NBC News published an in-depth story Monday about the behind the scenes investigation of the “health attacks” experienced by a number of American diplomats in Cuba and China. Back when this story was initially reported last year the U.S. was quick to send a couple of Cuban diplomats packing. When the attacks appeared to continue, Trump ordered all non-essential personnel out of Cuba and then, a couple weeks later, sent 15 Cuban diplomats home.

Then in May of this year, it seemed the same type of attacks were being experienced by U.S. diplomats in China as well. But the response to those, very similar, attacks has been more reserved. The NBC story suggests some friction exists between doctors at the Penn Center for Brain Injury and Repair at the University of Pennsylvania who are examining the diplomats and the State Department which decides who is a victim of a “health attack” and who is not. Of 15 diplomats serving in China who seemed to fail a special test (known as HABIT) used to identify the problems experienced by the Cuban diplomats, only one was judged to have experienced a “health attack” by the State Department. But doctors who actually examined the patients say the cases were very similar to what they saw in diplomats returning from Cuba.

With hundreds of diplomats reporting strange sounds or symptoms, who determines which are real, “confirmed” cases and which aren’t? If the U.S. still doesn’t know what’s causing the damage, how can it be sure?

Fifteen Americans who failed the HABIT test in China were medevaced to Philadelphia. In some cases, further testing at Penn found similar medical issues to Cuban evacuees, including acquired brain injury, vestibular dysfunction and sleep disorders, medical records reviewed by NBC News show. But State Department officials say 14 of them were determined not to be cases. One was deemed “indeterminate.”

In a few cases, patients who’d suffered concussions during childhood but fully recovered were told their current symptoms might have been caused by the earlier concussions, according to State Department correspondence reviewed by NBC News…

But U.S. officials involved in the process tell NBC News that Penn doctors perform the evaluations and tests, diagnosing specific conditions like acquired brain injury and balance disorder. Then they deliver their findings to the government. State Department doctors, who have not examined the patients, consider other information including the location of the reported “exposure” and past medical history before deciding whether the full picture matches what was seen in the Cuba patients…

Physicians treating the Americans wouldn’t speak on the record. But one of the doctors recalled telling the State Department that a China patient had the same symptoms and findings as the Cuba patients, only to see that patient be “cleared.” He said the Penn doctors are “getting thrown under the bus” by the “doubting voices in the State Department.”

Deputy Secretary of State John Sullivan issued a denial that the Trump administration was trying to minimize the health attacks when it comes to China:

The State Department, in explaining why it’s not setting up a review board to assess the response in Cuba, told NBC News that Pompeo didn’t believe there was enough information to prove that Werner’s injury was “related to a U.S. government mission abroad.”

Sullivan, after meeting with the Penn doctors, acknowledged “there may be a suspicion” that the U.S. government is trying to “minimize” what happened in China.

“I can assure you that is not the case. We are pursuing this vigorously,” Sullivan said on the conference call with patients. “There’s no conspiracy here to cover up or to minimize this or to limit it to Cuba.”

But the description given by Catherine Werner, one of the diplomats brought home from China after her health deteriorated, sound exactly like what happened in Cuba. She hears strange buzzing noises that seemed directional in the middle of the night. Her motor coordination and memory began to deteriorate and she would vomit for no particular reason. It got so bad that her mother flew to China, concerned she was becoming seriously ill. She and her mother bought dogs to help prevent possible break-ins at her apartment and the dogs became ill as well. Read the first six or seven paragraphs of the NBC story. It sounds identical to what the Cuban diplomats experienced.

When this all began the speculation was that the attacks might be sonic in nature. That would explain the loud, directional buzzing. But the consensus seems to be that ultrasound wouldn’t cause the type of brain injuries seen in some cases. The current thinking seems to be that this is the result of microwave beams. Here’s a Fox News report from last month:

Update: Here’s an interview with Josh Lederman, the author of the NBC piece, talking about his findings: