[Daddy Warpig]

For my next Shadowrun campaign, I'm working on an alt-history setting, set in 2032. This is the first piece of background I've completed, an encyclopedia entry about VITAS (annotated in familiar Shadowrun fashion).

Why VITAS? Because, in my alt-history, it began the wave of changes that lead to the world of 2032, and I needed an in-depth explanation of exactly what the disease was.

Here it is. Comments welcome.

# # #

VITAS (Virally Induced Toxic Allergy Syndrome)

VITAS, Virally Induced Toxic Allergy Syndrome, is an unique auto-immune disease which causes the body to become allergic to previously innocuous allergens. (Unique as no other autoimmune disease provokes allergic—Type I Hypersensitivity—responses.) These new allergies cause anaphylactic reactions in the infected, the observed anaphylaxis symptoms varying from mild—syncope (i.e. loss of consciousness), rashes, shortness of breath—to lethal—myocardial infarction or asphyxiation.

In normal circumstances, most people display no severe allergies. VITAS alters this dynamic as all infected become sensitive to a few allergens, and many became allergic to a multitude of allergens. Common allergens include wheat or milk, metal or vinyl, pet dander or dust mite excretions. VITAS can cause sensitivity to these and nearly any other allergen. The dangers to specific individuals vary according to which allergens they became sensitive to and how severe their anaphylaxis symptoms are.

> Something not mentioned, but important: these allergies were acquired for life. The virus changed the host’s body so you became allergic, and the allergies stuck around after the disease was cured.

Talk to anyone who survived the plague, and ask them what’s it’s like to be allergic to half a dozen random things, like metal or vinyl. Know how many things are made out of metal? Imagine that every time you touched a spoon or a car you got a rash, or fainted, or had an asthma attack. Plus, each time you’re exposed, you have a good chance of your reaction becoming stronger. Touch metal too much, and you can find your windpipe closing or your heart stopping. VITAS is still killing people, decades after the disease went away.
- Orc Rights Crusader

> Catch that? “Unique disease.” Let me translate that for you: no other disease in human history, before or since, has provoked allergic reactions. None. There are simply no other diseases that operate like this one does. That’s not natural. Don’t let anyone tell you otherwise.
- Paranoid w/ Enemies

> Let me guess. Vampires, Elves, Dragons, Big Pharma, Big Brother, Stuffer Shack, and NERPS are out to get you and engineered this virus to do just that, “Paranoid w/out Braincells”. Thanks for the heads-up.

Look kids, there are a lot of unknowns in biology and medicine, a lot of mysteries and idiosyncrasies. And that was before magic entered the picture. So, hey, how about tamping down the insanity? Sometimes, sh*t just happens.
- Lost Cause

Transmission

VITAS in an air-borne virus, simply breathing the same air as an infectious individual can transmit the disease. Once contracted, the disease has a latent period of 3-6 days, during which the carrier is infected but not symptomatic. The first symptoms are extremely mild, consisting of a light rash, shortness of breath, or lightheadedness. Severe symptoms, present in roughly half of all patients, usually begin 12-24 hours later. In most cases, VITAS infections last 5-6 weeks from the onset of first frank symptoms.

VITAS has an infectiousness of 75%; 3 in 4 individuals exposed to the virus become ill. Among those infected, it has a untreated lethality of approximately 55%. Between 5 and 6 out of of 10 infected but untreated people die.

> So, where did it go? Like a lot of lethal pandemics, it just burned itself out. It spread too fast, killed too often. Evolutionarily speaking, it was just too vicious to survive. Thank God.
- Global Anarchist

Treatment

VITAS treatment is entirely symptom-based; physicians manage the symptoms until the disease has run its course. VITAS-induced anaphylaxis can be treated with either steroids or, in acute cases, epinephrine. As steroids suppress the immune system, this often leaves the subject open to opportunistic infections (which require antibiotics to treat). Use of antibiotics strengthens the immune system, which can make VITAS symptoms worse. Physicians balance the dangers of both diseases when fashioning a course of treatment. Each case requires an approach tailored to that individual.

Due to the difficulty of managing a treatment regimen, the length of time required, and the expense of sustained care, the disease usually proves lethal to those manifesting severe symptoms. In the vast majority of cases, those who survived never developed severe symptoms.

