Illness overhaul

[Woolfy]

Hey there!

 

I had a cold last week and while curing I played TLD most of the day :)

And then I got this idea: peoples immune system doesn‘t work properly when freezing so what about having a chance to get sick the next day once warmth droped to minimum?(And by sick I mean feever (maybe a blur effect and some major stamina debuffs?) and cough (as a sound effect). 

I think a mixture of antibiotics, much water and constant warmth should cure it within 3 days in best case. The less you do against it the longer it lasts and if you do nothing you have a chance to die.

However, this mechanic should fade away by the time as you play because the body gets used to the harsh conditions and so does the immune system.

 

Personally I think this would be a nice and realistic extra challenge to deal with and an improvement to the overall survival mode experience.

What do you guys think? 

(And sorry, english is not my native language :/ ) 

[UpUpAway95]

Personally, I wouldn't want to see them add another illness where the arbitrary solution is to pop antibiotics... perhaps this is something that consuming birch bark teas could cure over 3 days combined with needing more sleep instead.  Alternatively, maybe we could find vitamins to help bolster our immune system or they could add it to the effects of herbal teas.

Edited August 10, 2019 by UpUpAway95

[Woolfy]

14 minutes ago, UpUpAway95 said:

Personally, I wouldn't want to see them add another illness where the arbitrary solution is to pop antibiotics... perhaps this is something that consuming birch bark teas could cure over 3 days combined with needing more sleep instead.  Alternatively, maybe we could find vitamins to help bolster our immune system or they could add it to the effects of herbal teas.

We could call it a viral infection then, so antibiotics are useless against it. Only thing you can do is to boost your immune system and avoid anything that could strain it. 

Well the details are not that important but I think its a logic thing to add into the game 

[Timmytwothumbs]

I've also wondered why the player doesn't get sick from freezing. I wouldn't mind getting a cold or viral infection maybe in game from letting my temperature drop in to the red. If it lowered your stamina, made your rifle shaky, the screen could be clouded also if it didn't allow you to study etc. It could be a new challenge and further increase the importance of warm clothing. Maybe the only recovery is time and rest and you have to consume more water. I thinks it's a good idea. 

[ajb1978]

Colds aren't caused by being cold, they're caused by being infected with something like rhinovirus. While this virus is quite communicable, it requires contact with people who are carriers.  It's possible to become infected by way of contact with an infected surface, but realistically if there aren't a lot of people around, your odds of contracting a virus are pretty slim.

[MrsHoneypot]

The character  touches other people's things constantly, harvesting clothes and towels for cloth. 

If the immune system is compromised by being constantly cold, there is a chance a person could get a cold from that.

I like the idea, we're just talking about specifics now.

Your English is perfect, by the way, I didn't see any mistakes. 🙂

[ManicManiac]

On ‎8‎/‎10‎/‎2019 at 2:02 PM, Woolfy said:

immune system doesn‘t work properly when freezing

12 hours ago, MrsHoneypot said:

the immune system is compromised by being constantly cold

On ‎8‎/‎14‎/‎2019 at 6:42 AM, Timmytwothumbs said:

I've also wondered why the player doesn't get sick from freezing.

...do you mean deeply hypothermic (as in one's core temperature is dangerously low)?  Because in general being cold doesn't impact the immune system in any direct or meaningful way; that's not how immune systems work  
Illness is caused by pathogens, not temperature.  The idea that being cold makes you sick is an unfortunate (and silly) remnant of medieval medicine  

 

On ‎8‎/‎14‎/‎2019 at 9:15 AM, ajb1978 said:

Colds aren't caused by being cold, they're caused by being infected with something like rhinovirus.

Absolutely right.

Edited August 29, 2019 by ManicManiac

[Timmytwothumbs]

@ManicManiac

@ajb1978

Not here to argue. First id like to say that yes there is a correlation between sickness and colder temperatures it may be hard to see today because we live most of our lives indoors during the winter but prolonged exposure to cold dry air absolutely has a negative impact on respitory health as well as the localized immune system there. Also hypothermia, frostbite, and freezing in fact suppressess the immune system in the entire body and in addition to that common viruses THRIVE in colder temperatures. Increasing the likelyhood of catching a "cold". Also the lack of sunlight absorbed by the skin because of the clothing we wear in the winter contribute to the demise of our immune system. It may be an old wives tale but there's truth to it. The temperature drops people are more likely to get sick especially when the body is under stress. The other thing to remember is viruses are able to live on surfaces especially uncleaned for varying amounts of time and we are constantly introduced to thousands of viruses everyday our immune system fortunately is able to fight off.. when we are HEALTHY. But starving yourself and freezing and the stress from the apocalypse all contribute to a weakening immune system. Just because there's no people doesn't mean there's no bacteria or viruses. Yes viruses need a host but something as simple as an insect, a bird, even a wolf can be a host. Not to mention viruses that mainly affect  animals that humans can be affected by as well like rabies, which could easily result from a wolf attack. Not saying this particular health system has to be in the long dark but your statements against it are unfortunately not guided by any research and are consequently untrue.

