In 2023, Owlcat Games released Warhammer 40,000: Rogue Trader, a 150+ hour leviathan of a computer role-playing-game, in which you inherit the role of a Rogue Trader: a feudal lord ruling over a minor fiefdom within the galactic fascist theocracy known as the Imperium of Man. As the Rogue Trader, you are granted exclusive privileges which allow you to condemn your citizens to a lifetime of slavery, carry out summary executions, and even press hapless innocents into penal battalions. Rogue Trader is an absurdist power fantasy whose roots lie within the proud tradition of 1980s British science-fiction satire, alongside Judge Dredd and Alan Moore's V for Vendetta, as a stark rejection of Margaret Thatcher's sadism.
As the Rogue Trader, you recruit a cornucopia of characters to aid you against a wide array of foes, including assorted cults which worship the four Chaos Gods: Khorne (Blood), T'Zneetch (Manipulation), Slaanesh (Hedonism), and of course, Nurgle (Pestilence). If you've been reading the PAI for a while, you'd be familiar with the continued references to the latter and his most devout followers. However, these are all elaborate fictions, and it should be widely understood that certain acts, such as collective punishment, are an atrocity in real life, as entertaining as it might be to carry out in the absurdist domain of Rogue Trader, in which you liberate humanity from the corruption of Chaos by unloading a pump-action shotgun into heretics.
Within the complexities of the real world, we accept that humans are imperfect, and granting supreme authority to any individual is wrought with folly, doomed to fail, and will inevitably collapse atop its mounting contradictions. To judge, much less condemn our fellow man, is not a task to be taken lightly. While entertaining in a fictional context, power fantasies are not something to celebrate, much less strive to realize as a political goal. Yet amidst the backdrop of the SARS-CoV-2 pandemic, our society has become infested with those who seek to exploit the virus as an opportunity to promote themselves and recklessly carry out judgements & condemnations of others they have so casually branded to be inferior.

Robert F. Kennedy, Jr. as Secretary of Health and Human Services under Donald Trump, and Stanford's Jay Bhattacharya as head of the National Institute of Health, (Frank Han) have openly declared their intent to carry about mass purges of doctors and scientists in charge of infectious disease research, or tried to protect the public from the worst of COVID-19 - and have already withdrawn from the World Health Organization for not embracing SARS-CoV-2 as harmless & benevolent. Their most dedicated fanboy, Vinay Prasad of the University of California San Francisco, has also openly fantasized about mass layoffs of anyone who dared utter the heretical suggestion that children be protected from COVID-19, a disease with well-documented harms on pediatric health & development. (PAI) These are obscene power fantasies divorced from reality, in which others will be forced to pay a heavy price for their foolishness and should be universally condemned.
Separating Fantasy from Reality
We all have fantasies and desires; this is a natural part of human existence. How we choose to express them, however, can be problematic. Not all fantasies are created equal, either. For example, the infamous author of "nerdgasm" tome Ready Player One, Ernest Kline, has produced rather misogynistic & depraved “spoken word” material:
As the singular species we're aware of in the universe which possesses the capacity for creativity, we also have a responsibility to self-reflect and interrogate our own desires and ask if they're clouding our view of reality. Everybody gets things wrong; we all make mistakes - this isn't a crime. What is a serious infraction, however, is refusing to admit error, especially in the midst of a global crisis.
Just months before a SARS-CoV-2 vaccine was widely available, Stanford's Jay Bhattacharya, Harvard's Martin Kulldorff, and Oxford's Sunetra Gupta posted a 900-word online petition titled the "Great Barrington Declaration:" an abstract fantasy which proposed that if hundreds of millions of unvaccinated Americans embraced COVID-19, that the SARS-CoV-2 pandemic would magically vanish, or become harmless, in only... "three to six months." This is an unserious proposal in which the authors presented not a single contingency plan if their proposal failed, which it very clearly did in Florida. They refuse to admit error.

On social media, UCSF's Vinay Prasad has spent years (PAI) peddling a power fantasy that he is the supreme judge of all fields of medicine and science, casually slinging insults and condemnations as cheap entertainment for his bloodthirsty anti-vaccine fanbase. Prasad has spent years demanding others perform impossible, highly unethical randomized control trials in the abstract, whilst designing and running none of his own RCTs, even with a lab named after him. This is solely to sell his fantasy that he is the intellectual superior to every doctor & scientist which dares question his wisdom, whilst posting elaborate & dishonest defenses of exploitative scam artists like RFK, Jr. - who already has the blood of dozens of kids on his hands.

