Preparing for Public Health Disasters With Tabletop Games
What can we learn from a wargame about combating illness?
In April 2025, professor John Bultena of the University of California Merced hosted a large-scale tabletop exercise, in collaboration with public health student Niove Aragon. Advertised as a “public health wargame,” UC Merced students took on the roles of stakeholder organizations across the university and simulated a campus-wide effort to combat an outbreak of foodborne illness. Drawing inspiration from The Expanse RPG and People Make Games’ documentary on government wargames, Bultena and Aragon devised their own system to explore how fraught and uncertain these situations can be.
Game designer Greg Costikyan wrote in his 2013 book, Uncertainty in Games, that “Uncertainty is not, in most circumstances, a good thing.” While Costikyan’s larger point is about the ways uncertainty is a useful tool in the game designer’s arsenal, his introduction highlights that outside of games, we’d really rather life be more predictable. In particular, he cites the fact that, seemingly overnight, disease can emerge from the ether and annihilate a previously-healthy population.
When it comes to disease outbreaks, it seems as though there is little we can do but recite the statistics and cross our fingers: 40% chance to get cancer; 14% chance to get the flu; 2% chance of a pandemic each year. As a tabletop enthusiast and public health worker, it sometimes feels to me like we’re staring down a series of random tables, hoping for a mild encounter. Sure, we’re probably not going to get another COVID next year. But knowing the odds doesn’t soothe the sting of an unlucky roll.
