Coral Cross: Pandemic Preparedness from the Hawaii Department of Health

coralcrossDystopic literature often turns to the threat of pandemics for inspiration. From Albert Camus’ La Peste to Stephen King’s The Stand, authors create global pandemics in their stories to confront issues raised by a threat to human survival that strikes at the very fabric of our society. In order to open a dialogue about Hawaii’s pandemic preparedness and allocation priorities, the U.S. Centers for Disease Control and Prevention is funding an alternate reality game starting in mid-May at

As part of a larger public engagement initiative that includes community meetings and a live TV panel, the Hawaii State Department of Heath has contracted with the Hawaii Research Center for Future Studies to produce Coral Cross, a “playable scenario” on the island of Oahu. According to Judy Kern at the Communications Office of the Hawaii State Department of Health, the goal of the ARG is to “help encourage public dialogue and elicit input for decision-makers on Hawaii’s pandemic priorities.”

The game is scheduled to launch during the second half of May, with each day representing one month of game time. While anyone can play, the game’s core audience will be located in Hawaii, particularly the island of Oahu. As Stuart Candy, researcher at the Hawaii Research Center for Futures Studies, explains,

First, we can make use of the limited geography — a captive audience, if you like — by using more real-life elements to augment the storytelling. Second, as a member of our design team observed, the fact that we’re tackling a global topic, pandemic flu, with a local tilt, not only gives it an interesting flavour, but it also helps the scenario. Instead of trying to evoke every last thing about how the world could transform as a result of a deadly disease sweeping across it, the island acts as a sort of microcosm in which, no matter where they’re from, people will be able to see what’s at stake more clearly and concretely, in particular how lives and communities are affected.

By restricting the geographic field of gameplay to a limited area, Coral Cross will hopefully be able to address the impact pandemics will have on local communities and social structures while providing a truly immersive experience for the participants.

For a number of years, the Hawaii Research Center for Futures Studies has been facilitating public discussions of future scenarios through “experiential futures.” And as a former Game Master for the Institute For the Future’s forecasting game Superstruct, Stuart Candy received first-hand exposure to the potential of the genre for community forecasting. With serious games like World Without Oil, Superstruct, After Shock, Ruby’s Bequest, and Coral Cross engaging the community in meaningful dialogue, Jane McGonigal’s dream of seeing a game designer win the Nobel Peace Prize is becoming increasingly likely.

Anyone interested in Coral Cross can submit their email address to in order to receive notification when the game begins in May.


  1. Steve Diddle

    I wonder what kind of safeguards are in place to avoid having the public believe that there is a real pandemic War of the Worlds style.

  2. Stuart Candy

    Michael, thanks for this report.

    Martin, I appreciate your comment.

    Causing undue fear or confusion is not part of our intention. Having people take these possibilities seriously, however, is very much part of the point. Therefore the “War of the Worlds” issue you raise has been the subject of much discussion within our team since the beginning.

    There are several cues to let users know that the pandemic in our story is not actually happening now. Perhaps the most obvious and important of these is the fact that this story is set several years into the future. (“Est 2011” appears beneath each instance of the Coral Cross logo, as you’ll see when you check out

    I hope you’ll enjoy taking part in May, and trust that the very real concerns to which this scenario points will provide provocative food for thought.

  3. Hazel Grian

    This sounds absolutely brilliant! Well done!

  4. Steve Diddle

    Thanks for the reply Stuart. I’ve visited the site (and signed up) and see that in addition to the reference to the year 2011 you also have a “What’s going on here” tab at the bottom of the page which explains the nature of the scenario. I’d suggest that even though that warning detracts from the “realism” of the game is should be on every page. Because even though the War of the Worlds radio program started each episode with an introduction explaining it was fictional people tuned in after it started and got the wrong idea. With search engines people can enter your website at any point and could get the wrong idea…
    I think this is an interesting topic for a serious game. Is the goal to educate the public on the government plans to deal with a pandemic or is the focus on gathering data and ideas for how the public would react to different pandemic reaction measures?

  5. mary quijano

    The threat from a pandemic flu is very real, not a science fiction “sometime in the nebulous distant future” scenario to scare and/or entertain. If you don’t believe the danger, read up on what happened just 90 years ago during the great pandemic of 1918; then realize that we still have no cures or vaccines that are truly effective against the influenza virus, any more than we did in 1918. Also think of the vast changes in the global community have occured since then, especially in the areas of mass transportation, urbanization, economics and communications. The current best contender for a pandemic is an avian influenza virus that currently is 30 to 40 times as lethal as the virus that killed between 50 and 100 million people WW in a little over a year back then. So a little well deserved “fear” is not unwarranted if it will spur people to take effective precautions to keep themselves and their families safe.

  6. Stuart Candy

    Hazel, thanks for the upbeat response!

