DEPUTY ASSISTANT TO THE SECRETARY OF DEFENSE ALYSSA FARAH: Hey, guys. Happy Friday. And we're going to do this on the record. We'd originally said background, but I know there's significant interest.
So I'm going to just go through a timeline and some facts for you, and then we'll take a handful of questions.
Q: All right.
MS. FARAH: So, first and foremost, following the attack on the Al Asad Air Base, we commend our commanders on the ground who took every necessary step to ensure the safety of U.S. forces.
Following the January 8th missile attack on Al Asad, a number of service members were given routine examinations for concussions. The vast majority of those who received initial exams needed no follow-on exams. However, a number of service members continued to display concussion-like symptoms days after the attack and reported them to their chain of command. Out of an abundance -- abundance of caution, these 11 members were transported for further evaluation to Landstuhl, Germany, on January 15th, where MRI equipment is available.
The symptoms of suspected TBI often do not fully materialize themselves until days after an injury, and thus often do not require continued monitoring -- and thus often require continued monitoring and follow-on care.
The Pentagon leadership was notified of the injuries yesterday, and made it public within hours. This is in line with reporting requirements, and the commander on the ground took the appropriate steps to ensure the service members received the appropriate level of care. We fully expect these service members to return to their duty when deemed medically able.
The safety and health of our personnel is of the highest priority. We commend commanders on the ground who took every necessary step to ensure the safety of U.S. forces.
ASSISTANT TO THE SECRETARY OF DEFENSE JONATHAN RATH HOFFMAN: So just a couple of things I’ll add. The secretary was made aware of this yesterday afternoon. I was actually in a meeting with him upstairs, and the vice chairman interrupted the meeting to give the secretary an update yesterday late afternoon; immediately directed us to -- to get the information -- get more details and get the information out, which we did. We -- we did that last night.
We've seen some reporting this morning on, why was this information not conveyed at a previous time or -- or earlier? I think Alyssa covered that.
Part of this comes under the terminology used for casualties -- all of you guys are aware of that -- whether people are able to return to duty. Our understanding is that these individuals were able to return to duty following the attacks. They knew they had concussion symptoms that -- that appeared shortly after the attack and did not diminish, and therefore they've been sent on for further evaluation, or they have concussion symptoms that appeared later -- that only manifested later, and therefore have caused medical personnel on the ground to move them onward for examination.
So I appreciate those of you who are very aware of this, having been in Iraq and Afghanistan, and have been able to, kind of, give that context to some of the reporting on it. Appreciate you guys getting that out there. So --
Q: Can I ask a quick question?
MR. HOFFMAN: Yeah -- (inaudible) questions.
Q: Just one quick one, that -- so what I'm having a hard time is, why was it on Monday at Al Asad, when all those reporters were taken out, they were told that there were a bunch of concussive injuries. So, because the Post reported it, like, a bunch -- a couple of reporters who were actually out there reported it.
So, is the only thing that's happened between Monday and now is, because they were still showing symptoms, they were sent on for further screening and testing, basically?
MR. HOFFMAN: I think the way to characterize that is that people still had some symptoms -- or indicated that they had concussive symptoms earlier, but that either those symptoms have not diminished. or that others have gotten -- or has had symptoms appear, and therefore they're being sent on for additional symptoms.
One of the things we've learned is that our facility in the Al Asad Air Base does not have an MRI machine.
Q: Right.
MR. HOFFMAN: So they -- they're being moved to a facility where they can receive additional treatment and examination.
We take the -- the -- the risk from concussions and potential TBI very seriously, and so they've been moved forward at the direction and advice of the doctors on the ground.
Q: But the -- but SECDEF wasn't just initially told about that yesterday, right? He must have been aware that there were people who were -- who had some --
MS FARAH: So --
Q: -- potentially were being monitored.
MS. FARAH: The -- the reporting requirements that -- we pulled this today, knowing there was significant interest.
So immediate reporting requirements up to the Pentagon are for incidents threatening of life, limb or eyesight. So actually, TBI wouldn't rise to that threshold. But because there's tremendous interest, we immediately went and, kind of, tracked down these facts and worked with our folks on the ground.
MR. HOFFMAN: Yeah. And I think you guys are aware -- aware that, you know, we look at the casualties. So if people were able to return to duty, the commander on the ground and his team make determinations and then report that up.
(inaudible)?
STAFF: Thank you.
Q: So the statement said, transported to Kuwait and Landstuhl; you just said Landstuhl. Are all 11 at Landstuhl?
MR. HOFFMAN: So -- so three -- three previously -- sorry, three of them are in Kuwait or went to --
(CROSSTALK)
STAFF: Yeah.
