavioral Analysis Unit profilers did not speak to any of the afflicted people directly, instead relying on transcripts of previous interviews that the FBI had conducted with patients.[84] The unit reviewed the patient histories compiled by the victims' neuropsychologists and other physicians, who had already ruled out mass psychogenic illness, noting that "many of the victims didn't know about the other people who were sick, and their bodies couldn't have feigned some of the symptoms they were exhibiting."[84] In November 2018, a previously classified State Department report by the JASON advisory group concluded that while the cause of the condition was unknown, "psychogenic effects may serve to explain important components of the reported injuries."[21]

Ragini Verma, the lead author of a University of Pennsylvania study published in JAMA in 2019 that found brain differences in diplomats, concluded that based on its findings, "a wholly psychogenic or psychosomatic cause was very unlikely." Verma added that she was unable to identify a cause based on brain imaging alone.[58]

A March 2018 editorial in JAMA by two neurologists argued that a functional disorder such as persistent postural-perceptual dizziness ("a syndrome characterized primarily by chronic symptoms of dizziness and perceived unsteadiness, often triggered by acute or chronic vestibular disease, neurological or medical illness or psychological distress") could explain some of the symptoms the diplomats in Cuba experienced.[85]

In a 2019 paper, Robert Bartholomew and Robert Baloh propose that the syndrome represents mass psychogenic illness rather than a "novel clinical entity".[12] They cite the vagueness and inconsistency of symptoms as well as the circumstances they developed in (affected staff would have been under significant stress as the U.S. had just reopened its embassy in Cuba) as a cause.[12][9] Bartholomew and Baloh co-authored a book, Havana Syndrome: Mass Psychogenic Illness and the Real Story Behind the Embassy Mystery and Hysteria (2020), arguing in support of their hypothesis.[86]

The 2020 National Academies analysis appeared to show that psychological issues were not the likely cause of the injuries,[87] but the different ways people were affected left open the possible influence of psychological and social factors.[88] The report reads, "the likelihood of mass psychogenic illness as an explanation for patients' symptoms had to be established from sufficient evidence" and "could not be inferred merely by the absence of other causal mechanisms or the lack of definitive structural injuries".[7]: 26  In its assessment of potential social and psychological causes, the committee notes the possibility of stress-based psychological responses, and that these were more likely to be triggered by potential threats attributed to human sources than other stressors. It concludes that these could not have caused the acute "audio-vestibular" symptoms some patients experienced, such as sudden unexplained sounds.[7]: 25  The scope of the provided data limited the committee's ability to investigate psychological and social factors.[7]: 26–27 

Reports outside Cuba

Beginning in late 2017, suspected attacks targeting U.S. intelligence personnel were reported in an expanding set of locations around the world,[11] including Moscow, Russia; Tbilisi, Georgia; Poland; Taiwan; and Australia.[89] Other reports came from Colombia, Kyrgyzstan, Uzbekistan, and Austria,[24] among other countries.[24][43][90][17][91][92][93]

The U.S. government has not released the number of affected persons, but media reporting indicated a total of 130 possible cases by the end of May 2021,[24] rising to more than 200 possible cases by mid-September 2021.[22] The cases variously affected CIA, U.S. military, and State Department personnel and their family members.[24] Some reports, after investigation, were determined to be possibly related to Havana syndrome, while others were determined to be unrelated; BBC News reported in 2021 that "One former official reckons around half the cases reported by US officials are possibly linked to attacks by an adversary."[8]

Guangzhou, China

Consulate General of the United States in Guangzhou

Starting in early 2018, U.S. diplomats in China began reporting symptoms consistent with Havana syndrome. The first such incident was reported by an American diplomat in China in April 2018 at the Guangzhou consulate, the largest U.S. consulate in China. The employee reported that he had been experiencing symptoms since late 2017. Several individuals were taken to the U.S. for medical examination.[94][95][96] A USAID employee at the U.S. embassy in Tashkent, Uzbekistan, reported a different incident in September 2017; the employee's report was discounted by the U.S. State Department.[97]

