Forget hard mode — you can now play these video games on 'Long COVID Mode' to experience what patients do

This screenshot shows one of the ways that long COVID symptoms are manifested as in-game hurdles in Minecraft with Long COVID Mode. (Long COVID Europe)

A new project is challenging video game players to try experiencing their favourite worlds with an added layer of difficulty: long COVID.

What if your Minecraft character kept leaving behind items because of weak memory? What if your avatar in Elden Ring had trouble firing an arrow on target or standing up after a rest?

These are some of the effects found in ‘Long COVID Mode’, a mod pack for Elden Ring, Minecraft and The Witcher 3, created by a Europe-based advocacy group for long COVID patients.

The mods cause the video game avatars to experience setbacks and symptoms within the games that mimic real-life long COVID symptoms.

“As gaming has become the most popular form of entertainment, overtaking film and TV, what better way to really show the impact of Long COVID than trying to beat Elden Ring, game of the year and notoriously difficult, while "suffering" from the same symptoms in-game,” Perri Karyal, a popular Elden Ring Twitch streamer, said in a press release. “I think this is such a poignant demonstration of the real problems people face, and a great way of spreading the message."

A trailer for the project shows glimpses of how the symptoms manifest as in-game hurdles, with wobbling screens, Minecraft players losing hearts while “you’re out of breath” warnings flash and the titular Witcher being plagued with a banner of “brain fog” that briefly make the surroundings white out.

Designers are hoping to provide players with a glimpse of what it is like to have long COVID.

“The challenges presented by Long COVID and other invisible post-acute infection syndromes like ME/CFS forced us to find novel means to show people without this experience what it really feels like to live with such a debilitating condition,” Ann Li, co-chair of Long COVID Europe, the group behind the project, said in the release.

“Living with Long COVID means facing new levels of difficulty every day. Gamers love new challenges in their favourite games. We simply connected these dots to create a vivid simulation of a life with Long COVID.”

Long COVID, which is the common term for post-acute COVID-19 syndrome, refers to symptoms that persist long after an acute bout of COVID-19 has cleared up.

Around 10-20 per cent of all COVID-19 infections will lead to some form of long COVID, according to estimates by the World Health Organization (WHO).

That’s at least 65 million people who may be experiencing this.

Research has found that long COVID can affect multiple organs and regions of the body, with presentation differing sometimes drastically between patients, and that it has a strong overlap with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Three years after the start of the COVID-19 pandemic, the existence of long COVID is something we’re all aware of. But just what it feels like for those who suffer from it can be harder to pin down.

The most common symptoms, according to WHO are fatigue, difficulty breathing/shortness of breath, chest pain, muscle aches, and issues with memory, concentration and sleep, among others. In practice, these symptoms can mean people with long COVID may be unable to exercise or even walk as much as they used, aren’t able to perform basic tasks as easily as they once could, struggle to hold onto thoughts or memories, and even struggle to get out of bed.

In the Long COVID Mode project, these symptoms are shown through gaming modifications that can be downloaded on the project’s website and then applied to the game itself.

The effects vary by which game you play.

For instance, in Elden Ring, the player will always be 25 per cent slower, have a slower stamina regeneration in combat, struggle to hit targets with spells and arrows and have difficulty standing after a rest.

They also may experience random other symptoms including exertion intolerance, where the player is forced to stop moving for 3-5 seconds; indigestion, where healing hurts the player; and post-exertion malaise (PEM), which makes the player drained and stunned for a few seconds, among other symptoms.

“I think it’s a creative way of raising awareness, and we wanted to take on such a project because we think doing a mod about it can definitely help people understand more about the topic, whilst also enjoying one of their favourite games in a challenging way,” Garden of Eyes, one of the modders who helped create the project, said in the release.

In The Witcher 3, one of the impacts of playing under Long COVID Mode is four stage of exertion: fatigue, exhaustion, myalgia and PEM, which each progressively make the game harder. In Minecraft, some of the effects of the mods include the player not being able to stay underwater for as long and experiencing a brief immobility after quick movements to show the impact of shortness of breath.

Developers chose the three games they did not only because of their popularity, but because they span a wide range of age groups, so that the message can be felt more widely, according to the release.

The project was released into the world on Friday, which was ME/CFS Awareness Day, something that designers say was deliberate.

“We want to raise awareness about Long COVID as a serious neuro-immunological disease and make a difference to people affected by this debilitating illness and other post-acute infection syndromes like ME/CFS,” Chantal Britt, co-chair of Long COVID Europe, said in the press release. “Despite the fact that those who are severely affected are forced to spend their lives housebound or even bedbound, such illnesses have been trivialized, underfunded, and neglected by research, medicine, and the society for centuries.”

Long COVID Europe is a network of long COVID patients in Europe, aiming to raise awareness about the condition and to push for more research and funding for treatments.