Continued Disagreements Over What Happened to U.S. Diplomats in Cuba

Many previous posts have discussed the disagreements between the U.S. and Cuba over what, if anything, happened to U.S. diplomats stationed in Cuba starting in late 2016. [1] That disagreement continues.

U.S. Medical Report [2]

The latest report on these issues by the University of Pennsylvania’s Center for Brain Injury and Repair was published in the July 23/30 issue of the medical journal, JAMA. Its abstract of the study said the following:

  • “Importance. United States government personnel experienced potential exposures to uncharacterized directional phenomena while serving in Havana, Cuba, from late 2016 through May 2018. The underlying neuroanatomical findings have not been described.”
  • “Objective. To examine potential differences in brain tissue volume, microstructure, and functional connectivity in government personnel compared with individuals not exposed to directional phenomena.”
  • “Design, Setting, and Participants. Forty government personnel (patients) who were potentially exposed and experienced neurological symptoms underwent evaluation at a US academic medical center from August 21, 2017, to June 8, 2018, including advanced structural and functional magnetic resonance imaging analytics. Findings were compared with imaging findings of 48 demographically similar healthy controls.”
  • “Exposures. Potential exposure to uncharacterized directional phenomena of unknown etiology, manifesting as pressure, vibration, or sound.”
  • “Main Outcomes and Measures. Potential imaging-based differences between patients and controls with regard to (1) white matter and gray matter total and regional brain volumes, (2) cerebellar tissue microstructure metrics (mean diffusivity), and (3) functional connectivity in the visuospatial, auditory, and executive control subnetworks.”
  • “Results. Imaging studies were completed for 40 patients (mean age, 40.4 years; 23 [57.5%] men; imaging performed a median of 188 [range, 4-403] days after initial exposure) and 48 controls (mean age, 37.6 years; 33 [68.8%] men). Mean whole brain white matter volume was significantly smaller in patients compared with controls (patients: 542.22 cm3; controls: 569.61 cm3; difference, −27.39 [95% CI, −37.93 to −16.84] cm3P < .001), with no significant difference in the whole brain gray matter volume (patients: 698.55 cm3; controls: 691.83 cm3; difference, 6.72 [95% CI, −4.83 to 18.27] cm3P = .25). Among patients compared with controls, there were significantly greater ventral diencephalon and cerebellar gray matter volumes and significantly smaller frontal, occipital, and parietal lobe white matter volumes; significantly lower mean diffusivity in the inferior vermis of the cerebellum (patients: 7.71 × 10−4 mm2/s; controls: 8.98 × 10−4 mm2/s; difference, −1.27 × 10−4 [95% CI, −1.93 × 10−4 to −6.17 × 10−5] mm2/s; P < .001); and significantly lower mean functional connectivity in the auditory subnetwork (patients: 0.45; controls: 0.61; difference, −0.16 [95% CI, −0.26 to −0.05]; P = .003) and visuospatial subnetwork (patients: 0.30; controls: 0.40; difference, −0.10 [95% CI, −0.16 to −0.04]; P = .002) but not in the executive control subnetwork (patients: 0.24; controls: 0.25; difference: −0.016 [95% CI, −0.04 to 0.01]; P = .23).”
  • “Conclusions and Relevance. Among US government personnel in Havana, Cuba, with potential exposure to directional phenomena, compared with healthy controls, advanced brain magnetic resonance imaging revealed significant differences in whole brain white matter volume, regional gray and white matter volumes, cerebellar tissue microstructural integrity, and functional connectivity in the auditory and visuospatial subnetworks but not in the executive control subnetwork. The clinical importance of these differences is uncertain and may require further study.” (Emphases added.)

U.S. Commentary on the JAMA Report

JAMA Editorial [3]  In the same JAMA issue containing the University of Pennsylvania report, two medical doctors published an editorial that cautioned readers that the relevance of the neuroimaging findings was “uncertain” and that the exact nature of the affliction “remains unclear,” adding that more scientific evidence is needed.

Washington Post Editorial [4] “The authors of the study  acknowledge it had limitations: a small sample, a control group that was not ideal, and the methods could not offer any clues about what external event caused the trauma. A fair amount of mystery still shrouds the whole episode. The FBI was brought in to investigate, but its findings are not known. There has been speculation the U.S. diplomats, and some from Canada, were attacked by a weapon or device such as a microwave beam or sonic waves, but there is no confirmation.”