 

 

[ManicManiac]

@Timmytwothumbs,

Airborne pathogens have to be able to survive in the open air... it's kind of their thing.  Just because they are resilient in a larger temperature range does not mean that cold weather makes you sick.  It's is just a very outdated belief, I'm sorry to have to say.

"Correlation does not imply causation."  
     - Science

 

Edited August 29, 2019 by ManicManiac

[Timmytwothumbs]

Viruses, such as rhinoviruses and influenza, cause colds and the flu, not the weather. However, exposure to cold weather can increase a person's risk of contracting a virus.

Research suggests that these viruses may survive and reproduce more effectively at colder temperatures, making it easier for them to spread and infect more people. Cold weather may also reduce the immune response and make it harder for the body to fight off germs.

@ManicManiac

Never said cold weather makes you sick... I said cold weather reduces the effectivity of the immunes system and also results in higher populations of airborne pathogens. Increasing the likelyhood of getting sick.

[ManicManiac]

"may also" and "can" are not definite terms.
It's kind of like saying rain may cause you to get struck by lightning... which is not the case... lightning may cause you to get struck by lightning.   

Anyway, I'm not here to argue either.  
I said my peace, I'm not interested in debating with anyone about it.

Edited August 30, 2019 by ManicManiac
Edited because I am no longer engaging in this conversation.

[MrsHoneypot]

Thanks for the backup Timmy.

I´ve read similar articles in british medical magazines, which is why i said it in the first place.

I´m a third person who´s not here to argue. 😉

Edited August 31, 2019 by MrsHoneypot

[rakshasa]

Real-world sickness mechanics notwithstanding, it'd be great to see more afflictions in the game, especially on longer time-frames. I'm all for a "you got sick" mechanic. I wonder about how the risk would function however, or be communicated to the player. The way all the existing afflictions work now is as a consequence of something else. Infection risk from an animal attack, food poisoning from dodgy food, hypothermia from being in the cold too long, sprains from goating around on slopes, etc.

As we all know from the discussion around sprains, adequate communication about the tradeoffs of risky behavior is key. Maybe the player could have an increased chance of getting sick the longer they spend below a certain condition threshold, to represent a stressed immune system?

[ThePancakeLady]

3 minutes ago, rakshasa said:

As we all know from the discussion around sprains, adequate communication about the tradeoffs of risky behavior is key. Maybe the player could have an increased chance of getting sick the longer they spend below a certain condition threshold, to represent a stressed immune system?

I could see an increased risk for some things, like infections, as a consequence of prolonged starvation. Nutrition is key for a healthy immune system. Not sure what other afflictions we already have would have a greater risk, though. Did you have any more specific ideas for new afflictions, and what would increase or decrease any risk factors?

[ManicManiac]

@rakshasa
I agree, I think it could be really interesting if there was the possibility of being afflicted by other pathogens.  I imagine in the world of The Long Dark, being stranded on Great Bear, in the deep winter, and with a bout of Influenza would be potentially very life threatening. 

[rakshasa]

18 minutes ago, ThePancakeLady said:

Did you have any more specific ideas for new afflictions, and what would increase or decrease any risk factors?

Perhaps pneumonia risk, calculated in a similar way to how cabin fever is done, e.g. % of time you've spent at risk for hypothermia in the last X days.

Edited September 24, 2019 by rakshasa

[ManicManiac]

Maybe, but I'm still not wild about the idea of associating viral/bacterial infection with "being cold" as the cause.
As I mentioned previously, the idea that being cold makes you sick is an unfortunate (and kind of silly) remnant of medieval medicine.

[rakshasa]

17 hours ago, ManicManiac said:

Maybe, but I'm still not wild about the idea of associating viral/bacterial infection with "being cold" as the cause.
As I mentioned previously, the idea that being cold makes you sick is an unfortunate (and kind of silly) remnant of medieval medicine.

This is true. But there appears to be a correlation between infection susceptibility / mortality for respiratory infections in cold weather conditions, so it doesn't feel like a huge stretch. And the difference between "cold weather causes illness" and "cold weather can encourage / exacerbate illness" feels a bit subtle and academic for a video game

Some stomach viruses like C. difficile and Norovirus can survive outside a host for weeks or, in the case of C. difficile, up to 5 months.

For stomach bugs, carcass harvesting could be a possible vector, perhaps with the risk increased if you are doing it with bare hands.

[ManicManiac]

@rakshasa

Now granted, it's only a game... so they could potentially set something like this up however they'd want. 

