In December 2020, the National Academy of Sciences, Engineering and Medicine (NAS) issued a consensus report, “An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies” to advise the U.S. State Department (DOS) about unexplained health effects experienced by government employees and their families at overseas embassies.

According to the report (1): 

“In late 2016, U.S. Embassy personnel in Havana, Cuba, began to report the development of an unusual set of symptoms and clinical signs. For some of these patients, their case began with the sudden onset of a loud noise, perceived to have directional features, and accompanied by pain in one or both ears or across a broad region of the head, and in some cases, a sensation of head pressure or vibration, dizziness, followed in some cases by tinnitus, visual problems, vertigo, and cognitive difficulties. Other personnel attached to the U.S. Consulate in Guangzhou, China, reported similar symptoms and signs to varying degrees, beginning in the following year. As of June 2020, many of these personnel continue to suffer from these and/or other health problems. Multiple hypotheses and mechanisms have been proposed to explain these clinical cases, but evidence has been lacking, no hypothesis has been proven, and the circumstances remain unclear.

The Department of State asked the National Academies to review the cases, their clinical features and management, epidemiologic investigations, and scientific evidence in support of possible causes, and advise on approaches for the investigation of potential future cases. In An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies, the committee identifies distinctive clinical features, considers possible causes, evaluates plausible mechanisms and rehabilitation efforts, and offers recommendations for future planning and responses.”

The report found that many of the patients’ acute symptoms were likely caused by microwave hearing and chronic symptoms were also due to radio frequency (RF) radiation exposure:
“The committee finds that many of the acute, sudden-onset, early phase signs, symptoms and observations reported by DOS employees are consistent with RF effects. In addition, many of the chronic, nonspecific symptoms are also consistent with known RF effects, such as dizziness, headache, fatigue, nausea, anxiety, cognitive deficits, and memory loss. It is not necessary for RF energy sources to produce gross structural damage to cause symptoms. Rather, as with the Frey effect or potential thermoelastic pressure waves, RF sources may trigger symptoms by transiently inducing alterations in brain functioning. 
There are several types of data that would be helpful and could improve both the findings and their level of certainty. While there are several studies on the health effects of continuous wave and pulsed RF sources, there are insufficient data in the open literature on potential RF exposure/dosage characteristics and biological effects possible for DOS scenarios. Specific experiments would be needed with RF exposure and dosage characteristics (frequency, pulse repetition frequency, pulse width, incident angle between potential source and subject, duration of exposure, number of repeated exposures, etc.) to quantify the biological effects, but would be ethically difficult to justify. In the absence of such data, it is difficult to align specific biophysical effects within the potential RF exposure regime that could explain specific medical symptoms reported by DOS personnel and the variability in specific experiences and timelines of individuals. Patient clinical heterogeneity could be due to variability of exposure dosage conditions, differences in interpretation of non-physiological vestibular stimuli, and anatomical differences that could influence individual exposure and/or response.”
The report concluded:

“… after considering the information available to it and a set of possible mechanisms, the committee felt that many of the distinctive and acute signs, symptoms, and observations reported by DOS employees are consistent with the effects of directed, pulsed radio frequency (RF) energy. Studies published in the open literature more than a half century ago and over the subsequent decades by Western and Soviet sources provide circumstantial support for this possible mechanism. Other mechanisms may play reinforcing or additive effects, producing some of the nonspecific, chronic signs and symptoms, such as persistent postural-perceptual dizziness, a functional vestibular disorder, and psychological conditions.
The committee is left with a number of concerns. First, even though it was not in a position to assess or comment on how these DOS cases arose, such as a possible source of directed, pulsed RF energy and the exact circumstances of the putative exposures, the mere consideration of such a scenario raises grave concerns about a world with disinhibited malevolent actors and new tools for causing harm to others….”
“The committee felt that these acute symptoms were more consistent with a directed radio frequency (RF) energy attack, and explored possible related mechanisms. At the same time, the chronic symptoms that were reported are often seen in patients after head trauma, as a result of chemical exposure, infectious diseases, or stress in a hostile environment. There did not appear to be any evidence for usual forms of traumatic injury, but the committee did evaluate possible chemical and infectious causes as well as psychosocial causes, for the chronic symptoms.”