After conceding that the new study reported in JAMA “does not solve” the issues, the Post editorial asserts that study “does require that it be pursued. . . .The [U.S.] must continue to demand accountability for whoever did this, and the first step is to find out who, and why.”

According to the editorial, service in Cuba “clearly was not safe for the diplomats who suffered brain trauma. Cuba has a pervasive security service. Surely it knows what really happened. Instead of urging everyone to look the other way, Cuba’s government should get to the bottom of this and make public the findings. The [U.S.] must demand no less.”

New Yorker Article [5] Adam Entous, a staff writer for The New Yorker, interviewed Dr. Douglas Smith, the director of the University of Pennsylvania’s Center for Brain Injury and Repair, about its study. Smith said that the study revealed tangible neurological changes that “are not like anything we’ve ever seen before.” But it “is clear that something structural in the brain was affected, but we don’t know what that is and what caused the effects.”  Nevertheless, Dr. Smith added, the “mass-hysteria hypothesis is debunked by very obvious neurological findings that you can’t imitate, you can’t mimic.” The study validated “that there are signs of brain damage.”

Dr. Smith also told Entous that the 40 patients also included CIA officers and that the study included imaging data for 36 of the 40 patients; the other four “were unreachable by any mode of communication,” presumably because they were CIA officers who are now operating under new covers in other countries.

According to Entous, although there still is no “hard scientific evidence about what caused the injuries, U.S. intelligence agencies still think the victims were attacked, most likely by Russia, which had ‘the means, motive, and opportunity,’ a second senior U.S. official told me. The official cautioned, however, that it was highly unlikely, at this late stage in the investigation, that U.S. spy agencies would uncover direct evidence, such as intercepted communications of Russian operatives admitting their culpability. The [unnamed] official said, ‘You almost never have it direct from the horse’s mouth, saying, ‘It was us. Great job, comrade!’ ”

Slate Article [6] After publication of the previously mentioned report, Slate published the following list of the suggested potential causes for the problems of these U.S. diplomats “ranked in highly unscientific order from least likely to most likely:” (1) noise; (2) microwaves; (3) viral infection; (4) previous trauma; (5) crickets or cicadas (partially); and (6) “it’s all in their heads.”

Cuba’s Reactions [7]

 At a July 30, 2019, press conference in Havana, Dr. Mitchell Joseph Valdés-Sosa, General Director of Cuba’s  Neurosciences Center, on behalf of the Cuba’s Expert Committee, presented reactions to the University of Pennsylvania’s report.

Dr. Valdés-Sosa said that this report does not allow clear scientific conclusions to be drawn. The medical results are confusing and contradictory, of special concern given the numerous questions already raised by the international scientific community, which have not been satisfactorily answered.

The article does not prove that the diplomats suffered brain damage during their stay in Cuba, contrary to speculation and what was raised in tan August 2018 article in JAMA. More specifically the Cuban expert asserted the following:

“1-The authors themselves acknowledge that the study is inconclusive and that they have no explanation for their findings.

2-The changes described are small, very diverse, inconsistent, and do not indicate a coherent pattern. This is not only the opinion of the Cuban medical group, but of recognized experts in the field of neuroimaging, who have stated that these results are not consistent.

3-It is common that in neuroimaging studies, as in other medical fields, there are effects noted in small samples, which are not replicable. They originate by chance. Some of the changes reflect a slight change toward the abnormal, but others are slightly hyper normal.

4-The degree of to which the two groups’ data overlap is not shown in the article.

5-The differences between diplomats and controls, if any, may be related to how the control group was selected. Any pre-existing illness in a group of diplomats, which is absent in the controls (and vice versa) could give rise to a difference in the images.

6-The measures of functional connectivity networks used are very nonspecific and are altered by the psychological state of the subject, as recognized in the article itself and by the scientific community.

7-There is no discernible relationship between the alterations detected in the neuroimages and the symptoms reported by diplomats.

8-There is no coherence between the findings reported in this article and those from the previous one. For example, in the previous piece, from the same research group at the University of Pennsylvania, alterations of executive functions in neuropsychological tests were described. In this work no functional connectivity alterations are found in the executive subnet.

9-Alterations noted in neuroimages, if any, may have originated before the subject’s stay in Cuba or due to a disease unrelated to the ‘directional’ phenomena of strange sounds and other sensations described by diplomats.

