What's up with the massive explosion of coronavirus-themed video games?

In early April, as many Americans were still coming to grips with the scale and severity of the coronavirus pandemic, Beat the Bomb, an “immersive video game company,” released Fauci’s Revenge. It’s a simple Space Invaders-style shooter, but with leading infectious disease expert Anthony Fauci’s disembodied head in place of a spaceship, firing lasers out of his eyes at gigantic virus balls and bad health habits, dodging viral particles, collecting good habits for health boosts, and trying to survive periodic Trump press conferences, which freeze your screen as viral bombardments continue.

Strange as the decision to make a game about a draining, divisive, and ongoing global crisis may seem, Fauci’s Revenge is hardly unique. In a July article for the Lancet, science writer Vijay Shankar Balakrishnan noted that board and video game developers, hobbyists and pros alike, had already released dozens of pandemic games. Dozens more have come out since then. Major game marketplaces like Steam are awash with titles like Be Coronavirus, Curing Covid, and even Toilet Paper Crisis Simulator 2020.

Game development and psychology experts say we can expect more still in the near future, because humans often respond to strife and disaster by translating it into games. During World War II, Jeremy Saucier of the Strong National Museum of Games says, “when the coin-operated game industry was able to make new games before and after rationing, they focused on the war.” One of his favorites from the era, he adds, “is a How to Fly Training Cockpit play set, sold as a ‘complete pre-flight training kit’ for older kids.”

These games, experts add, are not just frivolous oddities. They are potentially powerful public health tools. They can act as a source of cathartic comfort for some coping with stress during the pandemic. They can also act as a source of concise and interactive education for the many people who struggle to engage with dry articles and press conferences. However, if the games are poorly designed or intentioned, they risk becoming pandemic misinformation vectors instead.

Some of these new games are slapdash and simple, or even clearly reskinned old games, using the pandemic as nothing more than a marketing ploy to draw in eyes and dollars. Some are more substantive but still quick and easy updates to earlier games about diseases. At times, these games’ use of pandemic tropes can feel tacky or exploitative.

However, Stephanie Barish of the game festival organizing outfit IndieCade, argues many game makers “are like any other creators — making games is their medium for processing what’s going on in the world” internally. This is especially true for amateurs and indie developers, like Israel Smith, who this June, while in the sixth grade, redesigned the classic low-fi game Space Impact, turning its shootable enemies into viruses and sprinkling in PSA text bubbles, to channel his own pandemic anxiety. Many pro game developers are “also looking for a way they can contribute to the conversation and battle this disease” using their skill sets, adds Tim Cullings of Seattle Indies, a non-profit that supports independent game developers.

Strange as the decision to make a game about a draining, divisive, and ongoing global crisis may seem, Fauci’s Revenge is hardly unique.

Even if they just build a simple shooter like Fauci’s Revenge, they can offer players a sense of agency — the ability to fight and beat a virus they can’t really grapple with in everyday life — and catharsis. (Many shooters also create opportunities to donate to a good cause in-game. Fauci’s Revenge is free to play but encourages donations to New York City hospitals.)

However, Ari Mostov of WellPlay, a company that bridges entertainment and science to improve health — and that recently developed the AR game Virus Hunters to teach people about their immune systems — believes that games, if thoughtfully designed, can move beyond the cathartic release of a simple virus shooter. They can become powerful agents of public health information.

The Centers for Disease Control and Prevention has notably praised the 2008 game Pandemic, developed in response to the 2003 SARS epidemic, for its ability to condense and communicate information on infectious diseases in general. Doctors and educators have even been using the game throughout 2020 as a learning tool, as well as an agency-restoring, crisis-framing escape. The National Institutes of Health have also funded and promoted the development of both educational and engaging games about public health topics, like 2015’s You Make Me Sick.

A flood of developers have, since the spring, tried to build games that offer clear and substantive information about COVID-19 and how to respond to it. Many are simple board games, developed to teach people pro-health habits, lockdown rules, and COVID-19 symptoms by advancing their tokens when they land on something good, sending them back when they land on something bad — several of which are direct adaptations of the classic Game of the Goose. Some are straightforward pandemic trivia games, like Quarantrivia with Dr. Pixel. Some are nuanced simulations, like Survive COVID, developed this spring by the Indian social charity Yein Udaan to help people understand the challenges of navigating lockdowns and the pandemic while living in poverty. A few even attempt to help medical professionals learn about how to treat COVID-19 patients, or to help scientists learn about the virus by allowing players to try to interact with models of it, coming up with shapes and structures that might fit into key viral structures, thereby disrupting them.

