An Analysis Of Data And Hypotheses

AnalysisofData andHypotheses RelatedtotheEmbassyIncidents October2021 DISTRIBUTIONF.FurtherdisseminationonlyasdirectedbyU.S.DepartmentofState.Reason:Sensitiveinfor mationfortheshortterm.RequestsforthisdocumentshallbereferredtoU.S.DepartmentofState,1800Wilson Blvd,Arlington,VA,22209 ;October16,2001. Corporation 7515ColshireDrive ,Virginia22102-7508 JSR-21-01EmbassyIncidentsNovember7,2021 EXECUTIVESUMMARY 2INTRODUCTION Definitions Terminology 3ANALYSISOFINCIDENTANDSIGNALSDATA Assessment ofCaseData17 3.2SignalsData 4MEDICALDATAANDTHEIRINTERPRETATION NIHTraumatic BrainInjuryStudy Hypothesis -testingoncombineddatasets 4.1.2Exampleof vestibularmigrainewithauditory 4.1.3Thelook-elsewhereeffect 4.2DifferentiatingOrganic,Functional,andPsychogenicConditions FunctionalDisorders:Exampleofpersistentpostural-perceptualdizzi ness(PPPD) 4.2.2Psychogenicillness 4.3PotentialUnderlyingCauses. 4.4ClinicalContextoftheAffectedIndividuals 4.5UnderstandingandManagingtheRoleofSocialInteractions 5ACOUSTICATTACKHYPOTHESES 5.1Introductionand Background 5.2InfrasoundandReportedEffects 5.3UltrasoundandReportedEffects 5.4ConcludingRemarks JSR-21-01EmbassyIncidentsNovember7,2021 6ELECTROMAGNETICATTACKHYPOTHESES57 IntroductionandBackground 6.2IonizingRadiation Generation,focusing,absorption,andinterference Effectsonthe BoundsonRFWave Properties PenetrationDepth,SkinHeating,andtheCarrierFrequencyRange averageflux repetitionfrequency 6.4RFRadiationBeaming,Propagation,andAbsorption RFabsorptionandinterference 6.5RFEffectsonHumanHealth The<500MHzRange 6.5.3RequirementforRF-inducedTraumaticBrainInjury ThermoacousticphenomenaandtheFreyEffect Aretherenon-thermaleffectsofmicrowavesontissue? 6.6ExamplesofRFExposure TheMoscowEmbassyLilienfeldStudy TheNorwayShipRadar 6.7ConclusionsontheRF hypotheses 7ANINSTRUCTIVEANALOG 8COMBINEDASSESSMENTANDCONCLUDINGREMARKS AAPPENDIX:SampleIncidentIntakeQuestionnaire JSR-21-01EmbassyIncidentsNovember7,2021 BAPPENDIX:AcousticWaves,Fundamentals,andDetailedCalculations107 B.1SoundSpeedand Propagation B.2Acousticreflectionandtransmission B.3Soundattenuationandlocalization B.4SoundTransmissionthroughaSlab CAPPENDIX:MathematicalDetailsoftheFreyEffect DAPPENDIX:BlueJay2nd-genRFDetector EAPPENDIX:MicrowavePulser E.1CommerciallyAvailableComponents E.1.1Thelow- levelpulsedRF E.1.2Thepower GettingtoMegawatts E.2PortablePowerSources129 FAPPENDIX:Classified(S) GAPPENDIX: Classified(TS//SCI) HAPPENDIX: JSR-21-01DoSEmbassyIncidentsNovember7,2021 EXECUTIVESUMMARY Asofthetimeofourstudy,nearlytwohundredfederalemployeesandtheirfamilymembers assignedtopostsinembassiesandconsulatesaroundtheworldhavereportedadverse healthsymptomsperceivedtohavebeenprecipitatedbyincidentsexperiencedintheirwork placesorresidences.Thereportedincidentsrangefromunfamiliarsoundstoasensation ofheadpressure,whiletheassociatedsymptomscanincludevertigo,nausea,headache, andtinnitus.Insomecases,theseverityanddurationofthesymptomshavebeenintense, leadingtolastingcognitiveandvestibulardeficits.Identifyingthecausesoftheseincidents andprovidingmitigationandpreventionstrategiesconstitutesahighpriorityfortheUnited Statesgovernment.Aspartofthiseffort,JASONhasbeentaskedbytheDepartmentof