Microwave hearing has been called “the Frey effect,” named after Allan Frey who originally reported this phenomenon in 1961-1962. (2)

Appendix C of the NAS report indicates that the average intensity of the RF exposures required to create the Frey effect was considerably less than that required to produce thermal RF effects (1): 
“The average power densities associated with some of these effects (e.g., Frey effect hearing) are so low that they would not disrupt nearby electronics in a fashion similar to high-power microwaves (HPM) (Hoad, 2007; Jinshi et al., 2008). The lack of perceptual heating would also rule out other non-lethal HPM systems that have been developed for crowd control (e.g., Department of Defense’s 95GHz Active Denial System that only penetrates the skin to 1/64 an inch but heats the skin to uncomfortable levels within seconds) (D’Andrea et al., 2008; DoD, 2020; Nelson et al., 2000).”
In my opinion, microwave hearing (aka the Frey effect) is the most likely explanation for the acute symptoms experienced by the affected individuals and electromagnetic hypersensitivity is the most likely explanation for their chronic conditions. Moreover, the chronic conditions may have been caused by long-term exposure to low-intensity, non-ionizing electromagnetic fields (EMF) after an initial exposure of moderate intensity. Although the NAS report cited a recently-published review paper on electromagnetic hypersensitivity (EHS), the report did not discuss this syndrome.
In 2017 I told a reporter for the Daily Mail that I believed the acute symptoms were attributable to microwave hearing and the chronic conditions were due to EHS. Moreover, I hypothesized that the effects were likely caused by a surveillance system which employed moderate intensity RF radiation, rather than by a high-intensity weapon or “RF energy attack.”

“The finding that the attacks led to perceptible changes in their brains is also one of several factors fueling growing skepticism that some kind of sonic weapon was involved. 

‘This makes me think the victims may have developed electromagnetic hypersensitivity (EHS) from exposure to electromagnetic fields in the embassy,’ Joel Moskowitz, a community health professor at the University of California, Berkeley, told Daily Mail Online. 

‘This happened during the Cold War to personnel stationed in the US embassy in Moscow when the Soviets were bombarding the embassy with microwaves to monitor oral communications in the ambassador’s office.'”

In 2018, William Broad interviewed Beatrice Golomb and me for a story on this topic in the New York Times. He dismissed my hypotheses. He also did not refer to his interview with Dr. Golomb or the paper she shared with him, “Diplomats’ Mystery Illness and Pulsed Radiofrequency/Microwave Radiation,” which was published by MIT Press
Dr. Golomb’s paper concluded (3):
“Reported facts appear consistent with pulsed RF/MW [radio frequency microwaves] as the source of injury in affected diplomats. Nondiplomats citing symptoms from RF/MW, often with an inciting pulsed-RF/MW exposure, report compatible health conditions. Under the RF/MW hypothesis, lessons learned for diplomats and for RF/MW-affected civilians may each aid the other.”
Cellular and Wi-Fi technology rely on directed, pulsed RF energy. This environmental pollutant is responsible for many individuals worldwide who suffer from EHS in addition to EMF-related diseases. Self-report surveys estimate the prevalence of EHS to be 3 -13% in different countries. With the massive proliferation of RF-based devices and infrastructure and our increasing exposure to RF radiation, governments need to address this growing public health problem with effective regulatory strategies, comprehensive educational programs, efficient treatment regimens, and extensive research.
(1) An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies
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; David A. Relman and Julie A. Pavlin, Editors.


Description

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In late 2016, U.S. Embassy personnel in Havana, Cuba, began to report the development of an unusual set of symptoms and clinical signs. For some of these patients, their case began with the sudden onset of a loud noise, perceived to have directional features, and accompanied by pain in one or both ears or across a broad region of the head, and in some cases, a sensation of head pressure or vibration, dizziness, followed in some cases by tinnitus, visual problems, vertigo, and cognitive difficulties. Other personnel attached to the U.S. Consulate in Guangzhou, China, reported similar symptoms and signs to varying degrees, beginning in the following year. As of June 2020, many of these personnel continue to suffer from these and/or other health problems. Multiple hypotheses and mechanisms have been proposed to explain these clinical cases, but evidence has been lacking, no hypothesis has been proven, and the circumstances remain unclear.

