Before Even Receiving a Name, Omicron Could Have Spread in New York and the Country https://t.co/vw8j9Fh6B9
— Carl Zimmer (@carlzimmer) December 5, 2021
They wore fluorescent wigs and capes with gold tassels. They arrived in knee-high white platform boots, and with feathered wings affixed to their backs. Dressed like their favorite characters, or just wearing street clothes, they packed into Manhattan’s main convention hall — some 53,000 of them — over three days in November to celebrate their love of Japanese animation shows known as anime.
In the crowd was Peter McGinn, a 30-year-old health care analyst in town from Minneapolis. He attended discussion panels, chatted with strangers about his anime podcast and, at night, sang karaoke with friends. After flying home, he learned that one friend from the convention — an anime fan from North Carolina — had just tested positive for the coronavirus. In the days to come, many more of his friends from the convention would test positive, as well. Coughing and feeling tired, Mr. McGinn also took a test. He had the virus, too.
That was Nov. 23, a day before most scientists had even heard of the new variant that was tearing across southern Africa. The World Health Organization had not yet even given the variant a name — Omicron. But it was already present in the United States, undetected…
Some municipalities, like New York City, and states, like Massachusetts, built out large-scale contact tracing organizations. Most of the U.S. population — 60 percent — is vaccinated. Just a few weeks ago, before Omicron was identified, there was widespread hope that the pandemic, in this country at least, was easing. People felt safe as they flashed their proof of vaccination — at least one dose was required for entry, consistent with the city’s rules — and streamed into the Javits Center for the convention.
But amid tens of thousands of new Delta infections in the United States each day, Omicron’s landfall and spread are easily hidden. Many coronavirus infections are asymptomatic or have only minor symptoms, slipping under the radar.
Indeed, it remains unclear if the anime convention was a super spreader event. “We haven’t found evidence of widespread transmission at the convention,” Adam Shrier, a spokesman for New York City’s contact tracing program, Test and Trace Corps, wrote in an email…
New Interview: I talked to Tulio de Oliveira about his lab’s role in discovering Omicron, the questions remaining about the variant, and travel bans on South Africa. https://t.co/cMJyHZTw9M
— Isaac Chotiner (@IChotiner) December 1, 2021
… When did you first have a sense of the existence of this new variant?
I am the principal investigator and leader of the Network for Genomic Surveillance in South Africa, which involves seven genomic facilities distributed across the country. There was an uptick of cases in Gauteng Province. It was only a small uptick—we had around two hundred cases in the whole country every day. But they started growing, and so we met with our network and said we needed to understand why they were growing in the province that had the largest previous wave of infections of Delta. That variant was extreme in Gauteng, with somewhere between sixty and eighty per cent of people having gotten infected by COVID, according to serology testing.
So on Friday, November 19th, we decided that we needed to increase genomic surveillance in Gauteng… When I noticed that mutated variant on Tuesday, I phoned the director general of health, and he told me he would set up a meeting with me and the minister of health in thirty-six hours. So we had thirty-six hours to confirm whether it was real. At the same time I wrote to the World Health Organization, because I am a part of the virus-evolution working group. The next morning, we got over a hundred samples from over thirty clinics in Gauteng, and we started genotyping, and we analyzed the mutation of the virus. We linked all the data with the P.C.R. dropout, the increase of cases in South Africa and of the positivity rate, and then we began to see it might be a very suddenly emerging variant. By Thursday morning we got all the genomes back, and they were all the same variant—around a hundred randomly selected samples, from all over Gauteng, in which the same test failed. By then I was confident enough to present the results to our minister of health, and minister of science and innovation, who took the results quite seriously and asked me to talk to the President, Cyril Ramaphosa, at half past 10 A.M., which I did….
Can you talk about the COVID situation in South Africa before this?
I would break it into two periods. The situation in the last month was of minimal infections, about two hundred infections per day with a test-positivity rate of less than one per cent, which means that we had more than enough testing. Some scientists thought we wouldn’t have a fourth wave because we had such a high level of population immunity. So during that moment in the last month, we thought that’s it. We won’t have any more problems with COVID. People were relaxed, thinking that we could go back to normal life. Even my lab was sequencing other pathogens and viruses because that is what we do.
