Ilaria Capua flopped onto the couch of her brother's apartment in Rome. She stabbed at a bag of prepackaged salad, every cusp on her narrow face pleated in distress. She dreaded having to return to the parliamentary session after lunch and wondered whether it was worth the trouble, this political business.
Little more than a year earlier, in 2013, Capua, Italy's top avian influenza researcher, had taken a leave of absence as the director of the Division of Biomedical Science at the Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe) in Padua, to become a member of parliament. Capua was known as the Influenza Diva for her work developing a tool for differentiating between infected and vaccinated birds during two devastating avian flu outbreaks. Capua wanted to use her newfound platform to combat the country's uneasy relationship with science.
She opened her laptop. In her inbox was an email from a journalist at L'Espresso who wanted to know something about bird flu. She was well known for wanting to put genetic data about bird flu strains into the public domain to speed up the development of vaccines and treatments. In the case of Zika, Middle East Respiratory Syndrome and Ebola, information sharing led to the quick development of viable treatments. But something wasn't right. These days we are talking about Ebola, she thought to herself. Why would he want to know about bird flu? The first bird flu outbreak, caused by H7N1, started in 1999 and lasted until 2001. The second, caused by H7N3, occurred between 2002 and 2003. She had already spoken with a prosecutor in 2007 about something like this, but it had passed. Nothing came of it. The outbreak had sickened birds and at least seven poultry farmers. What could this guy want now?
Either way, Capua was eager to speak about her thoughts on furthering open science, on Italy's "brain drain" and mass exodus of researchers and their research funds (too much red tape at home), and on a number of initiatives she had planned to announce before the coming general elections.
She got on the phone and the reporter was instantly interrogatory.
"I'm writing a piece about illegal trafficking of viruses and vaccines," he said. "Do you know Paolo Candoli?"
Capua's vision sharpened and the world around her shrunk. Of course she knew Candoli.
"There is an investigation into the illegal trafficking of vaccines and viruses," he said, "and you are involved." The phone then went silent.
The story that was eventually published had all the ingredients of a biothriller: Scientists who trafficked in potentially dangerous viruses. Company executives who produced and sold an illegal animal vaccine. Corrupt government officials turning a blind eye. The Italian police report alleged that between 2000 and 2008, a "criminal organization" of more than 40 people colluded to profit financially from Italy's fight with avian influenza—and possibly even helped spread the disease.
The 400-page report, unpublished but obtained by Newsweek along with 1,300 pages of subsequent court documents, wiretaps and police reports, was the culmination of a 10-year investigation by the Italian Carabinieri.
The report detailed myriad transactions that included the two previous bird flu outbreaks, in which vaccines were allegedly illegally imported into the country and virus cultures were distributed among researchers without official approval. Further, the report alleged that Capua and her colleagues were seeking to make a profit off the vaccines being developed to stop an outbreak they had created. Candoli, with whom Capua often worked, was implicated in the case and the Italian military police began tapping his phone.
European Union regulations forbade the use of vaccines to bring avian influenza outbreaks under control, because vaccinated poultry can spread the virus without getting sick, making its spread invisible. Instead, outbreaks are usually stamped out by culling infected flocks, though Capua's technique would make it possible to vaccinate some birds in advance to prevent the mass cullings. The report said that Capua was responsible for "attempted epidemics": that she had worked alongside the pharmaceutical giant Merial and ignored the rules by producing an illegal vaccine against H7N1 in 2000 and selling it to Italian farmers eager to save their flocks. Police caught veterinarians administering the unregistered vaccine at a farm in Bagnolo di Sogliano al Rubicone, according to the report. The report quotes a wire-tapped phone conversation, years later, in which Paolo Candoli, a manager at Merial in Italy, asked a colleague "Did we buy it?" apparently referring to the deactivated virus to be used for vaccine development. "Yes, we did," the colleague said. "We bought it in Padua. We paid for it handsomely, as we did with all the strains we bought from her."
Candoli and his colleague were talking about Capua.