The Department of State asked the National Academies to review the cases, their clinical features and management, epidemiologic investigations, and scientific evidence in support of possible causes, and advise on approaches for the investigation of potential future cases. In An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies, the committee identifies distinctive clinical features, considers possible causes, evaluates plausible mechanisms and rehabilitation efforts, and offers recommendations for future planning and responses.

Suggested Citation

National Academies of Sciences, Engineering, and Medicine. 2020. An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies. Washington, DC: The National Academies Press. https://doi.org/10.17226/25889.
Open access paper: 


Appendix C: Additional Comments on Directed Radio Frequency Energy 
“In order to create the Frey effect hearing and sensation of pressure within the head, there are four distinct steps involving the energy conversion from radio frequency (RF) to acoustic modalities. First, the RF energy penetrates the skull and couples to the neural tissue as a function of impedance matching and absorption in the tissue, with penetrations of 2-4 cm for frequencies of 915 MHz to 2.45 GHz (Brace, 2010). This coupling, in turn, creates a rapid oscillation of temperature changes that leads to a rapid, volumetric thermal expansion and contraction of local tissues (i.e., the increase in thermal energy causes an increase in kinetic energy of atoms, pushing against neighboring atoms to create an expansion or swelling in all directions). The oscillating tissue expansion and contraction launches a thermoelastic pressure wave (Lin and Wang, 2007; Yitzhak et al., 2009). If operated at the right pulse repetition frequency, the thermoelastic pressure wave can propagate to and excite the cochlea and vestibular organs at the resonance frequency of the cranium (Lenhardt, 2003; Yitzhak et al., 2014). Intracranial focusing is possible depending on the incident angle of the incoming RF radiation. Localization and intensity effects within a room can be achieved through nonlinear beat wave effects with careful design of the RF source and antenna. The absence, however, of electromagnetic disruption of other electronics within the immediate home/office environment suggests an upper bound to the RF energy, with implications for a potential RF system design. The average power densities associated with some of these effects (e.g., Frey effect hearing) are so low that they would not disrupt nearby electronics in a fashion similar to high-power microwaves (HPM) (Hoad, 2007; Jinshi et al., 2008). The lack of perceptual heating would also rule out other non-lethal HPM systems that have been developed for crowd control (e.g., Department of Defense’s 95GHz Active Denial System that only penetrates the skin to 1/64 an inch but heats the skin to uncomfortable levels within seconds) (D’Andrea et al., 2008; DoD, 2020; Nelson et al., 2000). 
It is well-known that the vestibular end organs and regions of the brain involved in processing of space and motion information may be excited by energy sources other than rotational or linear accelerations. External sonic, galvanic, and magnetic stimuli are used for diagnostic, experimental, and therapeutic purposes in neuro-otology and vestibular research such as generating vestibular evoked myogenic potentials (sonic), investigating vestibular response thresholds (galvanic), and as emerging therapies for chronic dizziness (transcranial magnetic and electrical stimulation) (Cha et al., 2013). Clinical observations also suggest that certain patients with vestibular disorders (e.g., Ménière’s disease) may be susceptible to exacerbations of their symptoms in response to rapid changes in atmospheric pressure as occur with quickly moving weather fronts or changes in elevation during air or land travel (Gürkov et al., 2016). However, the potential for RF sources to stimulate the vestibular end organs via thermoelastic pressure waves or to excite central nervous system pathways via transduction akin to the Frey effect are not known. If these effects exist, then a few observations may be made about their potential manifestations. A thermoelastic pressure wave would be omnidirectional thereby stimulating the vestibular end organs in a non-physiological manner. This unusual form of vestibular stimulation could lead to very confusing percepts as central vestibular pathways do their best to resolve the non-physiological pattern of end organ stimulation resulting in sensations of physically impossible motions, unexpected reflexive postural responses to them, and faulty inferences about external forces causing them. Affected individuals could report different sensations in response to the same external stimulus; thus, immediate reports of affected individuals may not be veridical and sensations may vary from one individual to another. If a Frey-like effect can be induced on central nervous system tissue responsible for space and motion information processing, it likely would induce similarly idiosyncratic responses.”