> VITAS was not a disease that could be treated conventionally. Those who progressed to severe symptoms—about half the infected—died 99% of the time, whether medicines were administered or not. Even after the CDC and USAMRIID understood the disease well enough to devised a treatment, attending physicians had to constantly monitor the patient’s condition for a month and a half, balancing steroids and antibiotics, without making any mistakes. Most of them failed, no surprise. In short order, it became common to triage those with severe symptoms as untreatable. They were given pain meds and allowed to pass away.

And, since there were no known medications that could prevent the onset of severe anaphylaxis, it became a “pray-and-hope” disease. VITAS is considered the modern Black Death for good reason: we were just as vulnerable to it as Europe was to the Black Death. No prevention, no treatment, no cure.
- Broke-Down Back-Country Doc

Outbreak

The VITAS outbreak of summer 2010 began in a remote region of India, on the Chinese border, and was first reported to the World Health Organization by workers in outlying Indian villages. (Though later investigation showed that it was simultaneously spreading among Chinese peasants, the Chinese government failed to report any cases until the first mass graves were dug, sometime in late August.) It soon spread to several neighboring countries and the United Kingdom. Within a month, it became a global pandemic.

Once the disease entered the population most countries experienced death rates of 35% to 40%. (Though certain regions experienced greater or lesser death rates.) Worldwide, this translated to approximately 2.6 billion deaths, making VITAS the most lethal pandemic in human history. During the height of the plague years, from 2010-2011, the world population decreased from 6.5 billion to 3.9 billion.

> VITAS was a lot like the Black Death in other ways. BD caused massive political and cultural upheaval, so did VITAS. It was the proximate cause of the Balkanization of China, the breakup of the EU, and the birth of the NAN (among other things). The current global climate was shaped by two events: VITAS and the Awakening. And we haven’t seen the end of either’s effects.
- PoliSci Perpetrator

“VITAS” in The American Encyclopedia, 2021 Online Edition. Dr. William Kohl, MD; Pathologist, USAMRIID.

[Black]

Nice. And while you may be doing an Alt, your post is perfectly reusable in the standard setting... yonk, may use it myself.   Good Post.

I often think that the impact of VITAS gets a bit glossed over with everything else that was happening at the time.  But it killed 1 in 4 of the population.  Thats massive.  There would have been chaos as basic services failed, cities entered lockdown, civil society would have ended, at least for awhile.  Given at the same time the USA was at war with the Indians... who suddenly had magic and spirits at their disposal, and the whole 'why/how did the USA lose so badly' makes a bit more sense.  The government would have been at breaking point, its military streached thing keeping the country running as millions of people died, and they had to deal with the NAN forces who could use abilities like invisibility, mob mind, etc.  Would have been a nightmare.  No wonder the Shadowrun world has never really recovered.

Good post, thank you for sharing.

[Daddy Warpig]

Nice. And while you may be doing an Alt, your post is perfectly reusable in the standard setting...

Thanks! Though people who do use it for mainline Shadowrun will probably want to correct the few non-continuity things in it. Off the top of my head, I think the year of outbreak and the lethality (1 of 3 in mine), plus the description of the disease is a fair bit different than in Cyberpirates. I'm sure there are other, smaller differences.

There would have been chaos as basic services failed, cities entered lockdown, civil society would have ended, at least for awhile. The government would have been at breaking point, its military streached thing keeping the country running as millions of people died,

And... that's where Altered States begins. In my alt, the NAN started because the reservations were "triaged" during the chaos, denied any form of assistance by the Federal government. Howling Coyote blamed the Feds for every dead tribal, and gained a lot of followers. From that a guerrilla campaign and imprisonment, and when the Awakening kicked off he launched a full-blown war against state and federal forces who had no magical countermeasures, and so were defeated time and again.

VITAS is the start of the Balkanization of North America, not Seretech and the Resource Rush. (For various reasons I hope to post about shortly.)

[The Wyrm Ouroboros]

Don't take that '1 in 4' number too much to heart.  Like most global disasters, the worst hit are the lowest on the economic scale - Sub-Saharan Africa, the Indian sub-continent, South-East Asia, portions of South America.  Globally the death rate was 25%; locally it'll be much different.  You might completely lose five entire villages in Zaire, 10,000 souls lost, but in the US a town of 50,000 might lose 'only' 5,000 - 10%.  Combine the two, and you have 25% of the population lost - but locally the numbers are very, very different.