Q: So it's (inaudible) --
MS. FARAH: And nine moved to Landstuhl.
Q: -- total of 14?
STAFF: Yeah.
MR. HOFFMAN: So, no.
STAFF: No, no. Nine at Landstuhl, three at -- oh, sorry. Eight at Landstuhl, three at Kuwait.
MR. HOFFMAN: Yes.
Q: Okay. And what were some of the symptoms that manifested themselves?
MR. HOFFMAN: I don't -- I don't have that. We haven't talked to the doctor on the ground to get the individual symptoms.
Q: But your point originally was -- earlier was that in the cases where these people were able to remain on duty or return to duty, that was not considered an injury? Is that correct?
MR. HOFFMAN: I wouldn't say not an injury. I think what we're saying -- where they're characterized within the casualty reporting that goes up.
I think everyone would agree that this was -- that -- that we could consider this an injury, but I would point out that the reporting of it did not raise up to the point where the secretary was notified that there were a few people on the ground that may have had concussion-like symptoms on the ground.
Q: Is that why the president wouldn't have known? Because he gets his information --
MR. HOFFMAN: (inaudible).
Q: -- from the secretary.
MR. HOFFMAN: And as we -- and as we said -- yeah. As we said from the start, that the reporting was after an incident like this, we were trying to get the best information out there, we were doing battle damage assessments afterwards and additional information came up.
So this was not known outside of the unit on -- and then we actually -- outside of the unit until later, so did not come up.
And the other thing I'd say is that the -- speaking with the team on the ground, is that some individuals did not even report symptoms that they had until a few days later as well. We got a lot of people who are doing really tough jobs, and they're -- they want to be doing their job as much as they can, and so some of them may not have reported it until a little bit later.
Q: Does this rise to the injury to receive the Purple Heart? And --
MR. HOFFMAN: That's not a determination that -- that we -- no one's made that determination at all. And there are standards for the Purple Heart determination --
Q: Right, that's why --
MR. HOFFMAN: -- and so it's going to be whether somebody's been diagnosed with a TBI, whether it's been the result of -- of enemy action, and whether they were treated by a combat medic as a part of that. Those -- those determinations haven't been made, but there's a process for that and the Army will be looking into that.
Q: So you don't know if -- so say, if they do receive the Purple Heart, if the ones who only got evacuated do, or if I showed up with concussive symptoms --
MR. HOFFMAN: I just -- so the standards are, you're treated by a combat medic --
Q: Right.
MR. HOFFMAN: -- it was the result of enemy -- enemy action --
Q: Right.
MR. HOFFMAN: -- and you were diagnosed with -- with a TBI.
Q: Right.
MR. HOFFMAN: So those are the standards.
Q: Nobody's been diagnosed with it yet, you say?
MR. HOFFMAN: They've been -- so far, they've been sent forward with -- with symptoms for possible – but possible designation.
Q: But there could be more, if -- if they -- if they didn't get evacuated, but they could have had -- been diagnosed with a TBI --
MR. HOFFMAN: Evacuation has -- evacuation is not -- not a requirement for that. It is, you're treated by a combat medic.
Q: You'd mentioned earlier, all one unit. Can you say what unit all of these service members were a part of? And were they in a bunker or --
MR. HOFFMAN: I was using the unit as a general --
MS. FARAH: As everybody on the base, OK …
MR. HOFFMAN: -- as a -- as the term for those on the ground. I don't know what unit it was from, but they were all at Al Asad.
Q: And were they all flown out at the same time? Or can you give us a little timeline of when they were sent out?
MR. HOFFMAN: No. They were not -- they were -- sorry. There were some that were flown out on -- on the 15th, and there were -- one individual with a potential TBI that was flown out on the 10th. Then these were all on flights that were available. There were no --
MS. FARAH: (inaudible)
MR. HOFFMAN: Yeah, no priority -- or, sorry -- priority is not the right word. There were no --
Q: CASEVAC?
MR. HOFFMAN: CASEVAC-type aircraft that were used for this. They were under their own power on aircraft and -- and on their way.
Barbara?
Q: Jonathan, can you go back a minute? You say the secretary was immediately informed yesterday.
Precisely what was he informed of, of -- of the evacuations, of the injuries? Can you just --
MR. HOFFMAN: He was -- precisely, he was informed that -- that the CENTCOM commander had sent up a report that there had been 11 individuals that had been transported from Al Asad air base to receive additional treatment and screening based on -- exhibiting concussion-like symptoms and the possibility of a TBI.