So we were very surprised to see a variant emerge in a place with the highest population immunity in the country. I think that is one of the things that the world doesn’t realize. Some people tried to blame the variant on vaccine hesitancy. We have a problem with that, although potentially not as big a problem as the United States. But people really thought we got out of the woods. Unfortunately, the new variant emerged, and it seems clear that it can reinfect people, which is potentially the last nail in the coffin of herd immunity, which one of your Presidents famously talked about…
How has the vaccination campaign been going in South Africa, and do you connect the new variant to the slow speed at which many countries in Southern Africa began to get vaccinated?
The first thing to understand is that Johannesburg is what Atlanta is to the United States. It is our biggest travel hub. So we have no idea where this variant is from. It could be from South Africa, or it could be from anywhere else in the world or Africa. What we know is that it got amplified in South Africa.
I think it did not help at all South Africa or Africa to have such late access to the vaccines… We also had a massive supply problem until we gave up depending on COVAX from the W.H.O. and started procuring them independently. So they arrived far too late, followed by the third wave of infections. We have about twenty-five per cent of the population fully vaccinated, and that number has increased a lot. But, again, in countries like Botswana, they paid almost double the price for Moderna vaccines they have not yet received. So, in general, Africa got in the back of the queue of the vaccine.
So, I would be very reluctant to blame the problem on vaccine hesitancy, because that’s everywhere in the world…
Beyond the deaths & illnesses, the #Covid pandemic has triggered or worsened so many societal problems. A deeply troubling one is an increase in violence against women & girls, @doctorsoumya writes for @statnews. https://t.co/nPsJ4WRFeA
— Helen Branswell (@HelenBranswell) December 6, 2021
If we wanted to give the coronavirus an opportunity to circulate, adapt, and evolve, the best way to do so is to ignore the estimated 38.7 million people living with HIV, especially the roughly 10 million who remain untreated, @Laurie_Garrett writes. https://t.co/82LVn4rGXW
— Foreign Policy (@ForeignPolicy) December 4, 2021
… The evolution of potentially dangerous variants like omicron has been ensured by the wealthy world’s decision not to protect vulnerable populations outside its borders. Put simply, strategies rich countries have implemented to limit the carnage from COVID-19 inside their borders have not been mirrored at a global scale. In European countries, Canada, Japan, and the United States, for example, great pains have been taken to prioritize treatment and vaccination for people with weakened immune systems. But globally, one of the world’s largest concentrations of immunocompromised people—the untreated HIV-positive people of southern Africa—has been all but ignored…
If humanity wanted to give a coronavirus a golden opportunity to circulate, adapt, and evolve inside the bodies of human beings, eventually taking on a form that threatens all—rich and poor alike—it couldn’t do better than to ignore the estimated 38.7 million people living with HIV, especially the roughly 10 million who remain untreated, most of them residing in sub-Saharan Africa. In 2020 it is estimated another 1.5 million people were newly infected with HIV, almost 700,000 of them in eastern and southern Africa. More than 600,000 people died of AIDS-related illnesses around the world in 2020, while international attention was focused on COVID-19.
The great HIV/AIDS pandemic is rarely mentioned these days. Now that very efficient, minimally toxic, and inexpensive treatments are available, along with prophylactic drugs that can block infection altogether, HIV has become the out-of-sight, out-of-mind virus. But it’s far from disappeared…
In the United States, meanwhile, access to testing and treatment for HIV is remarkably lower among African American and Latino men, accounting for their higher death rates due to HIV and possibly some of the racial disparity in COVID-19 mortality. From March to September 2020, in the early months of the COVID-19 pandemic and well before vaccines were available, the number of HIV tests at a single major lab plummeted by more than 600,000, and the number of viral load tests performed to monitor HIV-positive patients’ treatment fell by more than 60,000. Gay men of color were most effected by the downturn in access to HIV testing and treatment in America, according to an October study: “People with HIV in the USA, particularly those with pronounced immunodeficiency, seem to be at elevated risk of COVID-19 hospitalisation and mortality. The exacerbated COVID-19 outcomes in Black or African American and male people with HIV suggest profound health inequities faced during the COVID-19 pandemic.”
