Frontline Pandemic: A Prototype

Just a heads up on my latest project... Working title: Frontline - Pandemic.

(This is NOT offiically connected to the Pandemic boardgame franchise...)

(The photo is of the mockup. If it gets published, I imagine all the graphics will change.)

I've spent the last 9 months or so (since ebola began to break) redesigning this commercial boardgame prototype, which I originally submitted to the publisher of the popular boardgame Pandemic back in 2010. It draws on what I learned doing tabletop work to train hospital staff to deal with epidemiological events. In this game a team of players cooperatively manage a hospital responding to a pandemic.

The first prototype was in submission for almost a year. This time I've overhauled it, simplified it and fine-tuned the balance design. The game has benefited from more than two years of design, redesign and playtesting. Particular thanks go out to my friend Chris MacAllister for his time in playtesting.

The game now I think has arrived. It takes about 90 minutes to play out, and it presents players with definite puzzles which they have to truly think about to survive the epidemic. Things get a little "grindy"... in other words, you must spend some time focusing on the details... but I couldn't get away from some of this. It is simply the nature of this scenario: dealing with patient loads, dealing with resupply of materiel and personnel, finding space for the patients, and so on. That's what an epidemic looks like in a hospital. To try to manipulate it otherwise, in my opinion, is to be dishonest to the subject matter.

The Pandemic publisher rejected it I think mainly because the game's frank honesty frightened them. They felt squeamish about the subject-matter. Well... Sorry, but patients sometimes die. Sometimes in waves if you aren't smart. But this is a pandemic, after all. Oddly, while the Pandemic game franchise deals with... erm... pandemics, and all the apocalyptic destruction native to plagues, disease and so on... that franchise has a reputation as being light and fun. So I guess they didn't want to disrupt this light funness with... you know... dealing with people who are sick and sometimes having to face your inability to save everyone. (That's one thing that new doctors and nurses have to face... That human limitation of medicine.)

Anyway, not everyone has that aversion to healthcare issues. That's why there are hit hospital shows like ER, Grey's Anatomy, House, etc.

One of the most satisfying parts in this game is the Healing Phase. If you've done your job well, you get to discharge many formerly sick patients, sending them home and increasing your Dedication score. It is a very light and fun thing to do, and dealing with the devil of the details is the investment you make to win such a reward.

Reduction: Mission 1 - Moving As A Team

Here's a runthrough of Mission 1 from the campaign Reduction, which I am designing... That's me playing with "Pancage" (new to the game Alien Swarm).

I like the top-down shooter format. I feel it's a better way to teach people "squad tactics" because it doesn't have the tunnel-vision that the first-person shooter format has. First person shooters (like Call of Duty) make people myopic: they're good for teaching shooting, but lousy to teach people how to move with your team-mates. Top-down shooters give people an all-around team perspective. Of course, we're dealing with "aliens" here, but imagine what else we could do with the format?

See the blog for Reduction at PrepareToDrop.com

Red Flags: 2015

Here's an interesting, to-the-point infographic on hypothetical future flashpoint scenarios...

Red flags, all of them.

To this list, I would add the following:

The threat of ebola becoming an endemic world disease. (And I don't care that it hasn't emerged as such... yet.... My articles on ebola were hit many times, and if they helped stop ebola from reaching this point, then that's a good thing! And by the way... I can pretty much assure you that there is a defacto world travel ban to the ebola-stricken West African nations... They won't call it a "travel ban", for political reasons, but getting out of there is extremely difficult now...)

The threat of economic and legal collapse in the United States:

• Legal collapse driven by many young useful idiots, who have grown up with the narcissitic self-delusion of a world controlled by smartphones and depicted in the fantasy of unrealistic videogames. These people are magical thinkers who fundamentally don't understand how the legal system works. It's not perfect, but it works better than any other way the human race has yet created... And in their quest to create some magical, perfect legal system... where police are psychic and know when someone is armed or not in the first 30 seconds... they'll do the evil that Voltaire noted: "Perfection is the enemy of the good." (Though I will say that using a chokehold on a surrendering person is pretty stupid. I was trained by a cop in chokeholds, including having been put into one. They're pretty terrifying.)
• Economic collapse simply because the US dollar, the world's international currency, is riding on fumes now. (And yet the US still has a magical aura when it comes to economic growth. Which is probably its only saving grace.)

Friction: Clausewitz, the military-thinker, gives us a term for this build up of red flags (albeit he was speaking in a context of warfare). "Friction." It's the general pile-up of unforeseen events (and even foreseen ones), which can cause unexpected, catastrophic failures.