Statetoconsiderallavailabledataandevaluatepotentialmechanismswithregardtotheir abilitytoproduceeffectsthatareconsistentwiththosereported. Makingprogressonidentifying thecausesofthehealthincidents(often referredto asAnomalousHealthIncidentsorrequirestwoparallelbutrelatedmethodologies. Thefirstonerequiresawell-definedmedicalcasestatementthatisbasedonidentifyinga uniqueclusterofsymptomsandestablishingthatsuchsymptomsexceedtheirprevalencein acomparablebackgroundpopulation.Thesecondapproachreliesonidentifyingacauseor causesthatcanbephysiologicallylinkedtothereportedsymptomsandphysicallylinkedto anecdotalevidenceintheincidentreports,underthe assumption thesesymptoms arerelatedtoasingleunderlyingcauseandarenotmanifestationsofacollectionofmedical conditionsandfunctionaldisorders.Werefertothesefirstapproachesand discusstheminmoredetailbelow. TheCentersforDiseaseControlandPrevention(CDC)currentlyadoptsawork ingcasedefinitionthatrequirestheonsetofsymptomsintwophases:afirstphasethat includesatleastoneofheadpressure,disorientation,nausea,headache,vestibulardistur bances,auditorysymptoms,orvisionchanges,followedbyasecondphasethatincludes eithervestibulardisturbancesorcognitivedeficits,withnoreadilyrecognizablealternate Weuseanecdotalinthefollowingsense,inaccordancewiththeOxfordEnglishDictionary:consisting of,orbasedon,reportsofindividualcasesratherthansystematicresearchoranalysis. JSR-21-01EmbassyIncidentsNovember7,2021 explanation.Thiscasedefinitionisbasedontheincidentsself-reportedbytheaffected personnelandonsubsequentmedicalevaluationsoftheassociatedsymptoms. TheDepartmentofStateprovidedtoJASONincidentdatafilesthatincluded,to varyingdegreesofdetail,thelocationandnarrativeofareportedincident,theimmediate sensationsdescribedbytheindividual,medicalsymptomsthatdevelopedovertime,anda descriptionofenvironmentalfactorsthatmayhavebeenpertinenttotheincidentorthe associatedsymptoms.Theaccountsarehighlyvariedinmanyregards:thenumberand specificityofthequeriesandresponsesnaturallyevolvedsubstantiallywithtime;thetiming ofthereportsrangedfromminutestoyearsaftertheincident,introducingdifferentdegrees ofrecallbias;thenumberofreportedsymptomsaccompanyinganincidentvariedfromnone tothefullsetincludedinCDC'scriteria. Thenarrativenatureofthereportsprecludedaquantitativeanalysis.Uponperforming aqualitativesystematicreview,JASONfindsthatthereportedincidentsthemselvesdidnot shareanyuniquelyidentifiablecommonsetofcharacteristics.Further,JASONfindsnatural andcredibleexplanationsfortheseincidentsinallbut20-30outoftheapproximately200 casesbecauseeithertheincidentsandsymptomsfallwithintherealmofeverydaycommon occurrencesorthesymptomscanbeexplainedinwaysthatarenotrelatedtotheperceived Withregardtothemedicaldata,investigatorsattheNationalInstitutesofHealth (NIH)presentedtoJASONpreliminarypopulation-aggregateddataofclinicaltestresults for65individualsenrolledinanongoing5-yearstudyontraumaticbraininjury(TBI) ofoverseasU.S.personnelShahimetal.