A Spanish study also found higher death rates in HIV-positive men in most of 2020. A study from February through June 2020 found that it’s possible HIV-positive Black men in Britain were also more likely in to suffer severe COVID-19 and to die of the disease if infected…
But there are still more than 10 million people in poor countries who carry HIV and either do not know it or refuse to seek care because of the tremendous stigma attached to being HIV-positive. Millions more suffer periodic treatment interruptions due to stock-outs of local drug supplies or their inability to get transport to a clinic or dispensary. Lockdowns and supply chain issues related to the COVID-19 pandemic have severely exacerbated these problems. It is estimated that 296,000 people in sub-Saharan Africa could die as a direct result of HIV treatment interruptions and exposure to COVID-19. “A chilling pattern of inequity shapes the burden of COVID-19 and HIV,” the British medical journal the Lancet said in November 2020…
Hong Kong needs to persuade Beijing to let it move forward by changing its zero-Covid strategy to living with the virus, according to Prof Keiji Fukuda, a leading epidemiologist and outgoing head of the city’s top public health school – @SCMPNews https://t.co/VbI0TH044N
— Jerome Taylor (@JeromeTaylor) December 5, 2021
“The consequence of having few cases is also that Hong Kong is relatively isolated, and there are so many people unhappy about the travel restrictions, about the quarantine restrictions, and you can see that many businesses have really suffered.”
— Jerome Taylor (@JeromeTaylor) December 5, 2021
Fukada also confirms what many of us suspected but which HKU never confirmed — that the non-renewal of his contract came as a surprise to him. He also says he was given no reason for why such a well qualified disease expert was being let go in the midst of a flock pandemic.
— Jerome Taylor (@JeromeTaylor) December 5, 2021
The Pale Scot
That’s one treason statue that should stay up, it’s so ridiculous
Felanius Kootea
Have there been any omicron deaths so far?
NotMax
Does Melania own a coat sporting the message “Delta Is Ready When U R”?
Asking for a friend.
delk
Inexpensive? The pill I take is $3,800 a month.
Roger Moore
@Felanius Kootea:
IIRC there have been, since there is early work comparing it to other variants in terms of how deadly it is. IMO, all that needs to be taken with a few kilos of salt. Not only is it too early for a lot of the infected people to die, there are reasons to think it is infecting a population different enough from other variants that the comparisons aren’t necessarily valid. In particular, if the vaccines are partially effective against it, it may produce a lot of comparatively mild breakthrough infections.
raven
@Felanius Kootea: Fauci says it’s way too soon to tell.
eclare
@delk: Holy shit!
trollhattan
Omicron was surely in the States before it was even identified. My county has yet to find a case, but it seems unlikely to not present itself. For now, Delta is the predominant edition at 10x.
Covid cases in hospitals have taken a slight uptick but not ICU cases, which might indicate vaccinations are at work or perhaps because treatment has improved too. We’re not following last year’s holiday spike, at least so far but there’s a month to go.
debbie
@delk:
A generic isn’t available?
Felanius Kootea
This excerpt from the New Yorker interview with bioinformatician Tulio de Oliveira struck me:
I was happy to find out that Tulio de Oliveira is a graduate of the Nelson Mandela School of Medicine at the University of KwaZulu Natal in Durban. I taught a short course there (when it was just called the University of Natal) almost 20 years ago as part of an NIH Fogarty grant. Glad to see that their genomic surveillance program is so strong.
Edited for clarity.
eclare
Two border states to West TN have reported cases. If it isn’t here yet, it will be soon.
delk
@debbie: nope. Some of the other drugs I have taken through the years were more expensive.
hells littlest angel
That is one brilliant opening to an article about an outbreak of disease. No wonder it took four writers to churn it out.
debbie
@delk:
I was googling around, and yikes. Guess I need to stop complaining about the price of inhalers.
frosty
Two pandemic posts in a day, AL? You’re making up for the Thanksgiving break aren’t you?
SiubhanDuinne
My brother is back in the hospital (he was there for about three weeks in November with Covid). They sent him home with 24/7 oxygen and a bunch of antibiotics. He has covid, pneumonia, emphysema, and a bacterial infection all vying for supremacy in his lungs. He also had a nasty infection on his arm where they had left the IV for days on end without cleaning it or changing it out. And near the infection site, he developed a small blood clot, which they said was superficial.
Well. This morning he was so short of breath he couldn’t walk from his bed to his dresser. When he got to the hospital, his blood oxygen level was 78. And the “superficial” blood clot had migrated and settled in his lung. He’s on blood thinners now, and his oxygen levels are back up, but what a clusterfuck.
Jesus.
eclare
@SiubhanDuinne: Oh God, I’m so sorry. I’m glad he’s back in the hospital and that his oxygen is up.