These games can make a real and positive impact. “We’ve heard back from hundreds of users about shifts in their perceptions about COVID-19 and its impact on the poor” after they play through a few simulations in Survive COVID, says Vedika Agarwal of Yein Udaan.

“Of course,” she adds, “such platforms can also be misused to spread fear or concerns,” rather than knowledge. Notably, in April the game Coronavirus Attack, which elevated debunked conspiracy theories about the intentional development and release of the virus by the Chinese government, promoted Sinophobia, and trivialized COVID-19, briefly popped off on a few marketplaces.

Even developers who try their best to take the pandemic seriously and provide helpful games may accidentally include incorrect or outdated information. “Information is evolving so quickly,” says Rob Daviau, designer of the Pandemic Legacy series of cooperative games, successors to 2008’s Pandemic. “Anything you put into a board game now is often outdated by the time it goes to print.”

Or, they may struggle to translate the nuances of the pandemic into simple and engaging game mechanics. The board game KILL COVID, for example, presents pro-health behaviors like mask wearing as random events you land on rather than activities people actively choose to engage in, and moves tokens towards the development of a vaccine, which is of course not the point of wearing a mask. Survive COVID, for all its nuance and value, also uses a COVID-19 risk meter which slowly ticks up as players make health compromises for the sake of economic stability until it hits 100 percent, at which point you catch the virus, and lose the game. This does not necessarily accurately reflect the consequences of taking individual health risks, or the way people contract the virus.

Markus Geiger, who earlier this year Kickstarted the board game Corona Battle Against COVID-19, argues that none of this is a real public health problem because people have the capacity to separate games from reality, and the maturity to understand that they may oversimplify issues. Rachel Kowert, an expert on gaming psychology, adds that “games are not typically a primary source of information,” so she’s far less worried about this than about, say, unhinged op-eds.

However, in mid-March 130 million people flocked to Plague Inc., a 2012 virus designing and world killing game, many explicitly looking to it as a major information source. (They crashed the game’s servers, and its maker, Ndemic, responsibly redirected the wave to health experts.)

And Mostov notes that Apple is concerned enough about COVID-19 misinformation that it’s kept pandemic games off of its app stores. After all, any misinformation is a risk, the effects of which can be hard to undo. Agarwal stresses that “creators must always be wary of the way their tools can be perceived, and the impact they can have on wellbeing,” beyond their initial intents.

If the player walks away with one core concept from the game, what would that be? - Tim Cullings

Barish and Mostov believe the best way to avoid these potential pitfalls is to foster collaboration between public health experts and game developers. Towards that end, IndieCade recently put on a digital-and-distanced indie rapid game design contest (or game jam) called Jamming the Curve at the Georgia Institute of Technology, during which they paired developers up with epidemiology and public health mentors to create games to help players learn about and respond to the pandemic.

Cullings, who helped organize that jam, says one of the big lessons he and the scientists he’s worked with in the past try to impart to designers is that they should not try to communicate fine-grained details through a game. “We try to get them to think instead, if the player walks away with one core concept from the game,” one broad and overarching idea, he says, “what would that be?”

Rick Thomas of the National Academy of Sciences, which was deeply involved in Jamming the Curve, hopes that projects like this will encourage developers to maintain active lines of contact and engagement with health experts well into the future, informing subsequent projects and seeding nuanced and responsible health information through the gaming world. That’s a lofty vision, but not unobtainable, given that even hobbyists have found ways of working with health experts on their projects — including a 10-year-old girl who this spring worked with her nurse practitioner grandmother to develop a game to help her 4-year-old sister understand the pandemic and the importance of lockdown measures.

Unfortunately, game buyers often will not be able to figure out, without extensive research that they may not even know to do, which pandemic game in a marketplace was thoughtfully designed to convey meaningful information, and which is a dangerous cash grab. The apparent level of polish and marketing materials may not be reliable proxies for their overall quality. Cullings and Thomas have a few ideas for how to address this, like dedicated quality-vetted pages in digital stores, certifications from health bodies, and promotional campaigns involving trusted experts. For now, though, consumers just have to do their best to pick and choose in a crowded environment.

And the pandemic gaming space will likely only get more crowded and complex. Saucier suspects that, at some point, pandemic fatigue will set in and kill the appeal of COVID-19 games for both developers and players. But as long as people are still worried about the virus, engaging with news about it and searching for information or a release, Mostov says, “well see more games about it.”