We first simulate viral status \(Z\) assuming \(Z\sim Bernoulli(p)\) with \(p=0.25\); and then conditional on \(Z\), simulate \({S|Z=z}=ceiling(W)\) with \(W\sim Gamma(\eta_z,\kappa_z)\) where \(\eta\) and \(\kappa\) are shape and scale parameters.\((\eta0,\kappa0)=(2.3,80)\) and \((\eta1,\kappa1)=(9.2,62)\).