Let the Epigames Begin! A MERS-X Epidemic Game at the International Pandemic Sciences Conference
By Andrés Colubri —
This July, at the International Pandemic Sciences Conference 2025 organized by the Pandemic Sciences Institute (PSI), my lab officially launched our new Epidemica platform and the Epigames mobile app (https://epidemica.info/). Very briefly, the goal of Epidemica is to facilitate the development of digital tools for infectious disease research, with Epigames being the first app developed under the Epidemica platform. This app is specifically designed to study the interplay between infectious disease spread, social contact networks, and human behavior through experimental epidemic games, or “epigames” for short. These epigames are gamified experiments in everyday settings (such as conferences), where participants join an outbreak scenario via the Epigames app and make decisions responding to the spread of a “simulated virus” between their phones via Bluetooth connectivity.
For such a project focused on understanding the effect of human behavior on disease transmission, what a better introduction than a live demonstration: turning the International Pandemic Sciences Conference itself into the stage for an epidemic game!
From Experiential Learning to Experimental Epidemiology
The concept behind Epigames builds directly on my earlier work with the Operation Outbreak (OO) project, which I created back in 2017 together with collaborators at the Broad Institute, Dr. Pardis Sabeti and Dr. Todd Brown (see this page for the full story of OO, also this opinion piece aptly titled “When It Comes to Disease, Why Wait for a Pandemic to Respond?”, we published exactly one year before the COVID-19 lockdowns). OO was designed primarily to offer experiential learning opportunities in outbreak science and public health. However, as we deployed it in various settings, particularly schools and college campuses, subsequent research (here and here) demonstrated its potential for experimental and network epidemiology.
This experience gave us an important insight: our real-life outbreak simulations could become a transformative research tool only if they were designed in a more systematic and principled way from the ground up. That’s the specific gap the Epigames app is built to fill.
The MERS-X Epidemic Game Scenario
The launch of Epidemica and Epigames at the International Pandemic Sciences Conference 2025 was an opportunity to demonstrate an epidemic scenario of interest to the conference delegates, all the while not distracting from their activities as delegates (this is in fact an important feature of epigames to capture realistic behaviors from participants). The scenario we came up with was the following: what if a novel pathogen, for example a variant of the Middle East Respiratory Syndrome (MERS-X), were to jump into the human population at an international conference such as this, spreading among the event’s attendees gathered in one place before they flew back to their respective homes all over the world? (Not unlike the Biogen conference at the beginning of the COVID-19 pandemic.)
To find out, we invited conference delegates to download the Epigames app and join the epidemic game. The response was very positive, as we enrolled nearly half of the delegates (over 160), who enthusiastically became participants in this large-scale outbreak scenario, which lasted for the two days of the conference.
Throughout the epigame, participants’ phones used Bluetooth signals to measure their proximity to others, forming a real-time, dynamic contact network. As the epigame progressed, individuals could become virtually “infected” and spread the digital MERS-X virus to others they interacted with. We set up a live visualization website, which adapted the Outbreak Visualizer tool developed by Fathom Information Design for OO, so everyone could see the network and the outbreak unfold in real time. The epidemic game was not only about passive spread; participants could also make choices, like using in-app points to purchase “diagnostic tests” from the app’s shop to check their infection status.
A couple of highlights of the epidemic game took place on the second day of the conference when, in the morning, Dr. Luca Ferretti gave updates from the ongoing outbreak (including transmission chains recorded by the app) as part of his lecture during the plenary session on Next Generation Disease Control. Dr. Ferretti also talked about how such gamified experiments could help in testing and refining new app-based tools for epidemic mitigation, including digital contact tracing, an approach that Dr. Ferretti spearheaded during the COVID-19 pandemic (Ferretti et al., Science 2020). Data from these apps can also enable high-resolution analysis of how contact duration & proximity influence the transmission of respiratory pathogens in real life (Ferretti et al., Nature 2023).
At the end of the day, Professor Peter Horby, PSI director, presented the results of the MERS-X outbreak during the conference’s closing remarks. Using the infection and country of origin data generated by the attendees over the past two days (the Epigames app asked where the participant came from upon joining the game), our collaborators from PSI ran a simulation of global transmission on the GLEAMviz platform. The audience watched as the MERS-X pathogen, carried by the conference participants, spread from the event to their home countries and then across the globe over the course of a simulated year. It was a compelling (albeit not meant to be scientifically rigorous) demonstration of how a local outbreak can become a global pandemic, driven by the very contact network we had all just created, but primarily, a powerful testimonial to the wide reach of pandemic sciences, with experts hailing from all parts of the world.
More Than Just a Game
Beyond the epigame’s fictional narrative and the final simulation of MERS-X global spread, this epigame also served an important research purpose by enabling gathering of high-quality data. Under the hood, the Epigames app was collecting anonymous low-level Bluetooth signal strength (RSSI) data from every interaction between participants. This detailed dataset is now allowing us to test and calibrate the core proximity-sensing technology in the Epigames app and refine our models of disease transmission. The figures below show a small subset of the RSSI data between devices, as well as the initial transmission networks generated from the index cases during the epidemic game.
These results hint to the some of the reasons why we built the Epidemica platform. For years, researchers have relied on methods like manual contact diaries, which suffer from recall bias, or sensor-based studies that capture contact networks but not the concurrent human behavior. We are designing the epigames to bridge that gap. By combining real-life contact networks with data on in-game behaviors (e.g. deciding to use a rapid test or self-isolate upon exposure) and survey responses about attitudes and beliefs, we can start to build a much more complete picture of why outbreaks spread the way they do under the effect of changing human preferences and actions.
What’s Next?
The project launch at the International Pandemics Science Conference was a remarkable success, demonstrating that we can rapidly deploy a study and engage a large audience while collecting high-quality research data.
This promising first step gives us confidence in a vision for Epidemica to create an open, reusable platform that allows interdisciplinary research teams — from epidemiologists and behavioral scientists to game designers — to design and run their own epigames. By creating this infrastructure, we hope to empower the scientific community to tackle critical questions about how social norms, peer influence, and public health interventions shape the course of an epidemic.
To learn more about the project, please visit our new website:
We’re just getting started on this journey and will have much more to share as we analyze the data from our inaugural game and run new ones. So, let the epigames begin!
Acknowledgments
Bringing Epigames at the PSI conference would not have been possible without the support from many individuals, including the conference organizing committee and my collaborators at the Pandemics Science Institute, Christophe Fraser, Luca Ferretti, Jasmina Panovska-Griffiths, and Lucie Abeler-Dörner, with whom we discussed ideas and arrived to the concept and planning of the MERS-X scenario. Special thanks to Caitlin Pley, PhD student at PSI, who carried out the GLEAMviz simulation, Adam Fowler, also PhD student at PSI and creator of the Herald Project (the proximity sensing software that powers the Epigames and OO apps), and to Jane Itzhaki and Ksenia Ananyeva, training and career development lead and events officer respectively, who made sure that everything ran smoothly behind the scenes (also, thank you for making a beautiful rollup banner for our stand). And finally, a huge recognition to Mansi Khandpekar and Andi Grozdani from my lab, who worked around the clock to get the Epigames app and online materials ready for the conference!
