 There are hundreds and hundreds of bodies lining the streets. I haven't actually figured out how to fire the gun yet. The report from the World Health Organization showed that the latest vaccination tests have failed. With the bureaucrats out of power, we can finally take the necessary steps. No, you haven't given enough instructions, I'm afraid. To be placed under martial law, all residents are required to report to their designated quarantine. Rights have continued for a third consecutive day, and winter rations are at an all time low. A group calling themselves the Fireflies have claimed responsibility for both attacks. Hi everyone, I'm Dr Benjamin Thompson from the Microbiology Society here in the UK. I'm joined at the Wellcome Trust by a group of experts. We're going to take a look at the last of us and maybe dip a bit into the science behind it and a bit of this sort of sociology behind it as well. How accurate do you think this particular scenario was? So we've learnt in the first 15 minutes of this game that everything has gone very bad, very, very fast. What are your thoughts on how maybe accurate this representation is of what would happen in a terrible situation like that? One thing I think they capture quite powerfully is the way that order in society is quite fragile. It's something that struck me particularly between five years ago almost to the day when we had the riots in London. The fact that it turned out there are only a few thousand police. You've got several million people in London and it turned out when it came to shove they were able to get less than 10,000 police on the streets. You realise that the number of police to the number of actual people in the society is so small that if everybody decides to go out at the same time and create problems or order breaks down then things can go out of control within minutes, within hours. It's quite difficult to get that control back again. I mean, why is it that you think that the game makers love the post-apocalyptic world? Well, there are many reasons. I mean the biggest is probably that there aren't so many people around in the post-apocalypse. There are many things that are important to a video game that aren't necessarily linked to the narrative that work with the post-apocalypse so you can control resources, for example. It lets you have familiar landmarks, present them in a new way, destroyed, overgrown, whatever. Obviously, when we're talking about the opening, there's a lot there that is unrealistic. I will bow to the experts. I think what's important about the way The Last of Us is presenting it is it's trying to give a very personal, ground-level view of how an unfolding pandemic might work. Were something ever to happen, let's say, today or tomorrow, I mean, goodness me, how would it play out, do you think? What would be the first reaction of the emergency services or the government? What would we think we would do? What, with a pandemic like this? Well, I mean, let's say a pandemic like this. Why not? Let's go for it. Let's go 10 out of 10 on an awfulness rating straight away. Well, I don't know. This is 11 out of 10 in that case. What's the first thing we'd see, you think, from an infrastructure perspective? The first thing you do is you bring together the Cabinet Cobra Committee. That's the Cabinet Emergency Committee. I'm assuming there must be some kind of protocols for it. There are some things in place so that part of the project I'm involved in at UCL, together with Public Health England and various other universities, is to create a pandemic early warning system, virtually to do things so that this never happens, so that you have a combination of observing what's happening on Twitter, Facebook, things that are openly available. You're putting together things like receipts from pharmacies, seeing whether there's a rise in people looking for certain sorts of meds and putting that information with doctors appointments to work out, or do we need to start vaccinating more people? So that you can create a dashboard where you can see where the disease is, it's moving where you need to put resources. So a lot of the game is about ensuring that it doesn't get out of control. The UK does have a pandemic strategy for things like influenza and other sort of infectious diseases, and obviously they have various threat levels. So I think a lot of it is about sort of planning as well, because as well as people being sick you're also going to have people off work and there's going to be that impact on kind of the workforce and the delivery. So it really is a lot of work sort of being done to try and ensure like a whole systems approach. What would happen in the first instance? Personally for me, I would be locking the doors, I would be closing the blinds, I would be putting heavy objects in front of the doors and not going out. Trying to look at the television, obviously the television's gone out there. What do we know about any research that's been done on what people tend to do? And what do you think you would do if something like this happened? I mean panic. That seems like the point one would be freak out. I'm not really the man you want in charge. I think let's say rather than turning people into raging zombies we were dealing with the pandemic that was very very contagious. Something like that. You would want to avoid other people. It seems to me quite unnatural in that situation you'd want to be in the middle of a crowd. But you're the same as me, you're staying in maybe a single bead of sweat in the head. I'm trying to avoid large crowds and then we'll see how long I last. What about yourself? What do you think? Stay in. Do you stay in? I would definitely be staying in. And me too. Maybe curfews and isolating people from others to prevent them getting sick. Now is this an effective way of keeping populations safe? And it's kind of the opposite of maybe a TB hospital. It's the other way around. We're trying to keep the healthy people in and the sick people out rather than the sick people in and the healthy people out. So I mean looking maybe from a historical perspective is this an effective way of preventing disease? Certainly in terms of like throughout history there's been lots of isolation you know right back to the 1600s when ships would come to Europe bringing cargo they would have to go through health authorities and be checked for plague and further infectious diseases and even right through to kind of the Ebola outbreak in the last few years isolating infected people is a way of managing a situation like that. So there's certainly room for elements of that in kind of the management of situations like this. By the way the most amazing day of the test I ever seen. I know it's the end of the second. So this was in 2013 I think is that right? No, well that's 2033. 