Q: So if -- I was trying to understand the reporting requirement.
So McKenzie sends up a report to the Pentagon that these people have potentially suffered this and they've all been evacuated. That -- that triggers -- because it's a McKenzie report, that is the thing that triggers the secretary being notified?
MR. HOFFMAN: I'd have to get back to you on that. I think that there's --
Q: Okay. So here's what I don't understand. He – in fact, you mentioned the first one was actually on the 10th. The event's the 8th. But it's not required to be reported to the Pentagon? I think it's, like, loss of limb and things like that.
MR. HOFFMAN: It's loss of limb, threat to life and loss of eyesight are the ones that require --
MS. FARAH: That meet the threshold.
MR. HOFFMAN: The threshold.
Q: I understand. I get it.
But I guess I'm wondering, does that need to change? I mean, it's kind of -- is the secretary going to review that whole notion that nobody tells him that 11 people have been -- have been wounded?
Because, of course, it goes to the question, those who suffer from this often think they're, you know, regarded as not priority injuries, that they're second-class injuries.
So, I mean --
MR. HOFFMAN: I would disagree with that, that we don't consider them serious injuries.
Q: I said people who suffer from it, many of them feel that way.
MR. HOFFMAN: But what I would say on -- regarding to the -- the reporting to the secretary, there are a number of different types of injuries with a million-plus people in uniform. There's different tiers of reporting that get up to the secretary.
He was made aware. As soon as it got into the Pentagon, as soon as it got to headquarters --
Q: Right.
MR. HOFFMAN: -- he was -- the vice chairman of the Joint Chiefs of Staff walked it in to tell him about it. So --
Q: So --
MR. HOFFMAN: So I cannot say that -- I think it would be unfair to say that he was not -- it was not something that came to his attention as promptly as we (inaudible).
Q: No, I understand and accept what you've said. I'm asking, is he satisfied with that, that nobody -- that it was not something that would have come to him?
Sometimes commanders say, "Uh-uh, forget the paperwork. I want to know right away."
MR. HOFFMAN: Well, I think you've got to go back and look at -- at how this has manifested itself. And from what we're -- we're still getting facts from the ground, but that some individuals had (inaudible) symptoms and injuries that either did not diminish the way they were expected or they manifested at a later date.
Q: So McKenzie's notification was yesterday.
MR. HOFFMAN: That is when we got it at the Pentagon. We were notified by the -- by CENTCOM yesterday.
Q: Okay.
Q: Just a follow-up to that Jonathan. If soldiers were flown out on the 15th and 10th, why didn't you put this out at the briefing yesterday?
MR. HOFFMAN: As I just said, I just found out about it yesterday, sitting with the secretary, when the vice chairman came in to tell us --
Q: The briefing was yesterday?
MR. HOFFMAN: It was yesterday afternoon.
Q: Okay.
MR. HOFFMAN: I said that.
Q: So can we in the media -- what should our assumption, going forward, be about you notifying the news media so we can inform the public about wounded troops?
MS. FARAH: Well, and I think you all are in communication with our forces on the ground, whether it's through CENTCOM or OIR. You're obviously welcome to reach out through those channels --
Q: Of course, but I'm not really asking -- of course. Is you have an intermittent policy of informing -- and if anybody wants to correct me, please do.
You have -- the department, not you personally -- has an intermittent policy of informing the news media when troops are wounded. Sometimes we know, sometimes we don't. So I'm just wondering if this --
MR. HOFFMAN: I'm not aware of an intermittent policy on that. I mean, I think it's --
MS. FARAH: In this case, we did within hours.
MR. HOFFMAN: -- as soon as we -- yeah, as soon as we were -- we were made aware of it, we got the information out and saw -- and when we saw that there was an appetite for more information this morning, we got you guys here for an on-the-record conversation about it. So --
(CROSSTALK)
Q: You don't think that, there was, maybe, the commanders on the ground or someone else, McKenzie, thought that there was an attempt to de-escalate, and therefore they didn't want to report the casualties?
MR. HOFFMAN: I think the narrative out there that some have put forth, that there was -- I have yet -- I have not seen a single administration individual -- sorry, let me back up.
Every administration official that's gone on the record on what the intentions of the Iranians were is -- including the vice president, the secretary and the chairman -- is that their intention was to injure or kill Americans.
So this idea that there was an effort to de-emphasize injuries for some sort of amorphous political agenda doesn't hold water to what the administration has said on the record.
