Plague Inc. – Designing Virtual Pandemics

by Arno Görgen

Fig. 1: Informational Realism in Plague Inc.

Plague Inc. and Corona

Plague Inc. is a strategy game that was developed by James Vaughn and his studio Ndemic Creations in 2012 – very successfully with over 120 million units sold by 2019 – for various platforms (including iOS, Android, PC). It played a (temporarily) central role at the interface of public corona discourse and the popular cultural dispositif of these discourses:

  • In the wake of the Covid-19 pandemic, sales of the game, which was already eight years old at the time, reached top positions in the app and game charts, particularly in Asia. On January 23, 2020, the studio finally felt compelled to publish a statement in which it warned that “that Plague Inc. is a game, not a scientific model and that the current coronavirus outbreak is a very real situation which is impacting a huge number of people. We would always recommend that players get their information directly from local and global health authorities.”
  • On February 23, 2020, Ndemic Creations announced that it would donate $250,000 on behalf of the players to research Sars-Cov-2. At the same time, a game update was announced, in which the player’s goal is the destruction of the novel corona virus. This means that game mode is diametrically opposed to the previous gameplay (and the inherent goal of the destruction of mankind by a pathogen). This mode will be developed together with WHO- and Global Outbreak Alert and Response network-experts.
  • On February 27, 2020, Ndemic Creations then published another statement. In it the studio announced the decision of the “Cyberspace Administration of China” that the game contained illegal content and had therefore been removed from the app stores. Unfortunately, no further background to this China-wide ban has been revealed since then.

In principle, however, it must be emphasized from the current position that the game was instrumentalized by the broader public as an analytical lens for examining the situation in China, which at that time was quite strongly reported but nonetheless opaque. This special interest can be justified both by the fact that a British game was censored in China, i.e. obviously cultural, political and legal positions came into conflict here. On the other hand, the content of the game and its radically mechanized pandemic simulation, which is both cool and objective in the perception of the player, also constitutes news value per se in this context.

The rather prominent role for a game within a pandemic discourse and the subversive potential of Plague Inc., apparently recognized by the People’s Republic of China, are nevertheless reason enough to take a closer look at the game with regard to its designs and framings of health, disease and public health.

Plague Inc. makes use of biomedical models and knowledge formations with regard to the visual language, terminology and presentation of the temporal course of disease. Hypothetically, it can therefore be stated that in the course of designing the game, various scientific-cultural perspectives and paradigms are elevated to a central narrative tool, constructing science (evolutionism, epidemiology and public health) as a temporally organized system within the simulation and narrative character of the game. This operationalization follows in every aspect the imperative of functionalization: the content, whether visual, textual or structural, is subordinated to the playability of Plague Inc.

Ludonarrative Reality vs. Referential Reality

Games are particularly suitable for epidemiological narratives due to their structural characteristics: in simple terms, all games can be regarded as interactive conflict simulations. Only a conscious decision within parameters given by the software enables the player to walk through the assumed text of the computer game. These procedurally circumscribed conflict situations allow socio-cultural expressions of a scientifically guided assessment of future developments.

In the game, reality can not only be mirrored but also anticipated from the player’s point of view. This special feature makes Plague Inc., in particular in times of the Covid-19 pandemic, not only a valuable information format, but also an assessment tool in which future developments seem to be predefined. This perception is true to the point that the developers had to stress that Plague Inc. is “just a game”.

The central point here is that games in a formalised form represent conflict situations of reality that can be learned and experienced without the risk of endangering oneself. For this reason, games are often integrated into narrative structures and aesthetics that refer to conflicts in the reference world. In the sense of Henry Jenkins’ “evocative spaces”, games are thus made more accessible, since the player can apply his or her own world knowledge in the game. From this perspective, areas of reality with an extremely high density of action decisions and a high effectiveness of the decision consequences are particularly suitable for adaptation in games. This applies primarily to war simulations, but also to scientific and especially biomedical settings, since (fictitious) individuals and societies are influenced at a central point of their respective autonomy, namely the physical integrity of their participants.

In Plague Inc. the player creates and modifies pathogens with the aim of eradicating the entire world population or, depending on the game mode or pathogen, “only” to enslave, zombify etc. The player can choose between different pathogens and has to successfully adapt them to various environmental and socio-cultural contexts as well as to humanity’s attempt to develop an antidote within a countdown that adapts to the course of the game.

From a design perspective, this complex mixture is dealt with on three game levels: the environmental conditions of the virus, human research, and finally the internal development of the pathogen. The result of the interplay of these three levels is in turn mainly displayed on a world map in the form of an abstract spreading course. In all levels, an attempt is made to show the respective sub-processes as a mechanical-logical process which is ultimately subject to a radical logic of quantification. Soft values and affects, such as empathy but also fear and panic, are either subjected to this logic or find no way into the equation. This is done both within an informational realism on a visual level as well as structurally, by referring to traditional knowledge. The in-game dashboards on the health (political) status of individual countries take up established forms of data visualization, as they can also be found in the context of the Covid-19 pandemic, such as the representation of national disease patterns in the context of the Covid-19 pandemic by Johns Hopkins University (see figures 1 and 2).