(2021).ThestudybeganinMay2018andwas designedtoevaluatewhethersignsofbraininjurywerepresentinanyofthepersonnelin thedaystoyearsfollowingtheincidents.Thedataincludedoutcomesfromamultitudeof diagnostictests,suchasMRIimaging,audiologyexam,serumbiomarkers,andassessment ofvestibularfunction(innerearandbalance)testsincludingeyemovement,gait,and VestibularEvokedMyogenicPotential(VEMP).JASONfindsnocompellingevidenceof TBIinthedataobtainedtodate.WenotethattheNIHstudyhasnotbeencompletedand thatwithadditionaldata,theNIHmaycometoconclusionsdifferentfromJASONs. JSR-21-01EmbassyIncidentsNovember7,2021 Havingcarefullyevaluatedallavailableincidentandmedicaldata,wefindthatsta tisticalconclusionsfromthefirst,data-drivenapproachcannotbedrawnwithevenalow ofconfidencebecause Appropriatecontrolgroupsforthepersonnelinquestionneedtobelifestylematched andwould,therefore,ideallybelimitedtoembassypersonnelonactiveduty.Because thisrequirementposessignificantlogisticalchallenges,thecontrolgroupsenrolledin currentstudiesaresmall,heterogeneous,ornotappropriatelymatched. Thenumberofcasesshowingasubstantialrangeofsignsandsymptomsissmall, leadingtosignificantstatisticalfluctuationsinthesampleanduncertaintiesinthe Administeringmanysuccessiveindependentteststotheaffectedindividuals,without aclearhypothesis,increasestheriskofencounteringaspuriouscorrelation. Self-reporting,variedinitialevaluationcriteria,andadditionalcriteriaforadmission intotheNIHclinicalstudyeachcontributetoselectioneffectsthataredifficultto quantifyanddisentangle. Thenetresultofthesecomplicationsisaninabilitytoprovidearigorouscasedefinition and,therefore,acorrespondinglackofguidancetowardanunderlyingcausebasedonthis data-drivenapproachatthistime. Turningtothesecondparallelmethodology,JASONevaluatedmultiplemechanisms aspotentialcausesthatcouldestablishaphysicalandphysiologicalconnectionbetween thereportedsymptomsandtheinformationintheincidentreports.Inparticular,the anecdotesprovided theincidentdatawould requiremechofdamagethatcanbe directedcovertlyandovershortperiodsoftimeatindividualswhoareindoors(asreported inmorethan90%ofthenearly200cases)andlocalizedtoaspaceoflessthanafewmeters (asreportedinapproximately75%ofthecases).Theproposedmechanismswouldalso havetoinducerecognizableandlastinghealtheffectsonhumansthroughsomeidentifiable physiologicalpathway.Inourevaluationofpotentialmechanisms,weassessedthephysics JSR-21-01EmbassyIncidentsNovember7,2021 ofdeliveringdirectedenergytoanindividualconsistentwiththeincidentreportsandwe evaluatedthepotentialofsuchmechanismstocausesensationsandsymptomsconsistent withthemedicalevaluations.Werefertotheseasourincidentconsistencycriteria.In devisingthesecriteria,weconsideredmoreheavilythesmallersubset(approximately15%) ofcasesthatdidnothaveimmediatecommonorenvironmentalexplanations,ratherthan includetheremainderthatappearedtobemoreconsistentwitheverydayoccurrencesof eventsandsymptoms.Theincidentconsistencycriteria,discussedfurtherinSection2, containthefollowing:energymustbeabletopenetrateintobuildingsthroughwallsand windowsfromadistanceofseveraltensofmeters,belocalizedtoareasthesizeofaroom orsmaller,begeneratedwithequipmentthatisandcovert,leadtoaudibleand/or recordablesounds,causeimmediatesymptomsofpressure,vertigo,headache,ornausea, andcauselong-termvestibularand/orcognitivedysfunction. Withregardtodirectphysicalattacks,thescopeofthisJASONstudywasfocusedon mechanismsthatcandeliverenergyfromadistance,owingtothethoroughworkpresented