It has been an inordinately long time since I last posted to my website. A lot has happened. In early July I travelled from Durban to Cape Town for a few days, seeing friends and staying with Derek and Lynn (my brother and wife). On Sunday 10th July I flew from Cape Town back to Norwich via Amsterdam. By Thursday I had a scratchy throat, headache, cough, and a metallic taste in my mouth. A day later I tested positive for Covid-19. The virus I had written so much about got me! I was not seriously ill, but it was not pleasant. I am convinced I was infected in an airport or on a plane.

I was due to travel to Montreal for the International AIDS Economics Network (IAEN) meeting ahead of the International AIDS Conference on Monday 25th July. Although I do not believe I was infectious, travelling seemed unwise. I was very relieved to consistently test negative in the days before I flew. At one point I thought my attendance was in doubt which would have been difficult for my colleagues as we were co-organising a meeting.

Covid-19 is a horrible disease. I had two vaccinations and a booster, but it did not stop me getting the virus. At no point did I feel my life was threatened, and indeed the new, essential, bit of medical kit, a pulse oximeter, indicated that my blood oxygen levels remained high. I was lucky I think, but the cough is taking ages to disappear. It is still annoying, especially at night. Thank heavens for the vaccinations. Interestingly, at the conference, when I revealed I had just had Covid, more than half the people I was speaking to said, “oh so have I”. It seems there has been a pandemic wave which, because it did not kill or hospitalise most people, has not been recorded or noted. Interestingly the other members of the household in the UK remained well! The conference may well have been a super-spreader event.

My reflection, having had the disease, is that it is probably impossible to avoid infection. Certainly, international travel, airplanes and airports mean one is very likely to be exposed, despite wearing masks (which was not mandatory for passengers on the flight to Europe). However, if people have been vaccinated, they should not get seriously ill. It can be treated with a range of drugs. A friend I saw at the conference, who took the medicine, warned that this seems to lead to a rebound positive test a few days later. I really hope vaccinations plus infection will ensure a degree of immunity for a decent time, but I don’t know if this will be the case.

It is over two decades since the first meeting of the IAEN was convened in Durban and I was involved from the very beginning. The Network generally held two-day meetings ahead of the International AIDS Society’s biannual AIDS Conference. In 2020 a virtual meeting was held in conjunction with the San Francisco conference. In Montreal we had a ‘hybrid’ meeting, as they are now called, with a mix of in person and virtual presentations.

Our meeting faced a number of challenges. In the past we raised sponsorship for scholarships and partnered with local academic establishments to save money on room hire. We were not able to do either this year. In addition, many potential participants from the developing world were unable to obtain visas in time for the meeting, indeed the senior Canadian government minister who was expected to attend did not. We suspect he knew he would be heckled and did not want the confrontation or the bad press that would follow. This lack of support was covered in the Canadian press, not that it will make any difference. Despite all this we were delighted to have 60 people in the room and present a full programme of research.

Montreal is a delightful city and I enjoy it, although we did not have very much time for sightseeing. Initially I stayed in the hotel my colleague booked us into. I won’t name it here though. It is a family hotel, run by Taiwanese immigrants, right on the edge of the red-light area. There is a hard to find door on the street that leads up to the reception area and then there were two floors of rooms. These were adequate but in need of renovation and redecoration. The reception was not staffed all the time, not that it made much difference since most people who appeared behind the desk did not speak very much English. I had to resort to the standard English practice when faced with this: speaking loudly, slowly and clearly and using mime. As I left one midday there was a couple checking in, without luggage. This led me to speculate that the rooms may be let for periods of less than a night. I found an unopened package of condoms on the floor next to my bed which tended to confirm this supposition.

I had been unable to get accommodation in this cheap hotel for the entire period, so ended up moving to an anonymous, but very standard, Travel lodge style hotel. This was nearer the conference centre, so it suited me. This hotel even had a gym, an amenity I would have used religiously until quite recently, indeed I found it marginally worrying that I did not feel guilty about it. Mind you the ‘Palais de Congress’ is a vast building, as a result I had no difficulty in managing my 10,000 steps per day. Unfortunately, I also kept up my wine intake.

This blog was partly written on the train from Montreal to Toronto, a journey of just under six hours. The train was late! I ended up in a carriage with two Chinese families in the seats in front of me. One mother was travelling with two children, about five and two. She brought their own food, and it was interesting watching the littlest one using chopsticks, she had about as much skill as I do. Obviously, this is a skill which has to be learnt rapidly. She spent a happy half an hour playing with her facemask and then moved on to sticky sweets! The journey is not particularly interesting, scenic, or fast! But trains are comfortable and environmentally friendly and the connection to Kitchener is good.

It was fantastic to connect with so many old friends and colleagues. One I only bumped into on the last day. Mitchell Warren heads up AVAC. I first met him when he was starting his career in Durban. I was able to tell him that I thought of him and his family frequently in Durban, my walk to the Glenwood Bakery takes me past the house they lived in. He was amused and pleased to learn this. The South African contingent was sizable and very present. I was told there were over 30 Swazis there, but I only met one. In the past we would have organised a meeting of Swazi researchers, but I failed to do this, largely I think because of travel and not being very well.

We did however manage to publish a special issue of the African Journal of AIDS Research on ‘AIDS in the Time of COVID’. This was thanks to superhuman efforts by the editorial team in Grahamstown, and the fact that authors and reviewers were responsive to the deadlines. Inevitably a few articles simply did not make it, so we will mop them up with a special section in the next issue, assuming, of course, that they get through the peer review process. I was delighted that we were able to produce such a timely issue with the support of UNAIDS. Even more pleasing is the fact that it is open access, anyone can look at it and download the articles, including anyone who reads this blog!