10-Although the article’s title refers to so-called ‘directional phenomena,’ the work does not show any relationship between the findings in the images and these alleged phenomena. This is important, given the scientific community’s widespread skepticism regarding theories of sonic or microwave attacks.”

Therefore, the Cuban experts believe “the only way to clarify the health status of those affected is through transparent scientific discussion and the exchange of open, unbiased information.”

These experts observations were previewed by Cuba Foreign Minister Bruno Rodriguez. He tweeted, “There isn’t the least evidence or scientific explanation supporting deliberate actions against diplomats in [Havana]. The article published by JAMA corroborates that. The [US] government lies are targeted against [Cuba]. The manipulation of this issue should stop.”

Conclusion

It is totally amazing that after nearly three years after the first U.S. diplomats in Cuba reported various medical problems, there still is no definitive public verdict on whether and why some diplomats (and CIA personnel) have suffered medical problems.

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[1] This blog has published many posts about this situation. See the “U.S. Diplomats Medical Problems in Cuba, 2017-18” and “U.S. Diplomats Medical Problems in Cuba, 2019” sections of List of Posts to dwkcommentaries—Topical: CUBA. 

[2] Verma, Swanson, Parker, et al., Neuroimaging Findings in US Government Personnel With Possible Exposure to Directional Phenomena in Havana, Cuba, JAMA (July 23/30, 2019); Lederman, Doctors find differences in brains of U.S. diplomats who alleged mystery attacks in Cuba, NBC News (July  23, 2019); Health incidents in Cuba and China; an explainer, Center Democracy in Americas (Mar. 15, 2019)

[3] Muth (MD) & Lewis (MD), Editorial: Neurological Symptoms Among US Diplomats in Cuba, JAMA (Mar. 20, 2019).

 [4]  Editorial, The U.S. must demand accountability for what happened to diplomats in Cuba, Wash. Post (July 28, 2019).

[5] Entous, Brain Scans Shed New Light on Mysterious Attacks on U.S. Diplomats and Spies in Cuba, New Yorker (July 29, 2019).

[6] Paulus, A Comprehensive List of All the Potential Causes of the Cuban “Sonic” Attacks, Slate (July 26, 2019).

[7] No clear scientific evidence exists on alleged sonic attacks against U.S. diplomats in Cuba, Granma (Aug. 5, 2019); Rodriguez, Tweet (July 24, 2019); Cuba dismisses findings of ‘sonic attack’ study, BBC (July 24, 2019).

 

 

 

 

 

 

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Did State Department Ineptly Investigate the Medical Problems of Some U.S. Diplomats in Cuba?

According to  Dan Vergano of BuzzFeed,News, the U.S. State Department has mismanaged its investigation of the medical problems experienced by some U.S. diplomats stationed in Havana since December 2016.[1]

This report says, “much of the early research into the mystery may have been botched or biased. The initial investigation was confined to two competing sets of researchers, both eager to publish studies on their own work, and whose findings have been at odds with each other. In one case, researchers were also seeking to promote their own newly approved medical device as a diagnostic tool. And until now, the effort has lacked broader oversight by an institution capable of cross-disciplinary research.”

The initial two medical teams “diagnosed the diplomats with injuries centered on their own respective areas of research expertise: inner ear damage and concussions.” Another team from the Center for Disease Control was asked to investigate over a year ago and has not yet submitted a report. Now the U.S. National Academy of Sciences will be starting yet another investigation, but there is concern this may be too late.

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[1] Vergano, The US Government Botched Its Investigation Into The Mysterious “Sonic Attack” in Cuba, Emails Reveal, BussFeed.News (May 29, 2019).  This blog has published many posts on this situation. See posts listed in the “U.S. Diplomats’ Medical Problems in Cuba, 2016-?” section of List of Posts to dwkcommentaries—Topical: CUBA.

Still Uncertainty Over What Happened to U.S. Diplomats in Cuba

A lengthy New York Times article reviews the different theories that have been offered about what happened to some U.S. diplomats in Cuba starting in December 2016. The article then concludes by saying that to this date no one really knows the cause(s).[1]

The article, however, presses the question of whether the diplomats symptoms “are primarily psychogenic — or ‘functional’ — in nature. If true, it would mean that the symptoms were caused not by a secret high-tech weapon but by the same confluence of psychological and neurological processes — entirely subconscious yet remarkably powerful — underlying hypnosis and the placebo effect. They are disorders, in other words, not of the brain’s hardware but of its software; not of objective injuries to the brain’s structure but of chronic alterations to how the brain functions, typically following exposure to an illness, a physical injury or stress. . . . [Such disorders are] the most misunderstood, debilitating and denigrated ailments known to medicine.”