[Daddy Warpig]

Like most global disasters, the worst hit are the lowest on the economic scale...  Globally the death rate was 25%; locally it'll be much different.

You're correct about the canon SR VITAS—Madagascar, for example, suffered 90% death rates (according to 6W Almanac, at least).

The (alt-history) version of VITAS above breaks that assumption, however. Because of its nature, wealthier nations had no significant advantage and suffered largely the same death rate as poorer countries (between 35% and 40%).

Which means the US suffered a 35% death rate from the disease, just over 1 in 3. Which lead to economic disruption, civil strife, and the bankrupting of the federal government and most state governments. Then, just as the plague was dying down, the Awakening arrived, and the NAN movement started a magical guerrilla war.

And out of that chaos came the political and social situation of Altered States.

[GiraffeShaman]

Don't forget the Computer Crash of '29 and Echo Mirage. Your game is starting literally just after Echo Mirage wiped out the virus code. Or is that not a coincidence? If this was an old Shadowrun novel, one of your runners would turn out to be one of the surviving 4 Echo Mirage team.

Of course by altering the plague's severity in North America you altered history and prevented crash 1.0 and North America is a nicer place. Okay my head hurts now.

[Crimsondude]

From 2001 to 2029, the U. S. lost almost a third of its population to VITAS

[Daddy Warpig]

Don't forget the Computer Crash of '29 and Echo Mirage. Your game is starting literally just after Echo Mirage wiped out the virus code. Or is that not a coincidence?

I'm not sure what I'm going to do with the Computer Crash and the Matrix. (Or, for that matter, tech and magical developments in general.) Most of my attention right now has been on world-building.

The reason I chose 2032 is that, in the alt-continuity, it comes just after the collapse of the NAN, and the birth of several new (or newly altered) states from the aftermath.

Why? I want to run a "technothriller" Shadowrun. (Or, to be pedantic, a techno-magic-thriller Shadowrun.) A Tom Clancy novel, if he wrote about the Awakened World.

The game still revolves around shadowrunning, e.g. breaking into places people want to keep you out of, performing assassinations, and other sundry nastiness. The PC's are secret agents, drawn from police forces, intelligence agencies, and military units from across North America. Instead of working for corporations, they are working for a secret organization with (at the beginning of the campaign) opaque goals. Much of the action is politically, racially, or nationally motivated, for example breaking into a Tir airbase instead of a Renraku gene lab.

So, it's the familiar Shadowrun, just emphasizing a different type of shadowrunning.

Of course by altering the plague's severity in North America you altered history...and North America is a nicer place.

Ha! My players wish. 

From 2001 to 2029, the U. S. lost almost a third of its population to VITAS

I think that figure includes VITAS 1 and 2 (2022). According to 6WA, SR4 20th, and (I just checked) the 1st Ed Rulebook, the kill-stat for VITAS I is 25%. Add in 10% for VITAS II, that makes it 35%, just over 1 in 3.

(Course the disease above is for my alt-history SR setting. It's more lethal on purpose.)

Thanks for the comments, guys.

[Black]

From 2001 to 2029, the U. S. lost almost a third of its population to VITAS

I think that figure includes VITAS 1 and 2 (2022). According to 6WA, SR4 20th, and (I just checked) the 1st Ed Rulebook, the kill-stat for VITAS I is 25%. Add in 10% for VITAS II, that makes it 35%, just over 1 in 3.

(Course the disease above is for my alt-history SR setting. It's more lethal on purpose.)

Thanks for the comments, guys.

Sounds good Warpig.  I think it will be a great game by the sounds of it.

I do want to point out that the above is bad statistics.  The 25% shouldn't just add to the 10% (it came later, so it would be 10% of the remaining population and this is ignoring population growth etc.) Makes for great fiction, but bad maths (must... let.... go...)  Sorry, just when ever I do provide a data analysis for the boys upstairs, they like to do the same thing with the figures...)  