So I appreciate those of you who have addressed that, with individuals who've brought that up. The -- this administration, this secretary, are trying to get information out there as much as we can on this. So, we appreciate you guys reporting it, and I appreciate that many of you have been out there talking about your own experiences and how you've seen this -- and how it manifests on the ground with people who are injured, because it's not a well-understood issue that -- but that is something we're -- we appreciate you guys putting that out there.
Q: Did the secretary update the president, given that --
(CROSSTALK)
MR. HOFFMAN: I don't know the answer.
Q: Just two days ago at this rally, he said there were no injuries.
(CROSSTALK)
MR. HOFFMAN: I don't know the answer. I can try to track that down, but I don't know the answer to that.
MS. FARAH: At the staff level, we've informed the White House.
Q: Can you let us know if, down the road, more people perhaps report injuries? And if you have additional people that are being treated, additional evacuations, can you --
MR. HOFFMAN: Of course we will.
Q: -- let us know?
MS. FARAH: And we conveyed that to OIR, we'd like updates on it.
Q: And do you think this is a failing by the part of the commanders on the ground to not inform the Pentagon of something so strategic and important when you have top leadership speaking about it?
MR. HOFFMAN: Look, I'm not going to get into what the commander on the ground, or the commander's medical team on the ground -- or even the individual soldiers' thought process is when they have an injury, and whether they think that something that is an injury that can be treated quickly or be treated on the base, and that the individual can return to duty in the base, and whether that requires alerting to the secretary of defense and the president.
I'm not going to double -- I'm not going to question the commander's judgment.
MS. FARAH: But they met the reporting threshold.
(CROSSTALK)
Q: -- this is clearly recognized as a big deal because -- this was clearly recognized as a big deal, because you said the vice chairman interrupted a meeting to bring the news to the secretary of defense.
MR. HOFFMAN: When we -- when we finally realized that individuals had been airlifted out, yes. But --
(CROSSTALK)
Q: Which happened on the 15th.
MR. HOFFMAN: -- I'm talking specifically about --
Q: The big airlift happened on the 15th, right?
MR. HOFFMAN: I don't know what time of day. I mean, it was yesterday afternoon, it --
(CROSSTALK)
MR. HOFFMAN: Yesterday afternoon, we were made aware of it. So within 24 hours of individuals being -- being airlifted out, the secretary of defense was made aware of it.
Q: Is that a good -- is that good? I'm serious. I mean, shouldn't -- he's the secretary of defense. Wouldn't he want to be --
MR. HOFFMAN: So, Barbara, I'll take you back to the standards for if individuals are -- are -- life, limb, loss of eyesight; those are -- those are the type of injuries that, based in the reporting system, that the -- that come up more quickly.
Q: I totally get it.
MR. HOFFMAN: So for individuals who get onto an aircraft under their own power, and are flying to receive additional medical examinations, I -- I'm not -- I don't have -- I can't speak for -- for what the standards have been at different times, but that seems to be an appropriate standard for the secretary of defense to be notified within 24 hours of that, so.
Q: Is there -- is there any chance of them maybe – which, as we appreciate the significance of TBI more now than we did in the past. I mean, I've had my bell rung before by, and -- and that's when you shake it off and you go back to work. But you think we might now alter that -- alter the system to add that to the list?
(CROSSTALK)
Q: -- with respect to TBI?
MR. HOFFMAN: So I would say that that has been altered. So that what happens is, we do baseline assessments under the MACE standard for concussions prior to individuals going into the -- to the AOR. In the -- in the hours after the attack, individuals who thought they may have had some sort of response were examined under the MACE system to see whether they had any indications of concussion.
And then that was followed up within 24, 48 hours. They were continued to be examined by doctors. And as we've seen, those that did have symptoms, if they didn't diminish, they were airlifted out. Or individuals who didn't have systems in this first 24 hours or 48 hours, didn't show symptoms, they continued to see -- be examined by doctors, and then as they exhibited it, came out.
So I would say that the -- the system --
Q: (Inaudible) want a reporting line, rather than the -- the treatment line, that it gets reported up -- I mean, just adding TBI to this list of loss of, you know, eyesight, loss of limb or whatever.
MR. HOFFMAN: That's -- that's something -- that's not something I have a view on, so -- but I've got to go, but I appreciate it.
(CROSSTALK)
Q: -- Is there (inaudible) civilian contractors or foreign --
MR. HOFFMAN: Excuse me?
Q: -- civilian contractors? I mean, if 11 U.S. service members were injured it seems (inaudible) --
MR. HOFFMAN: I don't have any information on whether contractors were a part of that --
Q: Can you take that question? Because it's -- there are a lot of contractors there.
MR. HOFFMAN: Okay, all right, thank you.
MS. FARAH: I'll look into it.