Olin is silent for a few moments. “I have come to agree with you.”

“About?”

“What you said earlier regarding the security threat,” Olin says. “No question. The recurrence of the medieval plague in Europe poses a potential threat to the NATO alliance.”

“Even if no terrorists are involved?”

“Regardless.”

“I feel badly for sounding the alarm,” Alana admits. “If I hadn’t pushed so hard on Yasin Ahmed’s disappearance . . .”

“Then three terrorists would still be free to bomb Genoa.”

The justification isn’t enough for Alana. “But Yasin was innocent. And the backlash against the Muslim community is real, Monique. Someone tried to burn down a mosque. And there are people, politicians even, who are calling for their expulsion.”

“Fear makes people irrational. Always. The best way to combat it will be to eradicate the plague.”

“I suppose.” But Alana doesn’t feel particularly reassured.

“What else do we know about the construction site?”

“Aside from the fact that a group of Zanetti’s workers conspired to hide the probable first victim of this plague?”

“Yes.”

“Not much. But, Monique, that old monastery they demolished . . . it somehow ties this whole outbreak together.”

“Then you had best figure out how.”

“Good advice. Any other helpful ideas?”

“Alana, I chose you for a reason.”

After she hangs up, Alana texts Byron to inform him of the developments. Although it’s barely five o’clock, he texts back immediately. He is aware of the case in Rome and asks her to meet him at the Ospedale San Martino.

Two hours later, Alana and Byron cluster together with a group of doctors, nurses, and other public health officials in the ICU. Every room in the unit is occupied by at least one ventilated patient, and some house two. It speaks to the impact of the crisis on the local health-care system that the ICU has had to admit multiple patients to the same room, an extremely unusual occurrence for a First World hospital.

Despite the relative silence, the atmosphere is charged. Alana senses that the staff are nearing the breaking point. No matter how many patients recover or die, more arrive by the hour to overwhelm them. It must feel as unrelenting and unforgiving to the medical staff as it did for the doctors and nurses in West Africa at the peak of the Ebola crisis.

An alarm wails from the room across from Alana. She watches through the window as someone applies electric paddles to the chest of the patient inside. The man’s body jerks off the stretcher from the defibrillator’s shock. But it doesn’t work, and someone else begins to perform CPR. One of the doctors in their group peels away to help, but the others ignore the alarm. Even Alana is numb to the sight of another plague-induced cardiac arrest. Is this what it has come to? she thinks.

Byron grabs Alana’s elbow and gently pulls her back from the others until they’re out of earshot. In the room beside them, she notices another patient connected to a ventilator, but his head is bandaged and his arm is wrapped in a fiberglass cast from his fingers to well above the elbow.