Answering questions from the House Foreign Affairs Committee in May 2018, Secretary of State Mike Pompeo testified that U.S. diplomatic staff in Guangzhou had reported symptoms "very similar" to, and "entirely consistent" with, those reported from Cuba.[98][99] On June 6, 2018, The New York Times reported that at least two additional U.S. diplomats stationed at the Guangzhou consulate had been evacuated from China and reported that "it remains unclear whether the illnesses are the result of attacks at all. Other theories have included toxins, listening devices that accidentally emitted harmful sounds, or even mass hysteria."[95] In June 2018, the State Department announced that a task force had been assembled to investigate the reports[100] and expanded their health warning to all of mainland China amid reports some US diplomats outside of Guangzhou had experienced the same symptoms resembling a brain injury.[101] The warning told anyone who experienced "unusual acute auditory or sensory phenomena accompanied by unusual sounds or piercing noises" to "not attempt to locate their source."[102]

Washington, D.C., area

In 2019, a White House official reported experiencing debilitating symptoms while walking her dog in a Virginia suburb of Washington; the incident was publicly reported in 2020.[17] In November 2020, a similar incident was reported on The Ellipse, a lawn adjacent to the south side of the White House.[17][103] Both incidents were similar to those that were reported to have struck dozens of U.S. personnel overseas, including CIA and State Department personnel.[17] Federal agencies investigated the incident at The Ellipse, and Defense Department officials briefed members of the Senate Armed Services Committee and House Armed Services Committee in April 2021.[17] Investigators told members of Congress that they had not been able to determine the cause of the events or who was responsible.[17]

Elsewhere in Asia

In August 2021, it was reported that two American diplomats were evacuated from the U.S. Embassy in Hanoi, Vietnam, after incidents of Havana syndrome were reported.[104] These reported cases also delayed Vice President Kamala Harris's visit to Vietnam.[105]

In September 2021, a CIA officer traveling with chief William J. Burns reported symptoms consistent with those of Havana syndrome on a diplomatic visit to India.[93]

Europe

U.S. embassy in Vienna, Austria

In 2021, dozens of U.S. personnel stationed in Vienna, including diplomats, intelligence officials, and some children of U.S. employees, suffered Havana syndrome-like symptoms.[15] The State Department confirmed in July 2021 that it was investigating the reports.[106] The Austrian foreign ministry stated it was collaborating with American investigators. Aside from Havana, Vienna has reported the most incidents. While no suspects were named for the Vienna cases, it has been noted that Vienna was hosting indirect talks between the United States and Iran on reviving the 2015 Iran deal.[107] In September 2021, the CIA station chief in Vienna (the top U.S. intelligence officer in the country) was recalled over concerns over his management; he had been criticized for not taking quicker action in response to the Havana syndrome cases at his post.[22][15]

In the months preceding August 2021, cases of Havana syndrome were reported at the U.S. embassy in Berlin, Germany, including from two U.S. officials who sought medical treatment.[108] Several new cases were reported at the embassy in October 2021.[109]

In 2021, the CIA evacuated an intelligence officer serving in Serbia suspected of being a victim of the neurological attack.[11]

Three White House staffers reported symptoms at the InterContinental London Park Lane in late May 2019.[24]

Elsewhere

One of the CIA officials who suffered symptoms in Australia and Taiwan was one of the agency's top five-ranking officials.[89] The Russian embassy in Australia dismissed reports of Russian operatives targeting CIA personnel in Australia.[110]

In October 2021 it was reported that U.S. embassy personnel and their families in Bogota, Colombia, had developed symptoms consistent with Havana syndrome.[111][4]