How is your other brother?
trollhattan
Speaking of things medical, binged “Dopesick” the last couple evenings and it’s a, superior television and b, not the least bit easy to watch. I felt as though I was watching the two young men I know who succumbed to this epidemic on the screen alongside the actors. Michael Keaton is a treasure.
“Loved” Rudy Giuliani showing up to do his Rudy thing on behalf of the Sacklers.
eclare
@trollhattan: Thanks for the review, I plan to watch it this month.
Michael Keaton is a wonderful actor.
trollhattan
@SiubhanDuinne:
When it rains it floods. Or somesuch. Hope they can untangle that enormous medical puzzle!
Peale
Ugh. So CNN and NBC are running with an alarming “Pfizer vaccine 41 fold less effective against omicron.” Headline. Based on a lab study of 12 samples. Then trying to explain that Its has milder symptoms by touring a hospital in which the symptoms do not appear to be mild. It really gives no proof that the hospitalized patients are all omicron. And while only 1/3 of the patients are in the ICU, that number seems actually quite high. They want to say that the symptoms are nausea and headaches without the loss of smell and taste, but report that many of the patients are on oxygen, which doesn’t seem like a treatment for a head cold.
anyway, I’d rather they just not report anything even if we’re anxious to know.
Dorothy A. Winsor
@SiubhanDuinne: OMG, how scary. Cripes. Who do you trust?
The Pale Scot
@SiubhanDuinne:
WTFFFF!!
I’ve had many courses of AB, the crew was paranoid about the IV line being clean
Matt McIrvin
@Peale: God, this is a case where you can actually find better news sources on Twitter.
debbie
@SiubhanDuinne:
This is a very scary disease, especially when lungs are already compromised. Glad your brother’s rallying and hope that continues.
Sure Lurkalot
@Peale: This is why I don’t understand the policy about free rapid tests. Yes, those who resist mitigations won’t use or heed them and their accuracy isn’t perfect, but if all who would use them tested themselves 2x per day it seems a lot of infection would be detected leading to more conclusive testing, less asymptomatic spread and better treatment outcomes.
SiubhanDuinne
@eclare:
@trollhattan:
@Dorothy A. Winsor:
@The Pale Scot:
ETA: @Debbie
Thanks, all, for your concern. It’s been an exhausting several hours. From what I understand, the hospital has been understaffed and overwhelmed for months, and unfortunately the patients end up paying the price for the resulting oversights and carelessness. I can’t remember the name of the hospital, but it’s the only one in Prescott, AZ. Anybody familiar with it?
Eclare, thanks for asking about Other Brother. He seems to have recovered well (which, of course, just reinforces all his wrongheaded beliefs about vaccinations). Forgive me, I’m still feeling a bit crabby about all this.
eclare
@SiubhanDuinne: It would be understandable to feel stabby about this. I hope your brother gets the help he needs.
Keep us posted.
stinger
@SiubhanDuinne: How awful. I’ve no doubt the hospital is understaffed, but that lack of care seems criminal.
Best wishes for him.
Yutsano
@SiubhanDuinne: Brookhaven Medical Centre? Never heard anything of it personally. The IV infection alone is a lawsuit waiting to happen, not to mention (unfortunately) he sounds nowhere near condition for discharge.
eclare
@SiubhanDuinne: I wonder if there is any way to get him to Phoenix? Apologies if this has already been considered.
raven
@Peale: I see no such headline on either site.
SiubhanDuinne
@Yutsano:
Nope, that’s not the name — unless the hospital has recently changed its name. It’s a name I don’t know how to pronounce.
ETA: How are YOU doing??
raven
@Dorothy A. Winsor: Did you know Sabrina Orah Mark in Iowa City?
raven
@Yutsano: Get the shot?
SiubhanDuinne
@eclare:
Our niece is in Phx — she’s Steve’s medical power of attorney and is prepared to haul him to the Valley if necessary. He wants to remain close to his home. Don’t know how that’ll sort out.
raven
@Yutsano: I saw your previous post, sounds good. I don’t get mine till Jan 5.
eclare
@SiubhanDuinne:
I’m glad to hear you have someone on the ground there ready to act if necessary.
Suzanne
@SiubhanDuinne:
Yep. I did multiple projects in it. Yavapai Regional Medical Center.
Best wishes for your brother, and for you.
Old School
@SiubhanDuinne: Here’s hoping your brother continues to improve.