Nevertheless, the State Department and the diplomats themselves have rejected this theory.

According to the article, one of the leading experts on such disorders is Dr.Mark Hallett, “who is the Chief of the Medical Neurology Branch and the Human Motor Control Section of the National Institute of Neurological Disorders and Stroke (NINDS), which is part of the National Institutes of Health. He  obtained his A.B. and M.D. at Harvard University, had his internship in Medicine at the Peter Bent Brigham Hospital and his Neurology training at Massachusetts General Hospital plus fellowships in neurophysiology at the NIH and in the Department of Neurology, Institute of Psychiatry in London.”

Last year the National Institutes of Health asked Dr. Hallett to examine the diplomats, but the State Department did not appoint him to the task force for such examinations, and that  Department and NINDS have instructed De. Hallett not to speak with the author of the Times article.

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[1]  Hurley, Was It an Invisible Attack on U.S. diplomats, or Something Stranger?, N.Y. Times (May 15, 2019). This blog has many posts about the issues posed by the medical problems of some U.S. diplomats in Cuba (and more recently in China). See the “U.S. Diplomats’ Medical Problems in Cuba, 2016–??” section of List of Posts to dwkcommentaries—Topical: CUBA.

 

Cuba Abandons Rhetorical Restraint in Comments About U.S.

Reuters has concluded that Cuba “has jettisoned rhetorical restraint” in commenting on U.S. policies and threats. [1]

The latest example of this new Cuba approach is its government broadcasting footage of military defense exercises showing “Soviet-era tanks rolling out from mountain caves, soldiers manning anti-aircraft missile batteries, spandex-clad women shooting rifles and factory workers taking up [military defense] positions around their plants.” This is described as training for “The War of the Whole People.”

This Cuban reaction, although lamentable, is understandable ever since the obvious increasing influence of National Security Advisor John Bolton, long known for hostile opinions about Cuba, as evidenced by his speech last November in which he called Cuba, Venezuela and Nicaragua as the “Troika of Tyranny.” More recently the U.S. has been hinting at U.S. military intervention in Venezuela with a possible spill-over against Cuba.

Another sign of Cuba’s “new” approach came last month in a speech by President Diaz-Canel denouncing a Trump speech as “high-handed, cynical, immoral, threatening, offensive, interfering, hypocritical, warlike and dirty.”

The long-simmering dispute between the U.S. and Cuba over the medical problems of some U.S. diplomats, while stationed in Cuba, saw more aggressive Cuban rhetoric on March 14 when Cuba denounced the U.S. continuing to call them “attacks” without any evidence and as part of a broader campaign to damage bilateral relations. Cuba’s director of U.S. affairs at its Foreign Ministry said, “The topic has been highly manipulated politically by the U.S. government, with unfounded accusations, that have been a pretext to take measures against bilateral relations. . . . This manipulation is also serving those who want to reinforce the idea Cuba is a threat and those who opportunistically look to catalog Cuba as a country that sponsors terrorism. It’s a scandal that the State Department is still using the term ‘attacks’ in its statements to the press, with total irresponsibility, This is a national security issue for Cuba, especially when you know the political intentions declared by some [U.S.] individuals, to conduct our relations by a pattern of confrontation.” [2]

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[1] Reuters, In Cuba, Obama’s Detente Becomes History as Trump Threatens, N.Y. Times (Mar. 14, 2019). See also the posts listed in the “U.S. (Trump) and Cuba, 2016-17” and “U.S. (Trump) and Cuba, 2018” sections of List of Posts to dwkcommentaries—Topical: CUBA

[2] Reuters, Cuba Says USA, Not Canada, Manipulating Diplomat Health Incidents, N.Y. Times (Mar. 14, 2019); Assoc. Press, Cubans Again Dispute Claim Attacks Made Diplomats Ill, N.Y. Times (Mar. 14, 2019); Cuba reaffirms that there is no evidence of any sonic attack, Granma (Mar. 14, 2019). See also posts listed in the “U.S. Diplomats’ Medical Problems in Cuba, 2016—??” section of List of Posts to dwkcommentaries.com—Topical: CUBA

Injured U.S. and Canadian Diplomats in Cuba: New Developments

There have been several recent developments regarding the U.S. and Canadian diplomats who have suffered injuries while serving in Cuba.