Design, knowledge and expectations of this knowledge go hand in hand here. In the following, this will be demonstrated by means of the macro-perspective visualization of the infection pathways, the statistical calculation of the infections based on the SIR model and the micro-perspective representation of the reconfiguration of the disease characteristics.

Fig. 2: Covid-19 dashboard by Johns Hopkins University

Macro-perspective Design

Plague Inc.’s world map (fig. 3) shows all major countries and transport hubs in the form of airports and ports. These are relevant because they are the most important means of transmission besides animal carriers, namely via ships and airplanes. Non-contaminated connections are shown in white, whereas connections with pathogens are shown in the warning colour red. The increasing complexity of these connection lines leads on the one hand to a better overview for the player, on the other hand the complexity of the propagation paths is gradually increasing and overwhelming. The quantity of influencing variables and the constant influx of changing environmental factors establish a time lapse that builds up and increases in complexity, putting the player under pressure and creating tension.

The infection of the population is – again, similar to the visualization done by Johns Hopkins University in fig. 2 – represented by red dots. The stronger the red colouring of the country, the more extensively the population is infected. If the disease is fatal, the colour changes to a dark red, post mortem the infection point fades, so that the map is almost emptied again towards the end of the round. With this type of representation, the game picks up on an old tradition of depicting epidemiological progressions, whereby a development is depicted in the game, which above all records prevalences, i.e. all cases of infection within the game period (incidences, on the other hand, only denote new infections within a specified period). This type of representation was first used by the British physician John Snow (1813-1858) in the form of quantitatively adjusted point clouds in a map showing the spread of cholera in London in 1855 (fig. 4). Since then it has been one of the standards in the visual presentation of epidemiological data. This kind of aestheticization of the course of the disease requires no further explanation for the player due to this long pictorial tradition and the player’s associated knowledge of the significance of representation in the sense of Henry Jenkins’ evocative spaces and thus represents an ideal starting point for the epidemiological simulation model.

Fig. 3: World Map in Plague Inc.
Fig. 4: John Snow’s map of cholera cases in London.

Adopting the SIR Model

The most important components are positioned at the bottom of the world map. There you will find an interface for pathogen reconfiguration on the left, an interface for monitoring the status of the cure development on the right and an interface with the most important epidemiological data in the middle. If desired, these show the data of individual countries or the worldwide development.

Plague Inc. uses these components to install a deterministic epidemiological statistical model based on a static population divided into a set of subgroups. It thus follows the so-called SIR model, which was developed by Kendrick and Kermack as early as 1927 and divides the population into the groups Susceptible (non-infected), Infected and Recovered (cured or deceased). In the basic system, a temporal course is already indicated, which is central to the simulation. This specifies and visualises the changes over time of the SIR parameters with regard to their increase or decrease in percentage ratio to each other within a stacked bar. While this information is already visible on the map level, the model is considerably more complex due to the interfaces for pathogen configuration and for monitoring the cure status. This determines both the pace and rhythm of the game, but is itself influenced by various scientific approaches (especially public health/epidemiology versus evolutionary biology) and the associated concepts of time (simultaneity versus succession/seriality).

Micro-perspective Design

A further element in which existing (and scientifically verified) knowledge is combined with existing pictorial traditions is the interface for the configuration of the pathogen.

This is divided into four parts: an overview page, “transmission”, “symptoms” and “abilities”. Here modifications are introduced into the pathogen with the help of a “currency”, the “DNA points”. These points are acquired by infecting and killing the population.

All elements of pathogen configuration are based on a phylogenetic understanding of evolution. A phylogenetic tree is a diagram showing the assumed evolutionary lineage connections of an entity. Well-known examples of such phylogenetic visualizations are linguistic or biological family trees. The visualization used in Plague Inc. is a modification of this principle, namely a simplified and abstract variation of the polypolar, decentralized “Voronoi tree map”, whose basic unit consists of polygonal cells, as they have already been used for the SIR icons on the cure level (fig. 5).

While in ‘real’ Voronoi maps the whole space is filled with cells, in Plague Inc. meaningfully clustered, merging ‘cell threads’ are spun, which gradually expand the map into an individually formed complex network of interacting symptoms. This functionalist network is expressed through medical attributions and has an effect on the degree of infectivity, disease severity and lethality, as well as the speed with which these are reflected in the population. Plague Inc. thus uses an evolutionary approach to compose a complex, synchronous cause-and-effect matrix, which, on the one hand, assumes the necessity of a diachronic development of the pathogens and, on the other hand, implements this chronotopic arrangement as one of the basic prerequisites for the game.

Fig. 5: Voronoi tree map in Plague Inc.

However, the principle of the modified Voronoi trees is used particularly clearly and effectively only in the player-controlled development of the disease symptoms (see fig. 3). Starting from six basic symptoms, which are not organically but rather biofunctionally located (nausea, cough, rash, sleep disturbance, cysts, anaemia), a symptomatic kaleidoscope of the disease is successively developed, which, in the accompanying explanations of the functioning of the respective symptom, makes use of precise medical terminology and nosology and reflects its effects on infectivity, severity of the disease or lethality. In the case of insanity, for example, it says: “Neuropathic processes of the pathogen in the frontal lobe cause severe emotional and behavioural disorders. Significantly more difficult to cure.”