Suzanne
@SiubhanDuinne:
Yavapai is pronounced “YEAH-vah-pie”.
I lived in Yavapai Hall for my freshman and sophomore years of college.
Yutsano
@SiubhanDuinne: @raven: I’m in that blessed 24-48 hour window when the Lidocaine is doing its magic. The actual steroid can take up to two weeks to kick in. I just hope I’m not a stinky mess tomorrow at work. No shower for 24 hours.
raven
@SiubhanDuinne: Not very good reviews.
Suzanne
@SiubhanDuinne: YRMC is a pretty good hospital. I don’t think he’s likely to get better care in PHX. If they’re understaffed in Prescott, they’re prolly understaffed in PHX.
raven
@Yutsano: Huh, they said to just show up and get it!
raven
@Suzanne: One of the google reviews
SiubhanDuinne
@Suzanne:
That’s the one, thanks!
Suzanne
@raven: There’s negative reviews of every hospital, including the best in the country. The healthcare system in the country is deficient and it has predictable results. I have never seen any actual data that indicates that YRMC has better or worse patient outcomes than any other community hospital.
OTOH, I have a list of hospitals I won’t go to.
SiubhanDuinne
@raven:
Wow, can you send me a link to that please? I need to make sure my niece has it in her back pocket when she does battle with them.
SiubhanDuinne
@Suzanne:
Thank you! I certainly trust your assessment, your professional judgment, and your own experience; but when Steve was in previously, my niece couldn’t get anyone on his medical team to return any of her calls, for days running, although she was listed as primary contact for him. And given the cavalier way they handled the IV infection and the blood clot, I’m concerned about quality of care.
raven
@SiubhanDuinne: I googled Yavapai Regional Medical Center and info on the right side of the page included 141 google reviews
eta What I meant to say is that there in no actual link to send.
raven
@Suzanne: I was surprised as well. People bitch and moan about the VA all the time but I’ve had good experiences.
Suzanne
@SiubhanDuinne: Follow your instincts! Like I said, there’s no data that I have seen that would suggest that they are worse-than-average or anything (and I look at this stuff a lot), but family involvement can only help. The system is so broken that it’s critical to be a good advocate for yourself or your family.
FWIW, last time my mom was hospitalized in PHX, I couldn’t get staff to return my calls, either, and I was also her contact. It sucks. The standard-of-care leaves much to be desired.
raven
@Suzanne: I’ve had a couple of experiences where I had my “unknown caller” on and couldn’t get a return call!
SiubhanDuinne
@raven:
Thanks. I’ll find it.
FlyingToaster
@Sure Lurkalot: Once a day is plenty, honestly.
The Weekly PCR pooled test is standard in MA schools, though for many schools it’s a survey test (testing 1/4 or 1/3 of the students weekly). A case in a class means that a) that kid gets sent home b) every kid in that gets an antigen test every morning before they can be admitted c) any positive antigen test gets a PCR swab and the kid is sent home on the spot.
We had a grade sent home for 2 weeks in November when their Monday Pool Test turned up positive; all kids given antigen tests Tuesday am and 2 were positive; ditto Wednesday with 2 more positive (and the individual PCR tests showed those 4 positive). Whole class sent home that afternoon, with 2 weeks of Zoom School Hell and daily antigen tests. And the 4 kids recovered, no further spread.
Mandates work better than anything else. Our school requires everyone to be tested, and all adults to be vaccinated.
Suzanne
@raven: There’s a lot of research on patient satisfaction in healthcare and most of what makes patients satisfied doesn’t actually have to do with the actual health care delivery part. It’s things like wait times, quality of food, the niceness of the shower, how quiet the facility is, how big their room is, how polite the nurses and doctors are. This is why I look for data. I read about a specialty heart hospital getting poor patient satisfaction scores on their food, and it turned out that lots of their patients were giving them crappy scores because they were pissed that they weren’t being served burgers and French fries.
Steeplejack (phone)
.
raven
@Suzanne: When I had surgery in June I had to lie flat on my back for 24 hours. The morphine had no effect on me so having this HUGE clock right on the wall in front of me really sucked!
Gin & Tonic
@Steeplejack (phone): Good to hear you’re out and back home. Just a suggestion that maybe we don’t need *quite* the level of detail you’ve been providing, though
ETA: now this comment seems to refer to nothing.