Back on point,  1/4th of the population in just a a year or two?  It would have, should have, changed the face of the world.  The Black Plague, first outbreak, killed around 1/3 to 1/2 of the population over four years.  VITAS was not quiet the Black Plague, but it was close.  On a side note, there was massive population growth after the plague subsided, which, if repeated, could explain the high population in the cities (that and the migration of non-native americans out of NAN terrirtory and into the remaining UCAS cities, particularly Seattle).

[Daddy Warpig]

Sounds good Warpig.  I think it will be a great game by the sounds of it.

Thanks. I certainly hope so.

I do want to point out that the above is bad statistics. The 25% shouldn't just add to the 10%

You're right, of course. Reduced pop, then pop growth, loss of the NAN, and all that should come into play before the 10% is calculated. Altogether NAGNA says that equalled roughly 33% casualties.

And feel free to keep criticizing my maths or anything else that seems off. I post so people can point out where I'm wrong and I can correct it. I like people telling me I'm wrong, so please do so.

Back on point, 1/4th of the population in just a a year or two? It would have, should have, changed the face of the world.

I agree. And I'm currently writing up "The Collapse", about just those things. I hope to get it posted soon.

The Collapse: Secondary to VITAS were problems in the medical field, economic problems, problems with violence and crime, and the breakdown of critical infrastructure. All of these contributed to global crises, radical political and economic changes, and the beginning of the second Long Depression (which is still going on in 2032).

could explain the high population in the cities (that and the migration of non-native americans out of NAN terrirtory and into the remaining UCAS cities, particularly Seattle).

My thought as well. In my continuity, Washington State is indeed the designated refugee destination. The Redmond and Puyallup Barrens began as refugee camps for whites who were ejected from the NAN. (In my continuity, the NAN ejected all whites, except metahumans and Mormons.) The ex-migration is what caused the economic problems which eventually lead to the breakup of the NAN in 2030.

The Black Plague, first outbreak, killed around 1/3 to 1/2 of the population over four years...On a side note, there was massive population growth after the plague subsided

Even with that, it took 130 years for global population to recover to pre-Black Death levels, and the political changes are still causing repercussions today. In history we think in terms of 5-10 years. Global pandemics have effects measured in terms of generations or centuries.

[The Wyrm Ouroboros]

The Black Plague, first outbreak, killed around 1/3 to 1/2 of the population over four years...On a side note, there was massive population growth after the plague subsided

Even with that, it took 130 years for global population to recover to pre-Black Death levels, and the political changes are still causing repercussions today. In history we think in terms of 5-10 years. Global pandemics have effects measured in terms of generations or centuries.

Side note here - this is before modern medicine had put the First World's infant mortality rate into the basement.  Sub-Saharan Africa is the most available comparison in this modern era.  In a press relief dated 17 September 2010, UNICEF stated that 1 in 8 children (12.5%) died before their 5th birthday, while according to the World Factbook's 2009 estimates, Angola had 180 of 1000 infants (18%) die before their first birthday.  Pre-industrial societies fare even worse; Black-Plague-era Europe likely had very high child mortality (birth to age 5) - I'd guesstimate at least 30-40%, which accounts for a 130-year recovery.

Modern era, where your worldwide child mortality is 5.7% and your population growth looks 'steady' at a billion additional souls per 12 years, losing 35% circa 2023 (when you had 8 billion) puts you back at 5.2 billion - which numbers at current growth rates (compare growth rate of 5 billion at 1987 to 6 billion by 1999) rebound completely to 8 billion by 2072, only 50 years.  Quite possibly sooner, if the 'post-plague baby boom' holds true.

Please note/remember that canon (and realism) does support the '3rd World Countries like those of Sub-Saharan Africa got it in the neck with VITAS'; medicines get produced and distributed best by 1st World countries, and modern travel still means that even remote villages can get infected in a matter of a week or four after Patient Zero.

[farothel]

We mustn't forget that even when 'only' about 10% of the population starts to die, a lot of those will be doctors and nurses, as they will have the closest contact with the diseased people and will not immediately recognise the allergic reactions as caused by a virus.  That will mean that hospital service will go down a lot quicker.

Also when society starts breaking down, production of medication will go down (due to the people who have to produce it also being infected) and if medication is produced, you still have to get it to the people that need it.  With transportation services affected (as airline personel will be in the same situation as doctors, even worse, affected in high numbers due to patients traveling before they show symptoms) how will those medications get to the patients, as they need quick, refrigerated transport by air (at least today they do).