U.S. government investigation

The U.S. State Department said in February 2021 that its ongoing investigation was "a high priority" for the department.[112] Citing unnamed intelligence and government officials, The New York Times reported in July 2021 that the National Security Council, Central Intelligence Agency, and Director of National Intelligence established two outside panels, one to investigate potential causes and the other to develop defensive countermeasures for personnel protection; cleared external scientists will be permitted to view relevant classified intelligence in their investigations.[113] In January 2022, the CIA issued a report on the interim findings of a comprehensive study of 1,000 cases. The report concludes that the majority of cases can be attributed to environmental causes, undiagnosed medical conditions or stress rather than a persistent global campaign by a foreign power. The CIA is still investigating two dozen cases that remain unexplained.[25]

Russian responsibility hypothesis

Many current and former U.S. officials identified Russia as likely responsible for the alleged attacks,[112] a suspicion shared by both Trump and Biden administration officials.[24] This view was shared by CIA analysts on Russia, State Department officials, outside science experts, and several of the alleged victims.[114] Russia has a history of researching, developing, and using weapons that cause brain injuries, such as the Cold War-era "Moscow Signal" targeting the American embassy in Moscow.[114][115] A 2014 NSA report raised suspicions that Russia used a microwave weapon to target a person's living quarters, causing nervous system damage; and Russia has an interest in disrupting cooperation among the U.S., China, and Cuba.[114] The U.S. diplomats stationed in China and Cuba who reported ailments were working to increase cooperation with those countries, and some CIA analysts voiced suspicion Russia thus sought to derail their work.[114]

In May 2021, Politico reported that three current and former U.S. officials "with direct knowledge of the discussions" said that the U.S. government suspected that Russia's military intelligence agency, GRU, was behind alleged attacks, although the U.S. Intelligence Community have not "reached a consensus or made a formal determination."[23] In May 2021, The New Yorker reported that the U.S. government's "working hypothesis" was that GRU agents "have been aiming microwave-radiation devices at U.S. officials to collect intelligence from their computers and cell phones, and that these devices can cause serious harm to the people they target."[24] The U.S. government has not publicly accused Russia; U.S. intelligence officials privately call the events "attacks" but publicly call them "anomalous health incidents."[24] According to two officials interviewed by Politico, "While investigators have not determined definitively that these incidents are caused by a specific weapon, some believe any such device would be primarily transported by vehicle", and "Some could be small enough to fit into a large backpack, and an individual can be targeted from 500 to 1,000 yards away."[23] James Lin of the University of Illinois, an expert on the biological effects of microwave energy, agreed that a Havana syndrome attack could be caused by a small apparatus that could fit in a van or SUV.[115]

Within the U.S. government, analysts debated whether the alleged attacks reflected a deliberate attempt to cause injury or whether the reported symptoms were "a consequence of a high-tech attempt to steal classified information from phones and computers of U.S. officials."[22]

A 2020 article by Julia Ioffe in GQ magazine stated that the "most compelling evidence" of Russian involvement derives from mobile phone tracking: "Using this sort of data, CIA investigators were able to deduce the whereabouts of Russian agents, and place them in close physical proximity to the CIA officers at the time they had been attacked when they were in Poland, Georgia, Australia, and Taiwan. In each case, individuals believed to be FSB agents were within range of the CIA officers who had been hit in 2019. In two of the incidents, location data apparently showed FSB agents in the same hotel at the same time their targets experienced the onset of symptoms."[89]

A 2021 report in the New Yorker cited a number of incidents recounted by Mark Vandroff, who served as the senior director for defense policy at the National Security Council: "One of the most dramatic episodes involved a U.S. military officer stationed in a country with a large Russian presence. As the officer pulled his car into a busy intersection, he suddenly felt as though his head were going to explode. His two-year-old son, in a car seat in the back, started screaming. As the officer sped out of the intersection, the pressure in his head ceased, and his son went quiet. A remarkably similar incident was reported by a C.I.A. officer who was stationed in the same city, and who had no connection to the military officer."[24]

