The frustration culminated in a tense conversation Mr. Pottinger had with Vaughn Bishop, then the deputy C.I.A. director, and other officials in November. Mr. Pottinger urged the intelligence community to do more to cooperate with the Pentagon and other agencies. The next month, the National Security Council convened a deputy-level meeting across agencies to again push for further action and a broader investigation.

Mr. Pottinger declined to comment.

The Biden administration has tried to further improve coordination, including directing agencies to each name a coordinator to work on both identifying the cause of the episodes and improving health care for the injured personnel. Even some Democrats who have been briefed on the incidents called on the administration to be more aggressive.

“I don’t believe that we as a government, in general, have acted quickly enough,” said Representative Ruben Gallego, an Arizona Democrat and former Marine who heads the House Armed Services Subcommittee on Intelligence and Special Operations. “We really need to fully understand where this is coming from, what the targeting methods are and what we can do to stop them.”

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Mysterious Ailments Are Said to Be More Widespread Among U.S. Personnel

WASHINGTON — Mysterious episodes that caused brain injuries in spies, diplomats, soldiers and other U.S. personnel overseas starting five years ago now number more than 130 people, far more than previously known, according to current and former officials.

The number of cases within the C.I.A., the State Department, the Defense Department and elsewhere spurred broad concern in the Biden administration. The initial publicly confirmed cases were concentrated in China and Cuba and numbered about 60, not including a group of injured C.I.A. officers whose total is not public.

The new total adds cases from Europe and elsewhere in Asia and reflects efforts by the administration to more thoroughly review other incidents amid concern over a spate of them in recent months.

Since December, at least three C.I.A. officers have reported serious health effects from episodes overseas. One occurred within the past two weeks, and all have required the officers to undergo outpatient treatment at Walter Reed National Military Medical Center or other facilities.

a report released in December, the National Academy of Sciences said a microwave weapon probably caused the injuries. Some officials believe a microwave or directed-energy device is the most likely cause.

The severity of the brain injuries has ranged widely. But some victims have chronic, potentially irreversible symptoms and pain, suggesting potentially permanent brain injury. Physicians at Walter Reed have warned government officials that some victims are at risk for suicide.

one in 2020 that affected a National Security Council official near the Ellipse south of the White House and another in 2019 involving a woman walking her dog in Northern Virginia, have no known connection to an earlier overseas event. While many officials expressed skepticism that Russia or another power would conduct an attack in the United States, agencies are investigating.

Congress has demanded more from the C.I.A. In a closed-door meeting of the Senate Intelligence Committee last month, senators accused the C.I.A. of doing too little to investigate the mysterious episodes and until recently showing skepticism about them, according to people briefed on the meeting.

During the Trump administration, some in the agency said there was little intelligence showing a foreign power was responsible and argued that it made little sense analytically for Russia or another foreign intelligence service to make unprovoked attacks on Americans. Others doubted the cause of the brain injuries.

The new C.I.A. director, William J. Burns, has tried to move aggressively to improve the agency’s response, current and former officials said. Mr. Burns has met with victims, visited doctors who have treated injured agency officers and briefed lawmakers.

He has also assigned his deputy, David Cohen, to oversee the investigation and the health care response. Mr. Cohen will meet monthly with victims and will lead regular briefings for Congress. The agency has also doubled the number of medical personnel conducting treatment and managing cases of injured officers.

In addition, the chief medical officer, who had been criticized by some former officers as too skeptical of the incidents and dismissive of some symptoms, announced his retirement. He was replaced with another doctor seen inside the C.I.A. as more focused on patient care.

another cohort of C.I.A. officers traveling in a variety of countries, including Russia, had said they were the likely victims of attacks and reported similar symptoms.

Lawmakers and the Trump administration’s National Security Council grew increasingly frustrated last year with State Department’s and the C.I.A.’s handling of the incidents.

Robert C. O’Brien, President Donald J. Trump’s last national security adviser, and Matthew Pottinger, his deputy, had already begun working in early 2020 to redouble efforts by their aides to understand the mysterious episodes and to get the Pentagon more involved.

But their staff members ran into frustration getting the C.I.A., the State Department and other agencies to share details about injured personnel, in part because of federal protections on health data. White House officials thought the investigation, in which the C.I.A. had been the lead agency, had run into a dead end.

The frustration culminated in a tense conversation Mr. Pottinger had with Vaughn Bishop, then the deputy C.I.A. director, and other officials in November. Mr. Pottinger urged the intelligence community to do more to cooperate with the Pentagon and other agencies. The next month, the National Security Council convened a deputy-level meeting across agencies to again push for further action and a broader investigation.

Mr. Pottinger declined to comment.

The Biden administration has tried to further improve coordination, including directing agencies to each name a coordinator to work on both identifying the cause of the episodes and improving health care for the injured personnel. Even some Democrats who have been briefed on the incidents called on the administration to be more aggressive.

“I don’t believe that we as a government, in general, have acted quickly enough,” said Representative Ruben Gallego, an Arizona Democrat and former Marine who heads the House Armed Services Subcommittee on Intelligence and Special Operations. “We really need to fully understand where this is coming from, what the targeting methods are and what we can do to stop them.”

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Intelligence Chiefs Warn of Russian Troops Near Ukraine and Other Threats

WASHINGTON — The Russian military buildup at the Ukraine border and in Crimea could provide enough forces for a limited military incursion, the C.I.A. director, William J. Burns, told senators on Wednesday as he and other senior officials outlined a range of threats facing the United States.

