At the Games For Health conference in Baltimore, epidemiologist Nina H. Fefferman, Ph.D of Tufts University and Rutgers University spoke on the difficulties in modeling disease origins and control, and how examining MMO populations could solve some of the problems inherent with more traditional models, joking that that she was going to "use gamers as my 'guinea pigs.'"



She started off by listing the three general models currently used to study disease control: compartmental models, network models, and agent-based models. Each has its own strengths and weaknesses, but the principle problem is that all three make significant behavioral assumption - and people are hard to predict. As Fefferman pointed out, they may stay home from work during an epidemic, or they may not; they may self-quarantine for fear of exposing health workers.



"During the anthrax scare, people acted irrationally, asking for smallpox vaccines," she pointed out. "You can't convince people on these things."



An Outbreak Of Corrupted Blood



A fascinating - and completely accidental - case study occurred in 2005 within Blizzard's World of Warcraft, which at the time hosted some 6.5 million players of diverse age and background. Issues of race, gender, and seniority issues are built in, since the players are real people, and the world is highly social, with real-world factors such as transportation, working together, and friendships arising as a result of game mechanics and player groupings such as guilds.



One of the game's bosses infected players in his immediate vicinity with a disease called "Corrupted Blood," intended merely as a short-term, short-range annoyance - but afflicted players were able to teleport back to large population centers, effectively starting a quick-spreading epidemic, leaving central hubs littered with bones and covered in blood as players dropped dead left and right. Normal gameplay was massively disrupted.



Players panicked, both in the game and on message boards, wondering whether the outbreak was intentional or an accident. It mirrored real-world epidemics in numerous ways: it originated in a remote, uninhabited region and was carried by travelers to urban centers; hosts were both human and animal, such as with avian flu; it was spread by close spatial contact; and there were asymptomatic individuals - in this case, invulnerable NPCs.



Of course, there were significant differences as well, such as the game's "accurate perception of risk" via the damage per second meter - there is no analogue to that in the real world.



Just Like Real Life



Blizzard attempted to institute a voluntarily quarantine to stem the disease, but it absolutely failed. Some players didn't take the threat seriously, and some malicious players used the pandemonium as a prime environment for griefing. Eventually, after several days of failing to cure the problem, Blizzard was forced to do a hard reset of the game servers.



Interestingly, player behavior was closely aligned with real-world behavior in such situations. Those with healing capability volunteered their services in city centers. Lower-level characters who could not tangibly pitch in warned others away at city limits. Nervous players fled to areas known to be uninfected. Suspicion and fear was rampant over in-game communication, blogs, and email.



One trait was particularly enlightening: curiosity, something epidemiologists did not generally build into their models. Some players attempted to enter infected areas to witness the chaos, then rush out before contracting the disease themselves. This behavior has real-world parallels, particularly in the case of journalists, who must rush towards a problem to cover it, then rush back out.



While the situation does not directly map to our understanding of the real world, Fefferman compared it to drug trials in mice - a really good first step. "These are my mice," she said. "I want this to be my new experimental setup."



Though it may seem a particularly video game-like behavior, griefing is something with unfortunate real-world parallels. There was the infamous "AIDS patient zero," who slept with as many people as possible and single-handedly pushed the AIDS epidemic up by some ten years, as well as "Typhoid" Mary Mallon, who infected 47 people with typhoid fever over the course of her career as a cook despite continued warnings and forced quarantines.



The unintentional simulation also raised questions: would groups of real people behave like guilds, who often kicked out longstanding members who infected guildmates due to a perceived "lack of responsibility"?



Infect Them All



Fefferman wants to design new diseases to be introduced into the game, perhaps non-deadly diseases. She could then study how risk is perceived, how rumors spread during such situations, and so on. It could also be interesting to see how public health announcements are handled - during the original outbreak, Blizzard made several strategic announcements, but kept changing its position as it was unable to effectively deal with the problem.



Would such intentional diseases ruin gameplay? Fefferman doesn't think so. Most gameplay in such games already deals with health challenges, such as combat, and in the medieval times that influences the fantasy genre, there was indeed a lot of disease. Those risks are in accordance with the setting. If researchers and developers work together, she argues, it could be fun.



Of course, scripted diseases could also be handled without such blunt endings as server resets. She has been talking to Blizzard since the original incident, and initially received an enthusiastic and positive response. Since then, the studio has been less outwardly excited about the proposition, but it has never closed the door on the possibility. Fefferman has also been in contact with other developers, hoping to run a simulation in a world with tens of thousands of players or more.



There are ethical details to consider, such as whether it inflicts undue trauma on unknowledgeable participants, but if the various concerns can be overcome, Fefferman believes there is a lot to be learned. The moral, as she puts it, is, "Gaming can help save the world."