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The Honolulu Advertiser
Posted on: Sunday, May 24, 2009

'Coral Cross' game brings computer reality to swine flu in Hawaii

By Dan Nakaso
Advertiser Staff Writer

Hawaii news photo - The Honolulu Advertiser

Stuart Candy is one of the game's developers.

Photos by NORMAN SHAPIRO | The Honolulu Advertiser

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Two sample questions

(answers below)

True or false

"The chances of contracting the current H1N1 'swine flu' can be reduced by avoiding contact with pigs and pork products."

Multiple choice

"How many flu pandemics have occurred over the last 100 years?"

a. 0 (none)

b. 3 (three)

c. 30 (thirty)

d. 10 (ten)

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Hawaii news photo - The Honolulu Advertiser

Scenes from the Web site: www.coralcross.org

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Hawaii news photo - The Honolulu Advertiser

Stuart Candy, a futures researcher at UH-Manoa, with a computer showing the educational game on flu that he has had a hand in developing for the state Department of Health.

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True or false

The chances of contracting the current H1N1 "swine flu" can be reduced by avoiding contact with pigs and pork products.


The H1N1 risk is more about other people than pigs. While it is possible to catch flu from an infected animal, the informal name "swine flu" refers to the origins of the current H1N1 strain, which is now passing from person to person and not from animals to people. Eating meat is not risky.

Multiple choice

How many flu pandemics have occurred over the last 100 years?

ANSWER: b. 3 (three)

In the last 100 years there have been three pandemics: in 1918, 1957 and 1968. The "Spanish flu" in 1918 killed at least 40 million people worldwide.

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State health officials will hold a community meeting on preparing for a flu pandemic from 9 a.m. to 1 p.m. Saturday at Ward Warehouse. Lunch will be provided.





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The designers of an online game that hypothesized a global flu epidemic hitting O'ahu in 2012 have quickly retooled "Coral Cross" for the real-world swine flu outbreak rapidly spreading across the island.

"Coral Cross was" and still is designed to help Island people differentiate between the realities and myths of flu epidemics and to help reach a community wide consensus on issues such as who should be vaccinated first in the event of a pandemic.

"It was a staggering coincidence that we found our alternate reality being overtaken by current events," said Stuart Candy, a researcher at the nonprofit Hawaii Research Center for Futures Studies and project lead for "Coral Cross."

Players can register at www.coralcross.org in preparation for the rollout of the game, which is scheduled for Tuesday.

"Coral Cross" relies on text, quizzes and community forums to impart flu information while gathering community input on people's priorities on who should be vaccinated first against a flu pandemic.

"Coral Cross" follows similar games centered on serious public policy issues, such as "World Without Oil" and "After Shock," about a California earthquake.

But it differs because it is an "emergent reality game versus an alternate reality game," Candy said. "Emergent reality attempts to make a serious difference to the unfolding of real events as they happen. ... This is not 'World of Warcraft' pandemic edition. But it's powerful. A game can make a difference to serious issues."


The original version of "Coral Cross" was based on a fictional emergency preparedness and response agency named "Coral Cross" that was established in September 2011 after a Category 5 hurricane devastated O'ahu.

There are no avatars, three-dimensional landscapes or dizzying graphics in "Coral Cross."

"It's text and images rather than a navigable space where you're wandering around with a sword," Candy said.

Players begin with a 12-question, multiple-choice answer pandemic awareness test. By the end of the test, each player will know all of the answers.

They also win "vigilance points" for answering questions correctly, and a game master awards even more points to players who raise provocative ideas or share interesting stories on discussion boards.

Points are also earned for inputting demographic information to determine where players lie among the five-tiered system from the federal government that ranks who should get vaccinated first during a flu pandemic.

"When you make things measurable, people pay attention in a different way," Candy said. "If you give people a big dose of information, they won't absorb it as readily."

The online game is one of three legs of a program by the state Health Department to help determine who will be inoculated first and who will have to face Hawai'i's next flu pandemic unarmed, at least until a vaccine can be developed and shipped to Hawai'i.

The final determination would lie with Gov. Linda Lingle.

"These are life-and-death questions," Candy said. "In the event of a pandemic, a vaccine would not be available for five or six months. It's necessary for each community to figure out what its values are in terms of who gets vaccinated first."


Before swine flu reached O'ahu this month, Hawai'i and five other states had already been chosen to participate in a federal program to carry out further pandemic planning.

With a grant from the federal Centers for Disease Control and Prevention, state health officials already have taken calls and e-mails on live television broadcasts, hosted a series of town-hall-style gatherings which will continue Saturday and were already planning to unveil "Coral Cross" after Memorial Day.

The original version imagined the scenario playing out in a strong grassroots community based on the concept of Obama-era public service, large-scale government intervention and people skilled in Twitter and social networking sites.

Then swine flu entered the world's consciousness.

"It would have been totally inappropriate to have a pretend pandemic," said Judy Kern, information specialist with the state Health Department. "We needed to adjust to the situation while still trying to get at a thoughtful, deliberative discussion when it comes to vaccine priorities."

In the three weeks that followed, the four-man team of Candy, Matthew Jensen, Nathan Verrill and Jake Dunagan stripped out the hypothetical aspects of "Coral Cross" and injected a healthy dose of reality.

Meanwhile, the number of cases in Hawai'i rose gradually from the initial three reported on May 5, to 44 on Friday. And the state Health Department has said it expects to continue seeing a handful of cases daily.

State officials have been quick to point out that Hawai'i has relatively few cases and that the cases it has have been mild.

"We recognized pretty instantly that having people think about a pandemic in 2012 would be redundant if we were looking at the beginnings of a pandemic in 2009," Candy said. "But we had to be real careful. Pitching the right amount of concern is very difficult. If you overshoot, you're accused of crying wolf. Having this conversation in a way that takes into full account the possibilities without adding unnecessary panic is really hard."

While "Coral Cross" is a game, Candy insists that anyone who plays it will leave it better informed about the realities of a flu pandemic.