What World of Warcraft could have taught us about epidemics

I was interested to read this 2007 article by Eric Lofgren (Tufts University) and Nina Fefferman (Rutgers University), published in Lancet Infectious Diseases (ungated here). Lofgren and Fefferman look at the interesting case of an epidemic that suddenly erupted in the World of Warcraft online role-playing game in 2005. As they outline:

On Sept 13, 2005, an estimated 4 million players... of the popular online role-playing game World of Warcraft (Blizzard Entertainment, Irvine, CA, USA) encountered an unexpected challenge in the game, introduced in a software update released that day: a full-blown epidemic. Players exploring a newly accessible spatial area within the game encountered an extremely virulent, highly contagious disease. Soon, the disease had spread to the densely populated capital cities of the fantasy world, causing high rates of mortality and, much more importantly, the social chaos that comes from a large-scale outbreak of deadly disease...

Is this sounding somewhat familiar? You can read more about the outbreak here (or in the Lofgren and Fefferman article, which has much more detail). While the episode presents an interesting example of unintended consequences, Lofgren and Fefferman highlight the potential for online games to improve our understanding of how epidemics spread, and what might be effective in mitigating their impacts. They note that:

In nearly every case, it is physically impossible, financially prohibitive, or morally reprehensible to create a controlled, empirical study where the parameters of the disease are already known before the course of epidemic spread is followed. At the same time, computer models, which allow for large-scale experimentation on virtual populations without such limitations, lack the variability and unexpected outcomes that arise from within the system, not by the nature of the disease, but by the nature of the hosts it infects. These computer simulation experiments attempt to capture the complexity of a functional society to overcome this challenge.

Online gaming worlds may even have enough social elements to mimic real world responses to a disease outbreak:

In the case of the Corrupted Blood epidemic, some players - those with healing abilities - were seen to rush towards areas where the disease was rapidly spreading, acting as first responders in an attempt to help their fellow players. Their behaviour may have actually extended the course of the epidemic and altered its dynamics - for example, by keeping infected individuals alive long enough for them to continue spreading the disease, and by becoming infected themselves and being highly contagious when they rushed to another area.

Lofgren and Fefferman also highlight some of the practical issues with using online gaming worlds as tools for research:

Studies using gaming systems are without the heavy moral and privacy restrictions on patient data inherent to studies involving human patients. This is not to say that this experimental environment is free from concerns of informed consent, anonymity, privacy, and other ethical quandaries. Players may, for example, be asked to consent to the use of their game behaviour for scientific research before participating in the game as part of a licence agreement... Lastly, the ability to repeat such experiments on different portions of the player population within the game (or on different game servers) could act as a detailed, repeatable, accessible, and open standard for epidemiological studies, allowing for confirmation and the alternative analysis of results...

If only this accidental epidemic outbreak in World of Warcraft had been followed up with detailed research (either on this outbreak, or on other controlled outbreaks in that game or other games). What might we have been able to learn about disease dynamics, social distancing, lockdowns or stay-at-home orders, etc.?

Finally, and importantly, should researchers be looking to partner with game developers now, to engineer outbreaks in more current massive multiplayer games, like Rust, Sea of Thieves, or Skyrim?

[HT: Tim Harford]