I think that of all the aliments a person can have in a setting like this, getting sick (viral/bacterial) is the one thing they could setup as completely "random" and it would make perfect sense from a reasonable standpoint.  I say that, because pathogen exposure is random anyways (that is to say that you never know when you touch a contaminated object or inhale an airborne pathogen - their effectively just proteins/cells unintelligently bumping around until they happen upon a more hospitable environment for them to flourish).

I do agree that malnutrition and hypothermia (as in your actual core temperature has dropped below the norm of homeothermic thresholds) can have an impact on how certain parts of the immune system behaves... but the Complement System exists to make sure the process never stops even if other various immune cells that may be slower to respond due to metabolic slowdowns.  However, word's like can and may are not definite terms.  This is why I was previously so quick to point out that when it comes "cold" and illness... correlation is not causation.

I do like a lot of your ideas in terms of points of contact/exposer that might present risk of viral/bacterial infection.

For the sake of simplicity, I'd say that the same effect can be achieved by perhaps making the system "random"... and having those kinds of activity sort of buff the percentage a little.  This way, sickness would be relatively rare... but it would seemingly come out of nowhere, just like most illnesses do.    The team already has experience with this type of system... the old sprain mechanic was hidden from the player as well, and it resulted in sprains that struck the player seeming at random... even when it didn't necessarily make sense in context.

 

Edited September 25, 2019 by ManicManiac

[ThePancakeLady]

On 9/24/2019 at 4:34 PM, rakshasa said:

Perhaps pneumonia risk, calculated in a similar way to how cabin fever is done, e.g. % of time you've spent at risk for hypothermia in the last X days.

Perhaps not *pneumonia*, but I saw this on Twitter this morning...

https://twitter.com/CDCgov/status/1176199560173150208?s=20

TB... field dressing deer that carry the bacteria can lead to zoonotic TB infections in deer hunters who don't use universal precautions. The link in the Tweet goes to an article about a hunter who developed a case of pulmonary tuberculosis, with the only exposure risk being... he was an avid deer hunter.

We aren't going to be finding trauma gloves and surgical masks all over the island. That would be silly. But an increased risk of an infection after harvesting deer or moose carcasses, or *possibly* wolf carcasses or wolf bites (since dogs/canids can carry Bovid TB as well as deer) is plausible. Either a pulmonary or cutaneous infection. For the sake of simplicity in the game, I don't think specifying which form would be appropriate, just increased risk of Affliction: Infection.  The risk would not be great, the zoonotic infection can happen (does happen), but all of the papers I found on it by the CDC and WHO show low numbers of confirmed cases, not widespread or common numbers.

But, since gloves and masks are not a "thing" in game (and should not be, IMHO), it could be something to be considered if a health and wellbeing system that includes hygiene (washing) were added to the game. X number of contacts with deer, moose and wolves, and lack of hygiene after the harvesting or contact = slight increase in risk. Small modifier change to risk from wolf bites, modifier added to carcass harvesting mechanic/skill. **Hell, include bear and rabbits as well. Make all animals potential carriers** A bit less complicated to code that way. As Carcass Harvesting Skill is leveled up, add a decrease in the infection risk, 0 risk at Lvl 5, to remove the risk from carcass harvesting, (you know how to efficiently harvest an animal now, and don't splash fluids from the animal's respiratory tract around any longer). As far as risk from wolf bites, bear claws and bites, or a moose standing over you snotting on you as it tap dances on your torso... small increase in infection risk from any animal attack, decreased by washing up within a certain amount of time.

TB is a bacterial infection, so treatment for the infection would not need to change. Antibiotics for the infection, bite wounds retain the current treatment for risk, general risk treatment for non-bite exposure would be... washing up.

Plausible. Semi-realistic. But still requires a new hygiene mechanic to be added, and changes to risk modifiers for certain interactions. Can it be done? Sure. Is it worth the time and effort needed for the devs to write the code? Maybe, maybe not. That's up to them, and their vision for the game and the experience they are trying to create for us.

[ManicManiac]

It's neat idea to be sure.

[Woolfy]

On 9/25/2019 at 6:00 PM, rakshasa said:

This is true. But there appears to be a correlation between infection susceptibility / mortality for respiratory infections in cold weather conditions, so it doesn't feel like a huge stretch. And the difference between "cold weather causes illness" and "cold weather can encourage / exacerbate illness" feels a bit subtle and academic for a video game

 

Thank you for pointing that out.

 

I never meant to say that cold temperatures make sick.

But I think in the end everyone knows that people get sick in winter months more easily whatever biochemical mechanic is responsible for that. 
The details are not that important for it to be „believable“ in TLD 

[Guest kristaok]

We already have the hypothermia and frostbite risk from being too cold for too long... hmm... maybe contracting pneumonia might work?, but it would have to be pretty rare or something, or perhaps the flu? whatever.  But with everyone moved on and gone it would be a lot harder / more rare to catch anything now anyway.

I do want to see more ailments, but I was thinking along the lines of "Rabbit Starvation".