Russia could simply be sending a signal to the United States or trying to intimidate the Ukrainian government, but it had the abilities in place to do more, Mr. Burns told the Senate Intelligence Committee.

“That buildup has reached the point that it could provide the basis for a limited military incursion, as well,” Mr. Burns said. “It is something not only the United States but our allies have to take very seriously.”

Mr. Burns testified alongside Avril D. Haines, the director of national intelligence, and other officials about an array of threats from global powers like Russia and China as well as challenges that have been less of a focus of intelligence agencies in the past, including domestic extremism and climate change.

annual threat assessment report, released Tuesday ahead of the hearing, the intelligence community said that China’s push for global power posed a threat to the United States through its aggression in its region, its expansion of its surveillance abilities and its attempts to dominate technological advances.

Russia has also pushed for a sphere of influence that includes countries that were part of the Soviet Union, like Ukraine, the report said.

Both China and Russia, however, wanted to avoid direct confrontation with the United States, the report said.

Mr. Burns said the Russian actions have prompted internal briefings as well as consultations with allies. President Biden’s call on Tuesday to President Vladimir V. Putin of Russia was intended to “register very clearly the seriousness of our concern,” Mr. Burns said.

The United States has been tracking the Russian troops for some time, at least since late March. American officials have said privately that the Russians have done little to hide their troop buildup, unlike in 2014 when they first attacked Ukraine. That has convinced some, but not all, officials briefed on the intelligence that the Russian activities may be mostly for show.

penetrated nine federal agencies, and another by China that compromised Microsoft Exchange servers. The Biden administration is expected to respond to the Russian hacking soon, most likely with sanctions and other measures.

Ms. Haines said Russia used hackings to sow discord and threaten the United States and its allies. “Russia is becoming increasingly adept at leveraging its technological prowess to develop asymmetric options in both the military and cyberspheres in order to give itself the ability to push back and force the United States to accommodate its interests,” she said.

Lawmakers also raised the issue of a series of mysterious episodes that have injured diplomats and C.I.A. officers overseas. Some former officials believe Russia is behind the episodes, which they have called attacks.

Mr. Burns said he was working with his colleagues to ensure better medical care for C.I.A. officers. He also said he was working to “get to the bottom of the question of what caused these incidents and who might have been responsible.”

Questions on China dominated the earlier Senate confirmation hearings for Ms. Haines and Mr. Burns, and lawmakers again pressed on Wednesday for assessments on China and its efforts to steal American technology. Ms. Haines outlined how China uses technological might, economic influence and other levers of power to intimidate its neighbors.

“China is employing a comprehensive approach to demonstrate its growing strength and compel regional neighbors to acquiesce to Beijing’s preferences,” she told senators.

another recent intelligence report, on global trends, highlighted how the coronavirus pandemic and climate change, along with technological change, were testing “the resilience and adaptability” of society. The “looming disequilibrium,” she said, compels intelligence agencies to broaden their definition of national security.

But at least one lawmaker, Senator Richard M. Burr, Republican of North Carolina, also asked a more practical question: How many intelligence officers have received coronavirus vaccines?

Mr. Burns said 80 percent of the C.I.A. work force was fully vaccinated and another 10 percent have had their first shot. He said all C.I.A. officers serving overseas “have the vaccine available to them directly.”

Mr. Wray was unable to give an estimate of how many of his agents had received a shot, saying that the vaccination rates varied in field offices in different states. Ms. Haines said 86 percent of her work force had had at least one shot, with a “fair percentage” being fully vaccinated. General Nakasone also had no estimate but said a vaccination center had been set up at Fort Meade, Md., where the National Security Agency’s headquarters is.

Lawmakers have also been pressing intelligence agencies to help examine the problem of domestic extremism. Senator Mark Warner, Democrat of Virginia and the chairman of the intelligence committee, linked the rise of domestic extremism to the same trends promoting disinformation produced by Russia and others. And he said he wanted the intelligence chiefs to outline how they could help provide better warnings of potential violence like the Jan. 6 attack on the U.S. Capitol.

“go back to school.” Mr. Trump’s last director of national intelligence, John Ratcliffe, chose not to release a threat assessment or testify before Congress last year.

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China Poses Biggest Threat to U.S., Intelligence Report Says

This year’s report offers a far more robust discussion of the national security implications of climate change, whose threats, for the most part, are long term, but can also have short-term consequences, the report said.

“This year, we will see increasing potential for surges in migration by Central American populations, which are reeling from the economic fallout of the Covid-19 pandemic and extreme weather, including multiple hurricanes in 2020 and several years of recurring droughts and storms,” the report said.

It adds that the economic and political implications of the coronavirus would reverberate for years, predicting that the economic damage would worsen instability in a few countries, though it does not name them.

Combined with extreme weather caused by climate change, the report says the number of people worldwide experiencing acute hunger will rise to 330 million this year from 135 million. The report says that the pandemic has disrupted other health services, including polio vaccinations and H.I.V. treatments in Africa.

Typically, the director of national intelligence delivers the threat assessment to Congress and releases a written report alongside it. But no declassified assessment was issued last year, as the Trump administration’s intelligence agencies sought to avoid angering the White House.

In 2019, Dan Coats, then the director of national intelligence, delivered an analysis of threats from Iran, North Korea and the Islamic State that was at odds with President Donald J. Trump’s views. The testimony prompted Mr. Trump to lash out on Twitter, admonishing his intelligence chiefs to “go back to school.”

Avril D. Haines, the director of national intelligence; William J. Burns, the C.I.A. director; and other top intelligence officials will testify about the report on Wednesday and Thursday.

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