Is the Divisions take on smallpox accurate or inaccurate?

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The last time I wrote about microbiology stuff was when I  discussed the Cordyceps fungus and its role in The Last of Us – namely why I felt it was somewhat improbable. I found a lot of enjoyment in applying my micro knowledge to that sort of thing, and it got a good reaction so I think going forward here or there I’m going to try to write something in that vein.So without further ado, I’d like to take a look-see at The Division – a Ubisoft multiplayer type game that I have not played as of yet, to keep that tradition from The Last of Us going-and ponder if such a thing could happen.  Also please understand that I’m a microbiologist in major/graduation mainly and not a researcher…yet. Even if I were my focus is not on viruses, but on bacteria, so I can’t claim to be perfect here. This is based on some research I’ve done both in my schooling and via looking up internet sources; I won’t claim it’s all perfectly right even if I believe it to be, so I apologize for any errors if they are present.

In The Division, a massive outbreak strikes New York City in the form of a modified variant of the smallpox virus, leading to massive civilian casualties and a breakdown of social order. This leads to sleeper agents being activated and deployed to restore order and figure out the origin of the virus.  Now as with before, I think it’s important to explain what the pathogen is and how it works to help understand its usage and feasibility in this game. While this version of smallpox is a different one, being a chimeric strain composed of several different viral genes, I think looking at the actual thing can still be informative and important.

“What is smallpox?”

Smallpox virus is shockingly-a poxvirus, and as such it uses double-stranded DNA-(the genetic blueprints to build anything in a cell)- to store its genetic information.This is important to note as there is a wide variety of storage methods available to viruses, with some even using RNA-(the messenger that translates DNA messages into protein messages)-in a bizarre format that is different than any other “lifeform” on earth.  Additionally, it reproduces in the cytoplasm-(think the goo filling the cell)-and has to encode several of its own pieces of machinery to make new viruses. Another key feature of the virus is that it’s good at avoiding the immune system via interrupting cell communication to immune cells, thus allowing the virus to continue growing until cell lysis and further release into the body.

The smallpox virus holds an interesting distinction: It’s one of the small number of organisms on earth that was intentionally and successfully driven to extinction. As of 1977 this virus has been extinct in the wild and only exists in labs for research after an estimated 5,000 year old run on this blue marble. Because the virus is a human-exclusive one, such efforts had a chance at being successful because there is no animal reservoir for the virus to hide in. The virus itself is a nasty one indeed: It begins its infection in the respiratory tract and from there after a week or two it causes rather disgusting-looking papules-”a small, raised, solid pimple or swelling, often forming part of a rash on the skin and typically inflamed but not producing pus”-that then turn into pustular forms, which as the name implies, produce pus. The death rate is around 30% and even if it doesn’t kill you, it leaves horrible scars on your body and can cause blindness.

This is to say nothing of what the virus can do in a virgin population that has never had the virus in its area. By some accounts when the virus made its way to Mexico when Cortez was attempting to take over, it had the potential to kill more than half of the population in a given area-and apparently that was not an uncommon occurrence. It’s sometimes credited as being the reason for successful conquering of the Aztecs-and with numbers of dead that high it’s not hard to see why. Now that this disease is gone from our world, the human population has no immunity to it as a whole-meaning that it could cause an incredibly high amount of deaths in a similar vein to the above instance-which is, after all, the entire conceit of the game.

Luckily there is a vaccine for smallpox-and in fact, it’s one of the most famous cases of vaccination in western history. It was eventually figured out, and then notably put forward by Edward Jenner, that you could use cowpox virus to vaccinate against smallpox virus without the risk of exposing people to smallpox. The vaccine as it is today consists of a two pronged needle which is dipped in vaccine liquid containing the Vaccinia virus-a close relative to both cowpox and smallpox that was at some point swapped in, probably by accident, and became the virus for vaccines-and then exposed to the skin via repeated pricks to it. This will result in a large pus-filled blister that will scab up and fall off, leaving a small scar where the virus was put into the skin. Unfortunately the virus can spread and cause complications, and it can also result in severe side effects in 1,000 people for every million.

So now that you understand what smallpox is, its place in human history, and why fears of it being used as a bioweapon exist, I think it’s time to examine the game version proper. Unfortunately for the world of The Division, this is a different version of smallpox against which the traditional vaccine is useless. Loosed upon a virgin population it causes massive devastation and huge amounts of death, with the previously useful vaccine being ineffective and no supportive care options available-aside from making the sick comfortable while they die. As I’ll get into later, this is what causes the breakdown in social order and requires agents to roll in to clean up rogue agencies and people taking advantage of the situation.

The world and status of society in The Division is heavily influenced by a simulation called Operation Dark Winter. Operation Dark Winter was a bioterror simulation ran in June 2001 that was designed to test the impact of a smallpox attack on the US. The key conclusions seem to indicate that the healthcare system would not be ready to deal with the surge of the ill, as well as the pharmaceutical/vaccine industries not being able to deal with such surges either. They also found that it would be entirely possible for civil disorder to occur and dubious ethics or legal practices potentially being used to attempt to restore order or contain the outbreak.

The Division is based off of this study, and the conclusions in the paper are what shape the city of New York during the outbreak in game. While this is an interesting concept and its clear Ubisoft has done some research here there is dumb action movie stuff as well, including an evil PMC and rogue agents etc etc. I can’t speak to the validity of a sleeper agent program though I assume it’s a plot device for the purposes of having a game. Additionally the smallpox virus in this game has several different viruses mixed into its genome such as “Dengue, Ebola, H1N1, Hantavirus, Marburg and Swine flu” which could potentially be based off of actual Soviet Union attempts to make chimeric viruses. I can’t describe the efficacy of that technique in terms of making a deadlier pathogen, though one assumes that mixing and matching genes like that would probably be more likely to create a dud.

Additionally, in the game sleeper agents are given extreme jurisdiction; apparently they are allowed to go rogue and kill other agents to accomplish their goals. Another thing to note is Directive 51, which is put into effect when this crisis occurs, which essentially gives the President total authority as opposed to the normal checks and balances in place when the directive is not in effect. From what I have been able to glean, agents also have a wide amount of latitude in what they do, which could potentially involve trampling on legal rights if they deem it to be in the best interest of their current task-a worrisome proposal that gets into the legal issues brought up by Operation Dark Winter.

Overall I think it’s interesting to consider that there is a lot of research put into The Division and that such an occurrence (minus the dramatized elements) could potentially occur. Ubisoft tends to put in some legwork when it comes to researching things and it seems they did a fair job here from the bits I’ve gleaned from online sources. Hopefully this blog proved informative or entertaining to you, and I’d happily take suggestions for the next topic! Thanks for reading!



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