The world is full of friction now.

If a wider war comes to us, I suppose the Western militaries can point to a failure of civilian leadership. It will be either because of the hawkish shortsightedness of the right (if you talk war so much, guess what you'll get?...) or the negligent stupidity of the left (if you ignore conflict red flags, or implement arbitrary and destabilizing policies - such as withdrawal dates that have no basis in reality - guess what you'll get?...).

Ebola: Let The Pilots Lead Us

Flying is, contrary to the cliché, very dangerous. Dynamically-speaking

It is so dangerous that pilots do a methodical series of checks before every flight. And they have many "fire-drill" style procedures to follow in case something goes wrong during a flight (for example, the stall procedure).

Because these checks and methods are in place, air travel is quite safe. Statistically-speaking..

I make this point because I want to reveal the dangerous illusion of thinking in a statistical manner rather than in a dynamic manner when it comes to disasters. You think in circles when you think statistically. You look at things as giant lumps, from a distance, but you don't open them up and get into how they interact and operate. And you need to do that to understand disasters.

Driving is more dangerous than flying, statistically, because it's so much safer than flying, dynamically. Because it's so safe to drive, dynamically, we have a lackadaisical attitude toward it. Thus, it becomes more dangerous overall -- statistically. (Who here drives a car with  the kind of safety checklist and emergency training a pilot uses while flying? Nobody. You just get in your car and go without too much thought.)

When you understand what pilots do, you see how statistics lie. Air travel IS dangerous. If your engine goes while you're driving, you can pull over, call a tow truck, et cetera. If your engine goes while you're flying, there's a good chance you'll die. Because of that, you make damn sure your engine won't go!: you check it before each flight; you put switches and gauges in the cockpit to give you precise control over the engine; you design the aircraft with multiple engines so one can go down and you'll still survive, and so on.

Likewise, you need to think dynamically when you think about disasters. You need to think more in terms of immediate cause-and-effect, less in terms of abstractions and removed statistics. Otherwise there's a good chance you'll kill people unnecessarily.

Lets look at some dangerous illusions being caused by statistical, abstract and circular (non-dynamic) thinking patterns about this ebola situation...

Ebola: Come As You Are

Last night I may have contracted ebola. That's a very slim maybe.

I was at the local watering hole. Karaoke night. It's fun.

The karaoke master has about three gigs, rotating, between various bars. With that microphone, passing hand to hand. He was vomiting outside the pub. Stupidly I shared a smoke with him. So if he has it I now do, too. But that's okay.

He seemed to think it was just because he was drinking. (Maybe it was.) But still, vomiting? I asked him if he had a sore throat. He said no. But still. A heavy drinker, vomiting?

Ah, it's okay. I'll monitor myself. It's not like I haven't been here before...

What You Can Do To Prepare For Ebola

If ebola spreads to your region -- if people are presenting in your area with symptoms and there is a great deal of fear and uncertainty -- there are some very simple steps you and your community can take to ensure your survival.

Who am I to give this advice? I was tapped to do design on a simulation to train hospitals to deal with medical resource management during pandemic events. I've done a lot of historical research and I've worked with these people. This said, you need to listen to public health officials and authoritative sources over myself in any contradiction. Now on with it...

Take Some Time Off (Self-Isolate)
A very simple and effective way to fight the spread of ebola is to simply avoid contact with others. Pretty straightforward. The more you can avoid others, the more you avoid the disease, the higher your chances of surviving. It's something simple and proactive you can do to stay alive and reassure yourself and your family.

Pandemic Response: The Simulation

Pandemic Response is a simulation to train hospital administrators to deal with epidemiological events, including pandemics.

I provided consulting game design for this project, over several meetings and design sessions. My main contribution was to research and design a full tabletop prototype early on, and then take the team through this scenario as a learning exercise.

Partly I drew on my own HAZMAT training from the army, and while attending a hospital disaster training in DC (where I did triage in full respirator and suit).

The approach I advocated in design emphasized the overarching principles and key on-the-ground actions and strategies involved, based on historical-qualitative experience (in particular, reports on the SARS event and response at the North York General Hospital in Toronto). The final approach taken in the game was quantitative, emphasizing data simulation, with key actions integrated in a summary manner.

Pandemic Response was developed to beta stage by Simquest (from the Washington DC area), working with Virtual Heroes, and was funded by the United States Office of the Secretary of Defence.