So I think that with an epidemic like that medication will not play a big role.

[Daddy Warpig]

Please note/remember that canon (and realism) does support the '3rd World Countries like those of Sub-Saharan Africa got it in the neck with VITAS'; medicines get produced and distributed best by 1st World countries, and modern travel still means that even remote villages can get infected in a matter of a week or four after Patient Zero.

Sure, I never said otherwise. In fact, I agreed with you. The canon VITAS did hit poorer countries much harder than 1st World countries. Madagascar is a perfect example, 90% death rate instead of 25%.

I wasn't contradicting you about the canon, when I was talking about the world of Altered States (my homebrew campaign). The situation is different in that alt-history.

1st World nations have better access to medicines, as you said. But conventional medicines did nothing against the alt-VITAS. There is no pharmacological treatment for VITAS. Hence, having better access to medicines doesn't make a difference.

And, 1st Worlders are much more vulnerable to both auto-immune diseases and severe allergies than the rest of the world. (A current theory is that it's too clean in 1st world countries, so our immune systems are never trained to recognize actual threats.) Since 1st Worlders are more vulnerable to developing allergies, a viral disease which causes the body to develop allergies (the alt-VITAS) could plausibly affect 1st Worlders as much or more than other countries.

So, in the AS universe, their version of VITAS had just as much of an effect medically speaking, in terms of how many were infected and how many died from the infection, in pretty much every country on Earth. It was an equal-opportunity killer. Poor or rich, white or black, illiterate or highly educated, people were infected and died at essentially the same rate.

You are correct, both about the canon VITAS and most infectious diseases. But, as "Paranoid w/Enemies" said, VITAS is unique among diseases. And it's unique aspects mean it spreads and kills in ways different from any other disease.

[The Wyrm Ouroboros]

We mustn't forget that even when 'only' about 10% of the population starts to die, a lot of those will be doctors and nurses, as they will have the closest contact with the diseased people and will not immediately recognise the allergic reactions as caused by a virus.  That will mean that hospital service will go down a lot quicker.

So I think that with an epidemic like that medication will not play a big role.

Au contraire.  When dealing with an epidemic, the medical professionals, even when they're dealing with it on a regular basis, are the most-well-protected.  They have the facilities, they have the procedures, they have the gear.  Are some of them going to get it, purely on accident?  Yes.  Are they most likely to get it?  No.  However, Tom Clancy's book 'Executive Orders' has in it somewhere one of the medical professionals discussing what happens, and at what point things start to break down critically...

[Black]

On the surface, your take initially appears to be a more detailed, realistic look at the vitas epidemic.  A lot of what is being discussed could still fit into the standard timeline.  For whatever reason (maybe with so much to focus on) vitas and it's impacts haven't been explored in detail.  But at a high level, many major subsequent events could and would have been impacted by vitas.  The USA unable to mount a full campaign against the Indian insurgency (who also had the 'new technology' of magic as well') , the way that people, for he most part accept surrender rather then continued fighting ( population devastated in the cities due to vitas, civil order breaking down, ghost dance blows up volcanoes, man on the street just wants it all to end). The depopulation of nan nations, the increase population of safe havens like Seattle. Nan nations, in general, have not all been that successful.  Pcc and maybe the Sioux, seem to be the exception, the rest are a bit hit and miss.  The continues rise of the mega corps in the face of drastically weakened nation states (fits the rise of the middle class due I the black plague) unable to resource and fulfil even their most basic obligations to their citizens.

And then your alt takes that a bit further, which is interesting.  The realistic approach your taking will certainly assist with the Tom clancy style games.

Wyrm, I think executive orders would make a great source, and one I'm sure warpig has consider benign a Clancy fan.  It certainly highlighted the locking down of borders etc ( whic in real life has generally been a bit slow.) and the impact on health professionals etc.  I will say that the Ebola variant ( from memory) did burn out fairly quickly though, while VITAS stayed strong for a year or two.  That would put significant pressure on medical professionals.  And this is during a major insurgency / full on military campaign with magic empowered Indian forces.  It would have been ... Challenging.