Trump administration and lapses in initial investigation

In October 2020, the New York Times reported that U.S. diplomats and intelligence officers, including senior leaders, had clashed with Trump administration appointees, including CIA director Gina Haspel and State Department leaders, over the nature and causes of the suspected attacks.[114] A Times investigation found that the State Department had "produced inconsistent assessments of patients and events, ignored outside medical diagnoses and withheld basic information from Congress."[114] Despite the general view within the U.S. government that Russia was responsible, two U.S. officials told the Times that Haspel was not convinced of Russia's responsibility, or even whether an attack occurred.[114]

A 2018 State Department report was declassified, and posted on the George Washington University's National Security Archive, after Freedom of Information Act litigation brought by the James Madison Project. The documents indicate that the State Department botched the handling of the initial reports. Peter Kornbluh of the National Security Archive noted that the 2018 report concluded that the department's "initial investigation assessment of what was going on" was marred by chaos, disorganization, and excessive secrecy.[114] In 2021, sources familiar with the various ongoing investigations told CNN that a primary obstacle to progress by the U.S. government in investigating the syndrome was a lack of interagency coordination between the CIA, FBI, Centers for Disease Control and Prevention, and State Department, which conducted separate and "largely siloed" investigations.[112] The limited coordination among the varying agencies was based in part on "the highly classified nature of some details and the privacy restrictions of health records, and that has hampered progress."[112]

A U.S. Office of Special Counsel investigation resulted in an April 2020 determination that there was "a substantial likelihood of wrongdoing" by State Department leadership.[114] Mark Lenzi, who was a State Department diplomatic security officer stationed in Guangzhou, accused the department of a "deliberate, high-level cover-up" and of failing to protect their employees.[114] Marc Polymeropoulos, a 26-year CIA veteran, who retired in 2019, similarly felt betrayed by CIA leadership, accusing the agency of failing to respond appropriately to a vertigo-inducing incident in Moscow in December 2017 (Polymeropoulos said the event was an attack and "the most terrifying experience of my life", worse than experiences in Iraq and Afghanistan).[112] Polymeropoulos fought with the CIA for years to obtain specialized medical treatment, after the agency cast doubt on the similarities between the symptoms he experienced and those suffered by the diplomats in Havana.[112] Polymeropoulos was ultimately diagnosed at the U.S. government's Walter Reed Medical Center with traumatic brain injury; attorney Mark Zaid, who represented almost a dozen clients who had also become ill under similar circumstances, said that Polymeropoulos was the only one of his clients who had received treatment at Walter Reed, with others obtaining treatment only from personal doctors or academic medical centers.[112]

Defense Department, State Department, and CIA task forces

Near the end of the Trump administration, the Defense Department established a task force to investigate reports of attacks on DoD personnel abroad.[17] The DoD established the task force partly due to frustration over what DoD officials considered to be a sluggish and lackluster response by the CIA and Department of State.[17] Christopher C. Miller, who was acting defense secretary at the time, said in 2021 that, "I knew CIA and Department of State were not taking this shit seriously and we wanted to shame them into it by establishing our task force."[17] Miller said that he began to consider the reports of mysterious symptoms to be a high priority in December 2020, after he conducted an interview with a person with major combat experience who detailed symptoms.[17]

In December 2020, the CIA established a task force to investigate.[17][112] The agency set up the task force after continued reports of debilitating attacks against CIA officers in various places around the world.[112] The CIA expanded its investigation under Director William Joseph Burns, who took office in 2021;[17] Burns appointed a senior CIA officer who had previously led the manhunt for Osama bin Laden to lead the agency's investigation.[22]

In March 2021, the State Department appointed Ambassador Pamela L. Spratlen, a career foreign service officer, to oversee the department task force charged with responding to the incidents.[17][116] Six months later, Spratlen left her position as coordinator of the task force because she "reached the threshold of hours of labor" that she could perform as a retiree. Spratlen's resignation had been demanded by people angered by her handling of a conference call with affected employees. During the call with employees (in which Secretary of State Antony Blinken also took part), Spratlen did not take a position on whether the psychogenic causes were the cause of the syndrome, a response that affected diplomats called "invalidating".[15][117] In November 2021, Blinken appointed two senior U.S. diplomats to oversee the department's internal Health Incident Response Task Force: career foreign service officer Jonathan Moore and Ambassador Margaret Uyehara.[118][119]