After the story was published, Capua and her husband, Richard, would go into their own "quarantine" for years as the prosecutor sat on the case. Her reputation was shattered. She left parliament. But she knew sharing deactivated viruses wasn't wrong. It wasn't illegal. More importantly, the virus strains the Carabinieri mentioned in their report were all wrong. Eventually the charges were dropped because of Italy's strict statute of limitations and because a judge felt the Carabinieri, the arresting Italian police force, had "built up accusations that are totally unfounded," and were "difficult to understand." That didn't matter. Her life would never be the same. She left Italy.
"We can't, as a community, kill scientists. That's what they tried to do," Capua told me. "Any one of the doctors now working on COVID could get involved in [a similar investigation]." She warned her cautionary tale went beyond the current pandemic, that future vaccines, for as yet undiscovered coronaviruses and other infectious diseases, depend on the sharing of viral sequences.
Capua's story and the race to find a coronavirus vaccine both illustrate how important open science is, but also how easily things can go wrong, either because the science is misunderstood—or because people are actually acting outside the contours of the law.
Open Science in the Time of COVID-19
The advent of the scientific journal can be dated to the Royal Society, founded in the 1660s as a learned society with the motto "take nobody's word for it." The open science movement, similar to the open source movement in technology that offers software and hardware specifications in a shared forum of transparency, enabled scientists and gave thinkers a basic tenant: the open dissemination of information which would be open to question, discussion, and advancement.
All results in the field of science must be repeatable. And the myriad scientific publications of today, including preprint servers which offer medical research before that research is peer-reviewed, have furthered that centuries-old idea of openness. In recent years, as the scientific community began operating in closed parameters, research and findings, methodology and data are kept secret for fear of duplication and lost revenues. Giving full access to something for free was the antithesis of early and late capitalism. And competition over who might create the next mass vaccine or scientific discovery meant security of information prohibited the open sharing of calculations, analysis and simulations to the scientific community and the general public.
"The worst situation would be, if when these tools are available, they go to the highest bidder—that would be terrible for the world," Melinda Gates, who along with her husband, Bill, supports health research to the tune of billions in charitable donations, told Politico in May. "COVID-19 anywhere is COVID-19 everywhere. And that's why it's got to take global cooperation."
She was addressing the fear that President Donald Trump might turn the race to a vaccine into a contest, that "America First" would incite death and facilitate the spread of the virus. Despite early efforts by Trump to secure exclusive "U.S. only" access to a COVID-19 vaccine developed by CureVac, the scientific community is witnessing an unprecedented moment in open science throughout the global coronavirus pandemic.
When the Wuhan health commission in China, where the virus is thought to have originated, released the complete genome of the virus on January 10, the blueprint touched off a wave of analyses and studies. In an interview with The New York Times, Melanie Ott, director of the Gladstone Institute of Virology in San Francisco, compared the current outbreak to the 1980s when AIDS was still new and unstudied. "A new virus, a rush to understand, a rush to a cure or a vaccine. What's fundamentally different now is that we have generated this community of collaboration and data-sharing. It's really mind blowing."
Anything on deadline is bound to be rushed. When lives, whether human or animal, hang in the balance there are certain to be errors. Open science allows for those errors to be a springboard to improvements and fewer mistakes by all. But sometimes those mistakes need to be reviewed, public entities held accountable.
And in the middle of her own epidemic, Capua found herself in the Italian judiciary's crosshairs.
The Case of The Virus Traffickers
Dozens of people were wrapped up in the investigation into whether the avian flu epidemic in the 2000s had been caused in Northern Italy by the scientists overseeing the spread and eventual containment. It is unclear why Capua became the figurehead of the case, as the lives of many were placed at risk. The timing of the investigation, when it first appeared in L'Espresso before even the courts informed those who were being investigated, was suspect: it had come nearly a decade after the epidemic, an investigation Capua and others had largely believed closed. It also came during Capua's first session in parliament.
(The journalist who first published court documents about the case, Lirio Abbate, and who initially provided Newsweek with partial copies of the court documents, did not make himself available for a follow-up interview.)
Capua moved to the U.S. to begin work at the University of Florida in the summer or 2016, two years into the investigation. On July 5, 2016, she had been in Florida for less than three weeks and felt the pull of home, questions unanswered as the prosecutors handled her case. She found it difficult to get a social security card, which she needed before getting her campus identification. She couldn't sit idle, busying herself with the dishwasher and setting place mats atop the breakfast table. She waited for the outcome.