(2) Allan H. Frey. Human auditory system response to modulated electromagnetic energy. Journal of Applied Psychology. 01 Jul 1962. https://doi.org/10.1152/jappl.1962.17.4.689.

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Abstract

The intent of this paper is to bring a new phenomenon to the attention of physiologists. Using extremely low average power densities of electromagnetic energy, the perception of sounds was induced in normal and deaf humans. The effect was induced several hundred feet from the antenna the instant the transmitter was turned on, and is a function of carrier frequency and modulation. Attempts were made to match the sounds induced by electromagnetic energy and acoustic energy. The closest match occurred when the acoustic amplifier was driven by the RF transmitter’s modulator. Peak power density is a critical factor and, with acoustic noise of approximately 80 db, a peak power density of approximately 275 mw/ cm2 is needed to induce the perception at carrier frequencies of 425 mc and 1,310 mc. The average power density can be at least as low as 400 μw/cm2. The evidence for the various possible sites of the electromagnetic energy sensor are discussed and locations peripheral to the cochlea are ruled out.

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https://journals.physiology.org/doi/abs/10.1152/jappl.1962.17.4.689

(3) Beatrice Alexandra Golomb. Diplomats’ Mystery Illness and Pulsed Radiofrequency/ Microwave Radiation. Neural Comput. 2018 Nov;30(11):2882-2985. doi: 10.1162/neco_a_01133. Epub 2018 Sep 5. 

Abstract

Importance: A mystery illness striking U.S. and Canadian diplomats to Cuba (and now China) “has confounded the FBI, the State Department and US intelligence agencies” (Lederman, Weissenstein, & Lee, 2017). Sonic explanations for the so-called health attacks have long dominated media reports, propelled by peculiar sounds heard and auditory symptoms experienced. Sonic mediation was justly rejected by experts. We assessed whether pulsed radiofrequency/microwave radiation (RF/MW) exposure can accommodate reported facts in diplomats, including unusual ones. 
Observations: 
(1) Noises: Many diplomats heard chirping, ringing or grinding noises at night during episodes reportedly triggering health problems. Some reported that noises were localized with laser-like precision or said the sounds seemed to follow them (within the territory in which they were perceived). Pulsed RF/MW engenders just these apparent “sounds” via the Frey effect. Perceived “sounds” differ by head dimensions and pulse characteristics and can be perceived as located behind in or above the head. Ability to hear the “sounds” depends on high-frequency hearing and low ambient noise. 
(2) Signs/symptoms: Hearing loss and tinnitus are prominent in affected diplomats and in RF/MW-affected individuals. Each of the protean symptoms that diplomats report also affect persons reporting symptoms from RF/MW: sleep problems, headaches, and cognitive problems dominate in both groups. Sensations of pressure or vibration figure in each. Both encompass vision, balance, and speech problems and nosebleeds. Brain injury and brain swelling are reported in both. 
(3) Mechanisms: Oxidative stress provides a documented mechanism of RF/MW injury compatible with reported signs and symptoms; sequelae of endothelial dysfunction (yielding blood flow compromise), membrane damage, blood-brain barrier disruption, mitochondrial injury, apoptosis, and autoimmune triggering afford downstream mechanisms, of varying persistence, that merit investigation. 
(4) Of note, microwaving of the U.S. embassy in Moscow is historically documented.


Conclusions and relevance: Reported facts appear consistent with pulsed RF/MW as the source of injury in affected diplomats. Nondiplomats citing symptoms from RF/MW, often with an inciting pulsed-RF/MW exposure, report compatible health conditions. Under the RF/MW hypothesis, lessons learned for diplomats and for RF/MW-affected civilians may each aid the other.

News stories

https://www.nytimes.com/2020/12/05/business/economy/havana-syndrome-microwave-attack.html

https://www.saferemr.com/2020/12/national-academy-of-sciences-report-on.html