inpreviousinvestigationsonmechanismsinvolvingbiologicalagentsandtoxins(suchasthe 2018JASONstudyandthe2020studybytheNationalAcademyofSciences).Weinves tigatedelectromagneticenergydeliveryintheformofradio-frequency(RF)andionizing radiation,and acousticenergyde ryintheformofinfrasound,audible,andultrasound waves.Presentdataallowustoruleoutsomeofthesemechanismswithahighdegreeof confidence.Weproposemethodsforcollectingdatatoassesstheremainingpossibilities Wealsoevaluatedthepotentialroleoffunctionaldisorders,i.e.,conditionsinvolving alteredbiologicalfunctionwithoutknownstructuralchange,inproducingthereported clusterofsymptoms(incontrasttophysicalattacksthatcandirectlycausephysiological damage).Weconsideredfunctionaldisorderswithdifferenttypesofprecipitatingevents, includingpurposefulattacks,inadvertentphysicalinsults,eventsthatcanbeconsidered ordinarybuthaveanamplifiedeffectduetoprevailingcircumstances(akintopost-traumatic stressdisorder),medicalconditionsunrelatedtoanyexternalinsult,orunidentifiedevents thatprecipitateafunctionalcondition.Wefoundthatthesedisorderspotentiallyexplainat leastasubsetofthelong-termsymptomsreportedbytheaffectedpersonnel,eventhough JSR-21-01EmbassyIncidentsNovember7,2021 itisnotpossibletoidentifyacommoninitialstimulusconsistentwithalltheeventsand Ouranalysisprovidesawaytofocusfuturedatacollectiononahypothesis-based definitionofAnomalousHealthIncidentsthatcombinesbothmethodologiesemployedhere. HavingreviewedallincidentdatatoselectthecasesthatarepotentiallyconsistentwithAHI andhavingexploredarangeofphysicallyplausiblemechanismsofattackorharassment,we identifythemostrelevantcriteriaonwhichafutureincidentquestionnairecanbebased. Furthermore,assigningnumericalweightstotheresponsesinthequestionnairecanfacilitate arapidanduniforminitialassessmentofreportedincidentsacrossallembassies,allow foraninitialtriage,andhelpguideappropriatemedicalandmonitoringresponse.We recommendthatonlyincidentsthatmeetathresholdbelabeledasAHIandselectedintoa differentdatabasetoincreasethestatisticalrobustnessinsubsequenthypothesisevaluations. Naturally,medicalcareandsupportoftheaffectedindividualsshouldbeahighpriority independentoftheAHI-consistencydecisions.Inotherwords,weemphasizethatjudginga casetobeinconsistentwithanAHIcarriesnoimplicationsaboutitsimportanceorseverity fromamedical standpoint. Regardingadversarialintent,itisnotpossibletoconcludeatthistimethattheevents reviewedbyJASONaretheresultofintentionalattacksthatcausephysicalharm.However, itisnotpossible,either,toruleoutmechanismsthatdonotcauseanyphysicalharmbut whichmightconstituteharassmentandleadtohealthconditionsandfunctionaldisorders, forexamplethroughunpleasantsoundsorpressuresensations.Giventhis,andinthe interestofprotectingembassypersonnelandtheirfamilies,itwouldbeprudenttobe vigilantagainsttacticsintendedtoproduceanxietyandtrauma,withanintenttoeither disruptoperationsand/orcauselong-termharm.TheUSgovernmentcouldminimizethe effectsofsuchtactics,ifpresent,throughopencommunication,education,andappropriate rapidmedicalresponsetoanyconditionsthatdevelop. JSR-21-01DoSEmbassyIncidentsNovember7,2021 Weprovideourfullfindingsandrecommendationsbelow. .85-90%ofthereportedincidentsareconsistentwithcommonandknownsymp