The former secretary general of the Ministry of Health in Italy, Romano Marabelli, told me that he and several on his team were suspended. The labs where the viruses were tested were part of the investigation, too, including Capua's colleagues. Virus sharing, according to the World Health Organization, "is vital to global pandemic preparedness. The sharing of viruses facilitates pandemic risk assessment, the development of candidate vaccine viruses, updating of diagnostic reagents and test kits, and surveillance for resistance to antiviral medicines."
While Capua wasn't managing a global pandemic, she was managing the local spread of avian flu. She told me her case was a petri dish for what might follow in the wake of coronavirus, at least in Europe. "You realize this investigation into how the pandemic was managed could cripple the country," she said.
The case was eventually tossed out, the judge citing factual disparities in the case, as the virus the prosecutor had said was spread by the scientists was not the one that impacted the avian flocks in the north. The statute of limitations had also long expired. An investigation was opened into the prosecutor of the case, but he retired shortly after and no action was taken against him. A superior at the University of Florida in Gainesville, where Capua now teaches, confirmed the prosecutor and Carabinieri had mixed up the viruses in the case.
For Italian healthcare workers, including doctors, cleaners, ambulance drivers, and other medical professionals, operating during the pandemic, there is pervasive fear about making a misstep and facing a similar fallout, one that friends of Capua feel risks happening again.
"An investigation into public groups, and not only them, is always possible because we have many obscure and contradictory laws," said Carlo Nordio, who spent his career at the District Attorney's office in Venice and was familiar with the case. "There's always room to report them. For example, school principals are terrified, because if a pupil gets infected with COVID-19 they could be investigated."
So-called virus trafficking is regulated, with guidelines ensuring that the practice is conducted safely, but there have been recent charges brought in America which underscore the need for the type of scrutiny faced by Capua and her colleagues.
Zaosong Zheng, a Chinese national, was arrested on Dec. 10, 2019, at Boston's Logan International Airport and charged by criminal complaint with attempting to smuggle 21 vials of biological research to China. (Zheng was a courier for Dr. Charles Lieber, of Harvard, and a National Institutes of Health and Department of Defense grant recipient, who was under contract from the lab in Wuhan tasked with researching viruses like Covid-19.) The arrest comes a year after vials containing SARS and MERS were seized by U.S. Customs and Border Protection agents at the Detroit Metro Airport.
Those cases are still pending.
Circular Health and the Future of Collective Medicine
Capua is still a recurring feature in the European media for her calls to rein in government encroachment on data and science sharing. Furthering that idea, she is now working with the European Organization for Nuclear Research in Switzerland to develop an open access archive dedicated to COVID-19 where real time data from hospitals and healthcare providers can be viewed alongside available pollution, rain, humidity, and cell phone tracking data, providing, Capua hopes, a fuller picture of the outbreak and how it spreads. She hopes that database will be the foundation to develop similar tools for open science.
In August, Capua published the digital version of her book Circular Health: Empowering the One Health Revolution, a conversation with an Italian journalist on rethinking the way healthcare is managed around the world.
"We need to be both vigilant and proactive in defending the inherent values of science," she says at the start of the book. "We know that science continually moves forward, the latest breakthrough leapfrogging over the one that came before, showing that what was true yesterday may not be true today and may be completely contradicted tomorrow."
Capua told me that she hoped Circular Health would be a methodology that might help rebuild the world post-COVID-19. "It's not about tomorrow," she told me. "It's about starting to think in a different way. And the pandemic has accelerated that need."
She still seeks acknowledgement from the Italian government, hoping they'll own their mistake and clear her name. From our various discussions over the last several months, it was apparent that what happened had been like a cardiac arrest to her ontological security, something unexpected and never resolved, lurking always in her mind.
Her book (Capua has also written one, in Italian, about the case) described this feeling of unexpected prosecution and the devastation that it wrought with the removal of a medical writer hoping to take a closed circuit industry and make it accessible to all.
"Health," she says in Circular Health, "has one inherent, paradoxical characteristic: you tend to think about it when it's not there; you appreciate it most when it's gone."
Alessio Perrone contributed reporting from Milan.
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