The Senate Intelligence Committee leadership (chairman Mark Warner and vice chairman Marco Rubio) said in 2021 that it was working with Burns and the CIA on connection with the investigation, saying, "We have already held fact finding hearings on these debilitating attacks, many of which result in medically confirmed cases of Traumatic Brain Injury, and will do more."[120] In May 2021, Politico reported that intelligence officials had recently told Congress that the investigation had expanded to include all 18 federal intelligence agencies and had focused "on the potential involvement of GRU, the Russian spy agency".[23]

In September 2021, CIA Deputy Director David S. Cohen said that the investigation had "gotten closer" to making a determination, "but not close enough to make the analytic judgment that people are waiting for."[22]

The BBC wrote the syndrome has "a real impact on the country's ability to operate overseas", reporting that one official called the deciphering of the cause "the most difficult intelligence challenge they have ever faced."[8]

After the reports of the incident at The Ellipse nearby the White House in Washington, Defense Department investigators briefed members of Congress, even though it occurred within the U.S.; this was because the DoD investigation was more advanced than the FBI or the intelligence community investigations.[17]

In January 2022, the Central Intelligence Agency issued an interim assessment concluding that the syndrome is not the result of "a sustained global campaign by a hostile power" and that the majority of cases could be explained by natural causes, although it couldn't rule out foreign involvement in approximately 24 cases, many of those from Havana.[26][121]

Legislative responses

In response to Havana syndrome, U.S. Senator Susan Collins introduced a bill (S. 1828), co-sponsored by a bipartisan group of nine other senators, that would close a loophole in the Federal Employees' Compensation Act that would normally not cover damage to organs such as the brain and heart. The Helping American Victims Afflicted by Neurological Attacks (HAVANA) Act authorized the CIA Director and the Secretary of State to provide financial support for personnel suffering brain injuries. The bill unanimously passed the House on a 427–0 vote, passed the Senate by unanimous consent, and was signed into law by President Joe Biden on October 8, 2021, becoming Public Law No. 117-46.[122][123][124] An appropriation for the funding authorized by the HAVANA Act has not been passed,[125] but has been included in drafts of a Defense Department appropriations bill.[126]

The National Defense Authorization Act for Fiscal Year 2022, passed by Congress in December 2021, included a section directing the president to designate a senior official as "anomalous health incidents interagency coordinator" to oversee efforts across the federal government and to coordinate with the White House Office of Science and Technology Policy; required relevant federal agencies to designate a specific high-level "anomalous health incident agency coordination lead"; and directed agencies to develop guidance to employees considered to be at risk of exposure.[127]

Criticism of media coverage

Media coverage of Havana syndrome has been criticized for what some allege is a conspiratorial tone or journalists' unwillingness to question official explanations. In Jacobin Magazine, Branko Marcetic wrote, "anti-Cuban hawks, using the establishment press as their megaphone, have baselessly and incessantly claimed that the illness was actually the result of 'attacks' carried out by Washington's geopolitical adversaries, and using a mysterious, never invented microwave weapon".[128] In January 2022, Ryan Cooper wrote in The Week that there is "shame on the great many journalists and members of Congress who stoked inflammatory, implausible claims about magic Russian ray guns".[129] Robert Bartholomew, a medical sociologist specializing in mass psychogenic illness, has dismissed 60 Minutes reports of a "smoking gun" connecting Havana syndrome to a foreign power or technology: "there is only smoke and mirrors generated by bad science and poor journalism".[130] In an interview with NPR, The New Republic's Natalie Shure said it was a "red flag" as to its credibility that "this story was being almost exclusively pushed by national security reporters and not by people who report on health topics".[131]

See also

Footnotes

  1. ^ Specifically, res-fMRI, multimodal MRI, and diffusion MRI.

References

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