As described above, the six basic symptoms are spun into a web of other related symptoms. The individual symptoms are displayed in hexagonal icons, which on the one hand represent an abstracting physical location and on the other hand the desired defect. These cellular icons represent a synthesis of popular and abstract scientific images. Their function is to communicate a vast amount of information quickly and easily within diverse contexts on a global scale. The map thus successively creates images that reflect changes in the temporal evolutionary course of pathogen development.

Pathological Ecologies

With the elements “transmission”, “symptoms” and “characteristics”, these functional semantic networks are in turn interwoven to form a semantic organism that affects the environment, the human being and thus the field of public health, and provides the simulated human opponent with a speed and rhythm for countermeasures. While the pathogen overview page congruently displays general data on the development of the pathogen including an animation of the pathogen reminiscent of an electron microscope image – this includes, for example, the chronological course of the pathogen modification, typological data such as the type of pathogen, start date of the game, incidence rate, etc. – the pages “transmission”, “symptoms” and “properties” are central to the actual development of the pathogen.

The pages on transmission and properties play with the idea of vector transmission, i.e. the assumption that diseases can also be indirectly transmitted from person to person, or that certain environmental conditions also permit other forms of transmission. For instance, the modification of transmission pathways by including vectors such as transmission by birds, insects, rodents and farm animals, the possibility of blood-to-blood transmission and finally transmission through water or dust particles drastically increases the effectiveness of the pathogen. In other words, the direction of action here makes use of environmental factors to spread the pathogen. This is also helped by the fact that the use of these vectors in particular can increase the chance of the pathogen mutating on the symptoms side.

Like the screen for transmission, the “properties” focus on the interaction with environmental conditions, but in the opposite direction of action. While the environment is instrumentalised in the modulation of transmission, it represents an obstacle on the properties level to which one must react. With the evolution and development of different properties, the pathogen can thus react to unfavourable conditions such as a climate that is too hot or too cold, to a slowed spread due to antibiotics or to the progressive development of a remedy. In addition, depending on the type of pathogen, unique properties are released, such as special modes of spread or mutation. The simple SIR model experiences an increase in complexity, which can drastically increase the speed of the game via the means of evolution and based on scientific findings in public health.


While illness is designed openly in the game and ecological and temporal vectors only become apparent in the course of the game and influence it, the (ludic) field of health care the framework is precisely defined by countdowns and influencing factors and is thus characterised by a deterministic understanding. The relationship to reality is thus reversed by 180 degrees. Here, illness usually follows (reasonably) predictable paths, which are determined by a multitude of variables. In contrast, it is health policy that adapts to these divergent paths and is sometimes open and difficult to anticipate. This reversal is due to the converted point of action of the game. While in reality the player would have to react to the disease as a member of a society, his or her position in the game is exactly the opposite: he or she reacts to the lurking danger of developing a cure. Although unrealistic in this reversal, the game gains its credibility from its nature as heterochrony or heterotopia. Although the game’s position as a Promethean destroyer of worlds is fictional, and even through its abstract aesthetics does not provide a visual platform to reproduce our earth in detail, Plague Inc. uses enough elements from the field of epidemiology to create its own dystopian ‘uncanny valley’ of realism, in which a world that falls victim to such a virus is thought.

It is obvious that in this subversive fundamental system – which has been repeatedly criticized as immoral in the past – a scenario is depicted that in 2012 still seemed unthinkable: the invasion of the entire earth by a virus. Sars-Cov-2 has made this actually “harmless” position obsolete. The danger is now imminent, and the moral discourse continues to shift towards the fact that the player’s subversive occupation of the pathogen’s position and the inherent game goal of exterminating humanity have become immoral. It is therefore only logical that Ndemic Creations has announced a corona scenario in which the direction of action is reversed, in which the player now takes the fate of humanity into his or her own hands. It’s an interesting reversal, as it reveals that disease is a political issue in the game as well. Whatever this game mode may be, an analytical look at the game design will also provide us with important information about this political foundation.

This text is loosely based on my article Görgen, A. (2016). Chronisch krank: Zur medikalisierten Ästhetik des Temporalen in Plague Inc.. In S. Höltgen & J. C. van Treeck (Hg.), Game studies. Time to play: Zeit und Computerspiel (S. 296–313). vwh Verlag Werner Hülsbusch Fachverlag für Medientechnik und -wirtschaft.


Eugen Pfister

Eugen Pfister leitet das SNF-Ambizione-Forschungsprojekt "Horror-Game-Politics" an der Hochschule der Künste Bern - HKB. Er forscht zu digitalen Spielen als historische Quellen (

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  1. 14/05/2020

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    […] spatial analyses of an outbreak of disease. (This infographic is also presented in the blog post Plague Inc. – Designing Virtual Pandemics by Arno […]

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