    Mary, we appreciate you pointing that out. Though the details are impossible to predict, periodic pandemics are regarded as a biological inevitability, which does make the comparison with “War of the Worlds” a bit misleading. Triggering appropriate levels of concern — not merely for dramatic effect, but to raise the warranted level of attention — is quite a challenge here.

    Martin, the thinking behind this initiative has more than one aspect, so it’s a combination of the things you mention; educating and soliciting input. I’ll speak to what we as the designers of this scenario had in mind, while seeking to understand and translate into action the Department of Health’s aims.

    On the education front, I’d say it’s a bit broader than helping get folks acquainted with government plans and responses. More than conveying pre-determined content, Coral Cross is about opening lines of thought and conversation, for *all* parties, including questions about how they themselves might behave in such a scenario. It also suggests that there may be things officials *won’t* be able to do (e.g. swoop in to save the day), making individual, family, and community preparedness all the more important.

    So on the matter of input, the hope is that the game will catalyse higher quality insights (higher, that is, than conventional bids to raise public awareness) into the possibility of a pandemic, by enabling sustained engagement with concrete details. (Ironically, I share more specifics for now!) Yes, some input mechanisms are part of the design. But not all such insights will be, nor do they need to be, captured in-game. Plenty of valuable conversation will happen around the water cooler or dinner table, for example.

    As futurists our aim is to raise the quality of engagement with a range of future possibilities, increasing the collective capacity for foresight, and with that, responsibility. Coral Cross has been created with this in mind.

  7. Loren

    Just got forwarded an internal memo for the DoH abouth the game from my Mom, who works there:

    For Immediate Release: April 15, 2009 09-025


    HONOLULU – The Hawai‘i State Department of Health (DOH) is launching “Vaccine: Surviving Hawai‘i’s Next Pandemic,” a public initiative project to involve the public in discussions of planning for a potential influenza pandemic, including how to prioritize the distribution of limited supplies of vaccine in the event of a pandemic. The demonstration project is funded by a grant from the U.S. Centers for Disease Control and Prevention, and invites the public to participate in any or all of three components: live, viewer call-in televised panel discussions, an Alternate Reality Game (ARG) in which a simulated pandemic strikes a future Hawai‘i, and community meetings in May.

    “The key to disaster response is preparedness,” said Lt. Governor James R. “Duke” Aiona, Jr. “With a focus on public engagement as part of the decision-making process, this project reinforces our efforts to develop a collaborative solution.”

    “Open communication with the public is an essential part of government transparency,” said Dr. Chiyome Fukino, director of health. “This project is designed to offer a range of opportunities for public dialogue and will be evaluated for use as a model for other states to follow.”

    “What are the community’s values and opinions regarding vaccine prioritization? What are the unique concerns facing Hawai‘i’s people? These are key questions,” said Dr. Sarah Park, chief, Disease Outbreak Control Division and principal investigator for the project. “We really want to hear from people on important community issues that should be considered by the leaders who will have to make the difficult choices in the event of a pandemic.”

    The television segment of the project starts today, April 15, 8:00 -9:00 p.m. on KHNL-TV Channel 8 and continues again on April 22 and 29 from 8-9 p.m.. The three live, call-in panel discussions will cover different perspectives on the subject of vaccine prioritization during a pandemic. Panelists will include Lt. Governor James R. “Duke” Aiona Jr., Dr. Chiyome Fukino, DOH director, Dr. Sarah Park, state epidemiologist and chief of the DOH Disease Outbreak Control Division, and a diverse lineup of other panelists from throughout the community. Rebroadcasts of the show will air April 19, 26 and May 3 from 6-7 p.m. on KFVE Channel 5, or viewers may log on to for streaming video of the broadcasts.

    The Alternate Reality Game ( will run May 24-30 and puts users into the scenario of Hawai‘i in the year 2012 in a simulated influenza pandemic, for which there is not yet a vaccine supply. Each day of the scenario will constitute one “virtual month,” and participants will gain insight into the social, economic, and public health aspects of a pandemic as it unfolds.

    The community meetings portion of the public engagement project is built around illustrative vignettes using representative characters drawn from Hawai‘i’s diverse population for the purposes of highlighting the difficulty of determining who should receive the vaccine first in time of shortage. The free and open meetings are scheduled for May, with times and places to be announced.

  8. connie harrison

    I am looking forward to this game as my grandfather lived through the 1918 flu as
    well my kids grandfather on the other side
    caught it as a baby and lived.Big strong men
    died and a frail little baby made it.What
    were all the factors in that big dice roll.
    When I was young went through the Hong Kong
    flu and almost bit it.Its very serious

  9. Davoice321

    This site looks like an interesting health-related ARG-like game:

    It seems more long-term, but could be interesting.