Secretary of Defense Lloyd Austin
© Maya Alleruzzo/APSecretary of Defense Lloyd Austin speaks in Tel Aviv, Israel, on Dec. 18, 2023. On Friday evening, A DOD spokesperson announced that Austin had been hospitalized since Jan. 1.
The news came as a shock to top staff, including national security adviser Jake Sullivan.

The Pentagon did not tell President Joe Biden and other top officials about Defense Secretary Lloyd Austin's hospitalization for three days, three U.S. officials said.

National security adviser Jake Sullivan and other senior White House aides didn't know of Austin's Jan. 1 hospitalization until the Defense Department sent over word Jan. 4, two other U.S. officials said. Sullivan informed Biden shortly after DOD's Thursday notification.

The officials said it was highly unlikely that Austin conveyed word to Biden privately before Sullivan's briefing. "If Jake didn't know, no way the president knew," one of them said. "Who would have told him of Austin's condition if not Jake? And if someone did tell the president, Jake would've been his first call."

All officials and other people who spoke for this story were granted anonymity to discuss a sensitive issue.

Biden held a "cordial conversation" with Austin on Saturday night, per one of the U.S. officials. "The president has complete trust and confidence in Secretary Austin," the official said. A National Security Council spokesperson echoed that sentiment, noting Biden "is looking forward to [Austin] getting back to the Pentagon."

But the news of Austin's situation came as a shock to all White House staff as they were unaware the Pentagon boss was dealing with complications following an elective medical procedure, the officials said. National Security Council staffers were surprised it took the Pentagon so long to let them know of Austin's status. The Pentagon didn't make the information public until Friday evening, notifying Congress about 15 minutes before releasing a public statement.

"This should not have happened this way," said one of the U.S. officials. The NSC and Pentagon declined comment.

In a Saturday statement after an earlier version of this story published, Austin said, "I could have done a better job ensuring the public was appropriately informed. I commit to doing better. But this is important to say: this was my medical procedure, and I take full responsibility for my decisions about disclosure."

Chuck Hagel, the former senator who served as defense secretary during the Obama administration, said the Pentagon absolutely had to let the NSC know about Austin's condition and whereabouts. "The NSC is part of your team, it's part of the family," he stated during a brief interview. "The president has to know where his Cabinet members are at all times."

Sen. Tom Cotton (R-Ark.), a member of the Senate Armed Services Committee, said in a statement that Austin " must address promptly" why the White House wasn't informed of his hospitalization for days. Sen. Roger Wicker (R-Miss.), SASC's top Republican, called Austin's silence "unacceptable" and demanded a briefing on the matter.

NBC News reports that Austin spent four days in the intensive care unit.

On Friday evening, as many people were turning toward their weekends, DOD spokesperson Maj. Gen. Pat Ryder announced that Austin had been hospitalized since Jan. 1. His deputy, Kathleen Hicks, partially assumed some of his duties from Jan. 1 until Jan. 5, when he resumed his full duties, according to one senior DOD official.

But Austin's hospitalization was a closely guarded secret, kept from even senior Pentagon officials and congressional leaders until just before the public statement, according to nine DOD officials and two congressional aides. Some Pentagon officials only learned of Austin's situation through Ryder's news release. One of the DOD officials said their office was told by Austin's aides that the secretary was working from home for the week.

The delayed news four days afterward — and the fact he'd relinquished some of his duties as Pentagon chief - was met with outrage by members of the press Friday. But the frustration extended beyond the fourth estate to the Pentagon's E-Ring and the halls of Congress.

"The vast, vast majority of leaders were unaware," said one U.S. official.

Austin's hospitalization comes at a tumultuous time for the military, as U.S. forces face near daily attacks from Iran-backed proxies in the Middle East. On Thursday, U.S. forces killed the leader of a terrorist group in Iraq targeting American personnel in the Middle East. Austin, along with the president, approved the strike before his hospitalization, said the senior DOD official.

There is no standard protocol for when to announce a defense secretary's hospitalization or temporary inability to do the job, said Brad Carson, formerly under secretary and chief management officer of the Army, though he added it could depend on the severity of Austin's condition. If Austin were incapacitated, Congress would surely want to know. But if he were still capable of making decisions, even under a doctor's supervision, "I don't think Congress has to be notified in such cases."

Still, when Gen. Eric Smith, commandant of the Marine Corps, was hospitalized after a heart attack Oct. 29, for example, DOD put out a statement within hours.

"It is so out of character for DOD and clearly was made after a deliberate discussion of how this information should be handled," said Arnold Punaro, a retired Marine Corps major general and former staff director of the Senate Armed Services Committee.

Hagel said DOD may have had a good reason to keep Austin's hospitalization quiet for a time, but he still said keeping mum for so long was the wrong call. "You've got to always play it straight with the media. It's all about trust," he said. "If I were incapacitated or in the hospital for any length of time, I would have instructed our people to be straight with the media and let the media know."

Across the river on Capitol Hill, congressional aides also expressed frustration that they had not been informed until Friday night. One aide said the relevant congressional committees were informed about 15 minutes before the Pentagon released the information publicly.

The Pentagon Press Association called the failure to report Austin's condition and hospitalization "an outrage."

"The public has a right to know when U.S. cabinet members are hospitalized, under anesthesia or when duties are delegated as the result of any medical procedure. That has been the practice even up to the president's level. As the nation's top defense leader, Secretary Austin has no claim to privacy in this situation," the group said in a Friday statement.

Ryder explained the delay Saturday: "It was an evolving situation, in which we had to consider a number of factors, including medical and personal privacy issues."

Austin is known for his privacy and has often shunned the limelight as a four-star general and now as Pentagon chief. While he engages the press, he is averse to speaking with the media regularly, preferring to maintain his influence within the administration by staying out of the headlines. That strategy has worked well for him, as he's kept President Joe Biden's confidence and is viewed as a key figure in maintaining Western support for delivering weapons to Ukraine.

While Austin remains hospitalized, the U.S. is working through options for responding to attacks by Iranian-backed militias across the Middle East, POLITICO reported this week.

Several American destroyers are currently in the Red Sea, where they have shot down dozens of attack drones and ballistic missiles launched by Houthi rebels. In Iraq and Syria, U.S. ground forces have also fended off over 120 missile and rocket attacks.