The atmosphere is somewhat tense on the seventh floor of the Bayle building. Employees are walking in and out for the final deliberations for the pandemic game, which is about to be played by two hundred students in just a matter of moments. “We’re doing this for the ninth time now, but it’s just as exciting for us this year,” Professor Roland Bal comments. “It is the first time that we’re doing it online and we have more students than ever taking part.”

The pandemic game is the final assignment for the first-year subject on The Dutch Healthcare System in the Health Sciences degree programme. During the game, student groups have to resolve a fictitious pandemic while playing the roles of the various parties involved. “We invented the game in response to the Mexican flu, but with the coronavirus, this exercise is more topical than ever,” says Bal, one of the game’s inventors as well as its coordinator. He’s a bit of a jack-of-all-trades today, so for now, he can sit quietly on a bench while teachers prepare for the outbreak in nearby offices.


Ronald Bal
Professor Ronald Bal. Image credit: Wouter Sterrenburg

The game starts with the transmission of a virus – at that time still unknown – which has been transmitted to a woman by a llama. Within thirty fictitious weeks, the virus spreads all over the world and it is up to the students to formulate measures, develop a vaccine and acquire it. Professor Bal: “The goal of the assignment is to familiarise students with how this would work in practice. In theory, it is perfectly logical that everyone would work together and that everything would go smoothly, but this kind of policy process is far more confusing in the real world.”

Whereas this would normally become clear in a large lecture hall where everyone is walking around amongst each other, things are rather different now. “We use, a platform from a Berlin start-up that allows students to walk across a digital square and ‘talk to each other’ so that they can discuss issues such as the price of the vaccine. Usually keeping an overview of the discussion is just a matter of listening in, but now teachers have to switch between the various digital discussions. That is a bit of a change of gear, but the teachers seem to be doing a good job of it. While the initial explanations come across as slightly formal, the first-year students soon calmly continue discussing the issues whenever their teacher ‘makes an entrance’. In the meantime, you can see through a series of dots how students move from the digital square to their own home bases for private consultations. Other students at their own hospital, ministry or head office are unable to listen in then.

Lying about the vaccine price

Although this format takes some time for students to get used to, the game goes pretty smoothly. For example, teacher Martijn Felder sees in his workgroup that students are able to take on their roles reasonably well: “Just now, the students who have the pharmacist role came up with the question of whether they are allowed to lie about the cost of the vaccine,” he laughs. “Students probably don’t give that much thought to something like that happening when they deal with it as a theory. That’s exactly why this exercise is so good for the students.”

Various teachers tell us that their groups are running out of steam: They had already held discussions about travel advice, lockdowns and other more extensive measures at an early stage in the game. In one group, the students try with all their might to contain the virus even before it arrives in their country, according to their teacher. “They have locked out the country from the outside world, and there is a mandatory quarantine for people who are suspected of having the virus. The police check whether they are complying with this,” says teacher Hanna Stalenhoef. Why are these students getting carried away? “They wanted, in their words, ‘not to be such a pussy like the Netherlands is.’”

Online discussie
Syb Kuijper listens to students who discuss their strategy in the pandemic game. Image credit: Wouter Sterrenburg

Once the game is finally over, it turns out to be all in vain. The measures that were taken to keep the game manageable have actually made no impact on the spread of the virus. Student Ivo Kruijt explains over the phone why he can understand that: “Reality works out a bit differently of course, but all in all, I thought this was a good way to approach course material from a different perspective. It makes it very clear how many parties are involved in making policy choices when it comes to pandemics.”

Total lockdown or travel advice

Bal sees the effect of the corona crisis in the number of measures taken. “Students obviously have a lot more prior knowledge than in previous years. Therefore, there was plenty of diversity in the policy choices made by the various groups, from a total lockdown to very laidback discussions about whether there should be travel advice in place. The students didn’t really come up with innovative solutions, but most discussions were far more specific than in other years. What’s also remarkable is that some measures were adopted very quickly. We got used to the fact that basic rights can be sacrificed because of a pandemic.”

In any event, this digital edition of the pandemic game was a success for Bal and the rest of the team: “The students thought carefully about what their goals were, how they could achieve them and who they needed to get things done. We should be very pleased about that, I think. All the same, I hope that next year we will be able to hold it in person again. Negotiations – fictitious or not – just work better if you can look each other in the eye.”