Gin & Tonic
Boy, things are really looking up for Chris Cuomo. CNN terminated him, now saying without severance, Sirius/XM canceled his show, and Harper Collins punted on his upcoming book.
This is my sad face.
trollhattan
@raven:
“Can’t wear glasses? NO PROBLEM YOU WILL ALWAYS KNOW WHAT TIME IT IS ANYWAY.”
Criminy
trollhattan
@Gin & Tonic:
“Cuomo Co-Cratering Causes Cuomofreude”
eclare
@Gin & Tonic: And wasn’t that book titled something like Deep Denial? Quite the irony.
Steeplejack (phone)
@Steeplejack (phone):
(Oops, edit fail.)
Post-op report:
Woke up about 5:40, got processed out of the med center and got back to Sighthound Hall about 7:00. Had Thai food with a Tylenol + codeine chaser. Getting into the “Ow! my balls!” zone. ? But the Tylenol+ is starting to work too.
Found a semi-comfortable (i.e., not actively painful) reclining position on the couch, and I’m trying to convince myself that I’ll be even more comfortable if I go upstairs to bed. Nutsack saying that the imagined improvement could be the enemy of the “It’s not so awful here, actually.” Negotiations continue.
. . . Oof. Just sat up to reach my glass on the coffee table—very bad move. Nutsack may have a point.
But the operation is behind me now, and it’ll get better from here. Thanks for all of your comments.
NotMax
@Steeplejack
Thailenol treatment?
;)
Ohio Mom
@SiubhanDuinne: When a loved one is in the hospital, I think their family member(s) can’t really advocate for them unless they are there, camped out in the room with the patient.
The medical staff (doctors, nurses,respiratory therapists, PTs, etc.) drops in at odd, unpredictable times, and that is when you can ask questions and bring up any concerns. You find out all sorts of tidbits. Plus, I suspect that seeing that a family member is present puts them on their best behavior.
So my suggestion would be that if it’s at all possible,for your niece to make the schlep to Prescott, if even only for a day or two.
trollhattan
@Steeplejack (phone):
Sounds like progress, congrats on the successful escape from Big Hospital. Although, will point out the operation is literally in front of you. ;-)
eclare
@Ohio Mom: When my mom was in the hospital a few years ago, someone here (MomSense?) said there were two places where you absolutely needed an outside advocate: a hospital and a prison.
Ohio Mom
@Steeplejack (phone): I am not sure what the doctors did to you but whatever it was, wishing you a speedy recovery.
If you have a moment where you think things are not going to plan, do not think twice about calling the phone number they gave you with your discharge instructions. That is what they are paid to do (and paid well to do it), answer phones in the middle of the night.
Good Luck!
Ohio Mom
@eclare: That’s MY joke! That was me!
eclare
@Ohio Mom: I got the Mom part right! That saying made an impression and gave me a much needed laugh at the time.
Steeplejack (phone)
@Ohio Mom:
Removal of cyst(s) from my goonaidal region.
Thanks for the reminder!
Steeplejack (phone)
@Ohio Mom:
Story started here.
eclare
@Steeplejack (phone): The worst is over. Try to take it easy as best you can and follow drs orders.
Hope you are snoozing now.
smedley the uncertain
@debbie:
Yeah, my wife takes a Trellegy$$$ daily; Ouch. They offer a discount so long as your not part of a Government program. Medicare and our Federal retirement program eliminates us. Nice gimmick.
Steeplejack (phone)
@SiubhanDuinne:
Oh, jeez, S.D. My condolences. ?
Steeplejack (phone)
@SiubhanDuinne:
Yavapai Regional Medical Center? Everybody wants to be a medical center these days not a mere hospital.
Ohio Mom
@eclare: I am glad my old joke eased a moment while waiting in the ER. I’ve long had a vague memory of a Juicer accompanying her mom to the hospital but did not remember your nym or any of the details.
What other blog community keeps its members company in the hospital?
frosty
@SiubhanDuinne: I’m late to the thread and I’m very sorry to hear about your brother. I just started reading Timothy Snyder’s Our Malady which starts with horrific hospital stays where he’s misdiagnosed, sent home, lather, rinse, repeat. Your brother’s experience sounds similar. I hope your niece can be an advocate for him.
Dirk Reinecke
@delk: In South Africa after civil society (Treatment Action Campaign) waged a campaign against the ANC government anti-retrovirals were made availlable cheaply.
It seems the average cost is around $10 a month. Source