2033 okay. The start of the game is 2013 and then it skips 20 years. I want to be inventing that one. Really okay. Yeah let's get on with that one. The fact that it's a fungus yes that shocked me because actually up to now I only know of fungus causing disease or causing serious disease and death only with people with a problem with the immune system. So yeah a fragile or non-existent immune system. So in the case of a pandemic that has gone so quickly with a fungus for me it's a strange choice of disease although the effect of it is a very common effect I assume. It's a rabies scenario. There's only everything. It's always based on rabies. People get mad and they want to bite the others and then they spread the infection. Classic. Well let's throw that over then maybe with your sort of game journalist hat and you're knowing game makers why have they chosen this one do you think? You know their primary consideration here is not whether spores are a realistic vector for spreading it's whether spores are an interesting visual effect that can make an interesting gameplay section such as wearing your gas mask and moving slowly through somewhere dark and then when you see the enemies themselves they obviously have this striking weirdness of being human but clearly not human. What do we do about stuff that we don't know about? How do we keep an eye on this? You mentioned surveillance a few times there. How do we look for new stuff? Where are we looking for it? That was exactly the case as Ebola the research was done in the early 2000 there was a vaccine, a pretty good candidate made and that's why it went so fast when it came out and the vaccine could then be progressed very quickly to a phase one and a phase two and so on. So the idea is then to fund research on this list of disease so that we prepare as much as we can for vaccines that are ready, not commercialised but then could be used in that situation before it gets out of control, let's say. So that's the preparedness plan. Okay, so be prepared then. Be prepared in terms of vaccines. We can't stop globalization but how can we mitigate its effects maybe? I think it's extremely difficult to mitigate the effects for it. I mean one thing that's interesting to look back to is the 1918-19-19 flu pandemic which killed more people than the First World War. Even in that case it turned out that it was carried on ships across the Atlantic and you saw it within a few months spreading across the world and now we're so much more mobile there's so many weather, just weather sort of fruits, livestock but also people travelling across and I mean you can have scanners at airports or do various things to try and check whether people have elevated temperature and so on. I think it can reduce the risk of the likelihood of catching every case and if you have a highly infectious disease then even if a few cases get through you can still start an epidemic and if the conditions are right you can still get out of control. So it's likely to give you a bit more time or to create a bottleneck which will mean that you've got more time to get things sorted out but I think the likelihood of, as it were, keeping our septic aisle pure from infectious disease by scanning people who are coming through the borders it's probably a UKIP fantasy. We have, Ellie, she has an armbite could, bearing in mind what we know about this world so let's assume there's not a great deal of science there could we take a sample of tissue or something from her armbite and use that to grow up a vaccine of some sort? Not a chance. No? No. One thing that really struck me when I was researching this a year or two ago is that if you really do have the massive pandemic and then there's a question of how do we vaccinate everyone it's out that there's one of the bottlenecks is the actual global capacity to manufacture enough vaccines and I think that part of the problem was that well it seems a bit of a waste of money to have all these vaccine factories doing nothing all the time and then to gear up actually to make sometimes you might need two doses of vaccine to make enough vaccine to vaccinate 7 billion people it's not something that the world can do at the drop of a hat how long would it take? It would take a lot of time and especially because several vaccines are made differently so you need different types of plans of conditions to prepare the vaccine to grow the vaccine it depends if it's an attenuated or a killed whole bug or whether it's a recombinant protein or this is a totally different plant and a different approach so normally I'm a preclinical vaccine developer I'm not working in private companies or pharma producing vaccine as much as I know the plant is actually designed for the vaccine when the vaccine is coming through the pipeline so plants are designed for specific vaccines very often so let's say the new pandemic needs a type of vaccines where there's maybe two plants in the whole world because there's two pharma companies producing it you entirely right there's no capacity at all to produce very quickly one vaccine for 7 billion people we've got her now she's infected she's developing the disease that's still interesting on the point of view she's a case study if nothing else so we take her to our resource pool but appropriate for the period research centre how long would it take to develop something that they could inject into me to prevent me getting infected with the fungus so before you test your vaccine in human can take in the best case scenario I'd say 2 years and in the normal scenario it's 5, 10 years 10 years, potentially 10 years well look at HIV for example how long are we? 20 years? 20, 30 years probably and we have things in clinical trials but not the product so it really depends on the complexity of the bug and the complexity of fighting it or finding ways to fight it and how the bug reacts to the fight some bugs just mutate an antibody that blocks it and the next generation it's mutated so that is a very big deal so typically we do say vaccine developers that if we're given a disease it takes 10 years 10 years is an optimistic do you think that maybe game makers should work more or work closer with scientists to ensure that at least there's a passing nod to what would really happen you say in this case maybe not but even if they just said we're going to make this vaccine it's going to take some time but we're going to do it with at least a nod towards realism I think even more than a nod it very much depends on the type of game you're making again if you are making a kind of brainless sci-fi shooter nobody is really playing that with science if you're making something and I think the last of us does have ambitions to be a kind of deeper game with deeper themes I mean obviously the themes here are more emotional they're about the father-daughter bond but it is a scenario where you can see it could present some of the ethical questions around vaccination and science what are the chances of this we've talked about infrastructure we've talked about science we've talked about vaccine development is this game purely science fiction it's a difficult one to answer but are there pieces of it we could take out and learn from what do we think? I'll hand over to the actual experts the only thing I would say is that if there is a pandemic the victims of it are more likely to be dying rather than running at you that would be the case anything's possible maybe that's too much of a hybrid question thank you all so much for joining me today thank you home for joining us as well I've been Benjamin Thompson we've been here at the Wellcome Trust see you again soon, thanks a lot