tomsofpathophysiologicalorenvironmentalorigins;theremainderappearmorecomplex anddefyastraightforward explanation F2.Theuseofuniformstructuredincidentintakequestionnaireswithquantifiable responsescanhelphomogenizecollecteddata,beusedforpreliminaryassessment(e.g., throughassigningnumericalvaluestoresponses)andappropriaterapidresponse,andmay illuminatepatternsandpotentialcauses. collectedthroughtheNIHstudyarenot,on cienttoexplainthereportedabnormalsignsandsymptoms.Furthermore,theaggregated medicaldataarenotsufficienttoinfertheexistenceofanovelclinicalsyndrome F4.UndertheCDC'sworkingdefinitionofacase,thereportedcollectionofsymp tomscouldderivefroma structuralcause,functionaldisorder, psychogenic somecombinationofthethree.Thegovernment'sresponsetothereportedincidentsmay becausingadditionalstresstotheaffectedindividualsandmayexacerbatenormalpsycho logicalresponsesthatarealmostcertainlypresent. F5.Onevaluationofspecificenergydeliveryhypothesesonthebasisofthecombina tionofmedicalandsituationaldata,andphysicalconsiderations,wefindthat: Nosinglehypothesizedmechanismcanexplainalloftheincidents. Usedhereinaccordancewiththemedicaldefinitionofasyndrome:agroupofsignsandsymptomsthat occurtogetherandcharacterizeaparticularabnormalityorcondition,forwhichadirectcausemaynotbe understood. JSR-21-01EmbassyIncidentsNovember7,2021 Ionizingradiation,electromagneticenergybelow500MHzandabove30GHz,and sonic(infrasound/audible/ultrasound)energydeliveredfromadistance confidence,beeliminatedas Short-pulseradiofrequency(RF)radiationprimarilyintherangeof500MHzto30 GHzcannotberuledoutconclusivelyasamodalityforasubsetoftheincidentsat thistime.However,itisunlikelygiventhatthereisnowell-documentedorbroadly acceptedmechanismtoinducelastingneurologicalorotherdamagewithfocusable RFenergythatwouldnotproduceasensationofheatingontheskin. SoundsassociatedwithcranialacousticsensationsduetopulsedRFwaves(theFrey effect)cannotproducebraindamagebymechanicalmeansattolerablesoundlevels. Further,suchsensationscannotberecordedbyelectronicmicrophonesand,therefore, associatedwithanyrecordedacousticphenomena. .Theabsenceofobserveddisruptionofelectronics(e.g.,cellphones,televisions, computers)reducestheallowedparameterspaceofanypotentialpulsedRFsignalsbut doesnotrulethemout,giventhatcontemporaryconsumerelectronicsmaynotbeaffected byshortpulsesatpeakfluxlevelsbelowapproximately25W/ F7.Persistentmonitoringwithappropriatesensorsatselectlocationsisneededfor furtherevaluationofRFhypothesesandcouldhelpexcludethisremainingpotentialmech F8.ItisJASONsjudgementthat,onthebasisofavailablereportsofevents,related data,andhealthevaluations,itisnotpossibletoconcludeatthistimethattheseevents aretheresultofintentionalattacksthatcausephysicalharm. JSR-21-01EmbassyIncidentsNovember7,2021 Recommendations .DOSshouldmodifyitsquestionnaireforincidentreportingtoenableauniform, structured,andquantitativedataset,focusingonsurveyingspecificphysicalsensationsthat wouldaccompanyremoteenergyattacks.Suchaquestionnairecanbeusedtominimize thevarianceandnoiseindatacollection,toprovideaninitialtriage,andtoinitiaterapid deploymentoffollow-upenvironmentalmonitoring.JASONprovidesanexampleofsucha questionnaireinthe R2.DOSshouldcategorizeonlytheincidentsthatmeetathresholdasAHIandselect