In a page taken from a Cold War-era playbook, existing evidence clearly suggests that sonic weapons are being used to attack American diplomatic officials in Cuba and China. The U.S. should operate as if this is a provocation that crosses a number of red lines, and it should consider stronger retaliatory actions against both governments.

More than 20 news sources in recent months have dubbed these incidents as a “mystery” or “perplexing.” No news source has been willing to recognize it as a strategic, deliberate action against our diplomatic officials. Thus, the only “mystery” is why the U.S. has not been more aggressive in pushing back against and increasing the consequences for the perpetrators, most likely official elements in China and Cuba. Fear of damaging the “normalization project” between the U.S. and Cuba should not encourage denial of what appears to be deliberate, hostile actions.

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In late 2016, U.S. diplomats in Cuba reported serious medical ailments related to incidents that occurred over several months and initially appeared to be linked to sonic attacks. Many of the victims reported strange sounds that were incapacitating and led to a series of medical symptoms, including hearing loss, cognitive issues, temporary imbalance, even mild traumatic brain injuries. Several victims have undergone rehabilitation and every victim is anticipated to return to work eventually. Nonetheless, these patients likely will need to be monitored for the rest of their lives, to determine the full impact of these attacks.

In June, U.S. officials in China faced similar attacks that affected at least one diplomat. Secretary of State Mike Pompeo Michael (Mike) Richard PompeoTreasury sanctions individuals, groups tied to Russian malign influence activities Navalny released from hospital after suspected poisoning Overnight Defense: Pentagon redirects pandemic funding to defense contractors | US planning for full Afghanistan withdrawal by May | Anti-Trump GOP group puts ads in military papers MORE said the incident was “similar” and “entirely consistent” with what happened in Cuba.

There are studies that have proposed possible explanations based on experiments, but these tests were limited and did not account for potential physiological damage. A University of Michigan study examined whether ultrasound could be the potential cause of the incidents in Cuba. This experiment led to various possible explanations including ultrasonic emitters – intended for eavesdropping – that produced audible tones that inadvertently may have harmed U.S. diplomats.

The incidents in Cuba targeted 24 government officials and their spouses in specific hotel rooms or private residences; some individuals reported that shifting even a few feet within the room made the auditory sensations cease. Medical examiners have recognized that, while these symptoms could come from viral infections, given the pattern of injuries it is likely the result of a “non-natural cause.” There are some technologies from the Cold War era that could be the source, and intelligence officials are investigating that possibility.

Given the similarities in the attacks and the lack of robust research and development efforts in Cuba, it is plausible that the technology was given to Cuba by the Chinese. China has recently become interested in non-lethal weapons, having developed a weapon known as the Poly WB-1, a long-range pain beam that can be used to break up protests or riots.

China has strong diplomatic and economic ties to Cuba, is Cuba’s number one trading partner, whereby Cuba imported $1.8 billion in goods from China in 2015; President Xi has visited Cuba on several occasions between 2014 and 2015. China has much deeper ties to Latin America and the Caribbean than 15 years ago; it is very plausible that China has military and intelligence links with Cuba. As recently as March 2017, China’s former Defense Minister, Chang Wanquan, met with Leopoldo Cintra Frias, Cuba’s Head of Revolutionary Armed Forces with the hope of improving military cooperation.

The U.S. expelled 15 Cuban Embassy officials – roughly 60 percent of the Cuban Embassy staff – after the 2016 attack, though the diplomatic positions of these individuals remain a mystery. Likewise, the U.S. pulled around 60 percent of its 54 personnel from the U.S. Embassy in Cuba, removing all “nonessential personnel.” The incident in China has not yet led to any expulsion of Chinese Embassy officials although, following these most recent attacks, Secretary Pompeo has called for a taskforce to investigate the possible causes.

Congress held a hearing on the incident in January. House Foreign Affairs Committee Chairman Ed Royce Edward (Ed) Randall RoyceThe 'extraordinary rendition' of a US Presidential Medal of Freedom recipient, 'Hotel Rwanda' hero Gil Cisneros to face Young Kim in rematch of 2018 House race in California The most expensive congressional races of the last decade MORE (R-Calif.) and Ranking Member Eliot Engel Eliot Lance EngelHouse panel halts contempt proceedings against Pompeo after documents turned over Engel subpoenas US global media chief Michael Pack The Hill's Morning Report - Sponsored by The Air Line Pilots Association - Pence lauds Harris as 'experienced debater'; Trump, Biden diverge over debate prep MORE (D-N.Y.) wrote a letter to the heads of the National Institutes of Health and the Centers for Disease Control, calling upon them to investigate the matter.

If these investigations prove what appears to be the case – strategic and deliberate hostile actions – then, clearly, much stronger action is needed.

These recent incidents follow decades of low-level harassment of U.S. Embassy staff overseas. Many U.S. diplomats in Cuba have reported incidents of suspicious behavior, invasion of privacy, poisoning of family pets, and other forms of harassment similar to attacks used in Russia on U.S. diplomats.

Given the continued provocations, it is time to admit that these governments see us as adversaries and are likely taking actions against us. China certainly does, given the recent leak of a Chinese memo in February revealing China’s aim to surpass U.S. military strength. Likewise, Cuba does not want normalization of relations; for many years the dictatorship under both Castros has aimed at protecting “the revolution,” and a recent speech by Cuba’s newly appointed dictator, Miguel Diaz-Canel, suggests he does not want normalization either.

We need to address this diplomatically and consider a variety of options, including possibly expelling senior Cuban and Chinese diplomats, until what are very likely purposeful attacks on our personnel stop. We cannot have a normal relationship if we are being abused. We should recognize that this is part of standard operating procedures of both countries, and we need to increase the consequences.

Daniel Runde is a Senior Vice President and William A. Schreyer Chair in Global Analysis at the Center for Strategic and International Studies. He previously worked for the U.S. Agency for International Development, the World Bank Group, and in investment banking, with experience in Africa, Asia, Europe, Latin America, and the Middle East.