First, the two counties’ diplomats have sued their respective governments.

The Canadian lawsuit in Toronto on February 6 alleges that the Canadian government was slow to respond to complaints about these injuries and has failed to provide sufficient medical care.The suit seeks (CAN)$ 28 million [(US)$ 21]  in damages on behalf of 14 diplomats, spouses and their children.

The U.S. lawsuit, which was commenced on February 7 by some of the affected U.S. diplomats, is a Freedom of Information Request to obtain documents related to the State Department’s Accountability Review Board’s investigation of the situation.

Second, the State Department has commissioned the National Academy of Sciences, Engineering, and Medicine to conduct a new study to understand “the possible causes of these cases and approaches for future incidents, whether of an apparent acoustic nature or a different environmental or clinical presentation.” This investigation will look at “health monitoring, medical interventions, risk assessment and exposure mitigation for overseas locations that may present a higher risk of adverse health effects.”

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Bilfsky, Canadian Diplomats Sue Their Government Over Mysterious Disease, N.Y. Times (Feb. 7, 2019); Assoc. Press, Canadian Diplomats File suit Over Injuries Suffered in Cuba, N.Y. Times (Feb. 7, 2019); Atkinson, State Dept. asks scientists to study mysterious illness scare in Cuba, Axios (Feb. 5, 2019); Center for Democracy in the Americas, State Department asks scientists to study mysterious illness scare in Cuba: U.S. personnel file suit, U.S.-Cuba News Brief (Feb. 8, 2019). 

Canada Reducing Cuba Embassy Staff 

On January 30, the Canadian foreign ministry (Global Affairs Canada) announced that another of its diplomats in Havana had fallen mysteriously ill. [1]

This is the 14th such case.  “To date, no cause has been identified.” As a result, Canada is removing up to half of its embassy staff.

The Canadian statement added, “Canada has a positive and constructive relationship with Cuba. We have had close cooperation with the Cuban authorities since the health concerns of our employees posted in Havana first surfaced in the spring of 2017.”

Cuba’s Ambassador to Canada, Josefina Vidal, said Cuba “understands the obligations of the government of Canada to protect its diplomatic personnel in any part of the world, and to try to find answers to the health symptoms reported in Cuba, [which] remains committed to preserving the good state of relations and expanding its ties with a country to which strong ties of friendship and cooperation unite us.”[2]

Nevertheless, the Cuban Ambassador found the Canadian decision to reduce its Havana Embassy staffing “incomprehensible.”  It does “not help solve or find answers to the health symptoms that diplomats have reported and will have an inevitable impact on the conduct of relations.” Instead, this decision “favors those in the United States who use this issue to attack and discredit Cuba. It is known that individuals with a high responsibility for foreign policy in the United States are committed to provoking a climate of bilateral tension and being able to point Cuba as a threat.”

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[1]  Global Affairs Canada, Statement on health and security of Canadian diplomatic staff in Havana, Cuba (Jan. 30, 2019); Assoc. Press, Canada Cutting Canadian Staff at Cuba Embassy in Half, N.Y. Times (Jan. 30, 2019). Other posts about Canadian diplomats’ illnesses in Cuba may be found in the ” U.S. Diplomats’ Medical Problems in Cuba, 2016-??” section of List of Posts to dwkcommentaries.com–Topical: CUBA.

[2] Josefina Vidal: Decision by the government of Canada to withdraw part of the diplomatic staff favors those in the United States who attack Cuba, CubaDebate (Jan. 31, 2019)

Crickets Caused Sounds Heard by U.S. Diplomats in Cuba

As previously reported, some of the U.S. diplomats who suffered injuries in Cuba complained that they had heard strange sounds when they were being injured.[1]

Now two scientists–Alexander Stubbs of the University of California, Berkeley and Fernando Montealegre-Z of the University of Lincoln in England—claim that male Indies Short-Tailed Crickets emitted these sounds during courtship.[2]

Such sounds, however, the scientists say, did not cause any of the injuries sustained by the diplomats.

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[1]  See posts in the “U.S. Diplomats Medical Problems in Cuba, 2016-??” section of List of Posts to dwkcommentaries—Topical: CUBA.

[2] Zimmer, The Sounds That Haunted U.S. Diplomats in Cuba? Lovelorn Crickets, Scientists Say, N.Y. Times (Jan. 4, 2019).