theseintoadifferentdatabase.Thethresholdshouldbebasedontheintakequestionnaire toprovideclarityasquicklyaspossibletotheaffectedpersonnel.DOSshouldguideindivid ualstoappropriatemedicalcareandsupportindependentoftheAHI-consistencydecisions. R3.DOSshoulddevelopcriteria(e.g.,linearclassifiers)toranktherelevanceofinci dentreportsinthecontextofhypothesistesting.Thefocusshouldbeonhypothesesthat havenotbeenruledoutby existinganalyses. R4.Inconjunctionwithotheragencies,DOSshouldconsiderusingtheuniformtriage processtoselectaffectedindividualsforinclusioninfuturemedicalstudies,carryingouta specificseriesoftestsalldoneinthesameorderandwithinaspecifiedtimeframe,striving tomakeappropriatelyselectedcontrolgroupslarger,andprovidingincentivesforindivid participateinthe controlgroups. R5.Informedbyrelatedeffortsbyotheragencies,DOSshouldanalyzeexistingand futurepatient-levelhealthdatainconjunctionwithreportedsensorysymptomstoidentify possibleclusters,whichmayhelpdefineapotentiallynovelsyndrome. R6.DOSandcollaboratingagenciesshouldadapttheirbaselinemedicalevaluation JSR-21-01EmbassyIncidentsNovember7,2021 programsothatit comprehensive andresponsivetoavarietyofhypothesized mechanisms,tobeadministeredpriortodeploymentoverseas.Theseevaluationsshould beusedonanindividualbasistoprovidecontextforanyfuturehealtheventsandinan aggregatedmannertoprovideanappropriatecontrolgroupforthereportedsymptoms.It maybeusefultoconsiderofferingincentivesforindividualstoparticipateinthisprogram. R7.DOSshoulddeploybroadbandRFsensorstolocationsofinterest.Thesensors shouldbecapableofdetectingRFwavesinthe0.530GHzrange,fromcontinuouswaves tonanosecondpulses,sensitivetoaveragefluxlevelsdownto20mW/andpeakflux levelsdownto1W/,andwithsufficientsamplingratestodetectabroadrangeof pulserepetitionratesfrom1to10,000pulsespersecond.Atwo-tiermonitoringprogram couldbeemployed,wheresomesensorssensitivetoasubsetofthefrequenciesaredeployed morebroadlyandsensorssensitivetothewholefrequencyrangearedeployedatselect locations.Sensorsforcontinuousdatarecordingshouldbedeployedinvarious,randomly selectedlocations.Inaddition,sensorsshouldbedeployedspeedilyatanylocationwhere adocumentedincidenthasoccurred. R8.DOSshouldcarryoutexperimentsusingRFonrelevantandcommonlyused electronicstoestablishthefrequency,power,andpulsedurationrangesthatmightdisrupt theiroperationandtrackspecificmodelsofelectronicdevicesthatmightbedisruptedby futureevents.Thedatafromsuchexperiments,togetherwiththeabsenceofdisruptions duringreportedeventscanbeusedtosetparameterlimitsondirectedRFpowerthatmight .GiventhatfearandstresscancauseorexacerbaterealharmtoDOSemployees, DOSshouldconsultwithrelevantexpertsconcerningmessaging,training,guidance,and othermeasurestoreduceanxietyassociatedwiththereportedincidents. Thesecould includebuildingawarenessoftheverylimitedmechanismscapableofproducingphysical harmviaenergydeliveryatadistance.DOSshouldrecognizepsychologicalphenomenaas realafflictionsthatcausepainandtreatthosecasesthesamewayasothertypesofinjuries. JSR-21-01EmbassyIncidentsNovember7,2021 ThisPageIntentionallyLeftBlank JSR-21-01EmbassyIncidentsNovember7,2021 INTRODUCTION ThepossibilitythatUSpersonnelhavebeensubjectedtointentionalattacksleading