This is childish, unscientific nonsense that seeks to simplify the challenges of public health and modern medicine into an abstract game to "win."
The Gamification of Public Health
In game design, we simplify the many complexities of real-world challenges into rule-based frameworks, often meant to help wrap our heads around very real challenges. In contrast to the competing national identities of the Civilization series, Sid Meier's Alpha Centauri is a competition between mankind's ideologies, struggling to forge a new home upon an alien world. In the historical wargame The Campaign for North Africa, set during the Second World War, the player in charge of the Italian forces is required to secure extra water supply, so their Italian soldiers can boil their pasta rations. Civil engineering expert "donoteat" has posted an extensive critique of how the SimCity spiritual sequel, Cities Skylines, does a lackluster job portraying industries & free market economics:
While games can grant us space to play with different perspectives, and better inform how we understand our reality, they aren't a meaningful replacement for the challenges of real-world decision-making. A large part of the Great Barrington Declaration's popularity has been its ability to exploit the fictional abstract of which it infests: any serious attempt to model such an approach to the COVID-19 pandemic ends in a massive amount of death & disability, much worse than what we have already experienced, which includes tens of millions of deaths worldwide. We are free to fantasize endless alternatives to the complex challenges of life, and modern civilization has no shortage of those selling fantasies in many different forms. The do-nothing, talk-lots academics behind the Great Barrington Declaration are solely in the business of selling fantasy, and unfortunately, many who should know better have legitimized or bought into their childish silliness.
Among us are exploitative vultures who seek to promote themselves by riding these waves of contempt into our highest offices of public health and force further pestilence upon our children. What the Great Barrington Declaration was proposing was to treat the challenges of SARS-CoV-2, and future pandemics, like a casino roulette table, eager to gamble with the health and lives of hundreds of millions of other people. This absurd abstract was completely divorced from reality, and universally condemned by those who understand political fantasy is not a suitable replacement for public health policy. To better understand this, we need to pry open the history & politics of "citybuilder" games such as Sim City, and Cities: Skylines.
The Politics of Citybuilders & Public Health
Sim City is an iconic videogame franchise, much like Civilization, as an impressive neoliberal rebranding of central planning to try and make sense of how cities are birthed and evolve into modern cultural pillars. After the tragic failure of Electronic Arts' reboot of Sim City in 2013, developer Colossal Order released Cities: Skylines to continue the proud tradition of drawing up zoning districts on a map to forward humanity. Compared to the minefield of complexity which dominates American urban politics, these games are an abstracted power fantasy which end up replicating many prejudices, and one might argue that their influence has fostered a nihilistic feedback loop in the modern "YIMBY" vs. "NIMBY" divide. To summarize the politics of Sim City and Cities: Skylines:
"The United States during the Clinton era was the peak of civilization and that's what everyone should strive for, forever" -donoteat, (Said sarcastically) Three Moves Ahead podcast, Episode 451
Cities: Skylines presents itself in a rather apolitical context, giving the player a godlike level of control over a developing city, in which little time is dedicated to negotiating with various special interests’ groups who all have their own political agendas. We have talked before about the fantasy of an "apolitical" response to the COVID-19 pandemic, but in reality, we unfortunately do have to argue and debate about what must be done in the face of such a collective disaster, instead of smugly shrugging our shoulders over brunch while our hospitals are overwhelmed, and schools are shutting down due to unmitigated disease outbreaks.

We can't prevent every single COVID-19 death, but we should at least make an attempt to try, much like how driving an automobile is one of the most regulated activities in America. On the flip side of this rather basic sentiment, there is no shortage of voices boldly telling you that no finger should have ever been lifted to prevent a single COVID-19 death, nor any deaths caused by future pandemic-level viruses. This is morally depraved rambling from scam artists who derive their self-worth by being eager to sign the death warrants of their fellow American, in exchange for a fantasy of life free from personal inconvenience.
America is rife with those who imagine themselves to be some sort of enlightened scholar, alleged titans of intellectualism. Rabid dog Christopher Rufo, helmsman of the "think tank" known as the Manhattan Institute, drafted model legislature for a ban on COVID-19 PPE; targeting the minority of Americans still protecting themselves from a deadly & disabling virus that has upended the lives of millions of Americans. Advertising himself as one of the "brightest minds," Rufo is a pathetic, hate-filled white nationalist: a perverse & sadistic peddler of hate with zero contributions to civil society. He, much like many of the loudest voices condemning doctors, scientists, and public health officials as "Covidian" heretics, have nothing to offer beyond presenting themselves as supreme judges to dole out "justice" against those who have seemingly inconvenienced them since the spring of 2020.
By now, you've heard of countless proposals on how the COVID-19 pandemic should have been handled in the spring of 2020, including such depraved suggestions as demanding that schools should have openly embraced SARS-CoV-2 from the start, or that COVID-19 would be rendered harmless in just a few months of those designated "low-risk" embracing the virus on behalf of "the vulnerable." These are abstract fantasies that exist solely in the realm of fiction, decreed by those who either know this would end in a torrent of needless suffering, or are so incompetent that they fail to realize how these sorts of proposals would never survive the challenges of reality. Either way, they have nothing to contribute beyond peddling childish fantasies. In the face of a potential H5N1 pandemic, this chorus of pestilence lovers are desperate to rewrite the history of COVID-19 and force the rest of society to celebrate outbreaks of disease, instead of resisting them like civilization has done for millennia.

In their most depraved fantasies, the modern anti-vaccine movement openly lusts for show-trials and public executions of doctors and scientists, in what is commonly referred to as "Nuremberg 2.0."
Is Public Health Truly Worse Than Hitler?
Looping back around to Warhammer 40,000: Rogue Trader, at one point the player is given the opportunity to carry out public executions of an entire bloodline for the infractions of an individual, by simply choosing a dialogue option from a conversation tree. Obviously, this is absurd: the casual extinguishing of life with mere clicks of a mouse isn't something to be celebrated or aspire to. Yet, the modern anti-vaccine movement has spent years openly drooling with bloodlust and elaborate fantasies of supposed revenge for a varied array of offenses, in what they've declared to be a "Nuremberg 2.0" style purge of those they deem unworthy. They've casually deemed wide swaths of people worthy of death, in an absurdist self-indulgent power fantasy where one sees themselves fit to carry out horrid acts of violence without an ounce of self-reflection. It's obscene perversion and should be condemned, yet many struggle to take a stand against such obscenity.
Bret Weinstein is a loudmouth anti-vax academic who comically proposed that Ivermectin would induce “herd immunity” to COVID-19 in 2021. Years later in 2023, he openly fantasizes about mass executions of the actual scientists and doctors who utterly humiliated him with basic facts.
The list of suspects grows by the day in the cesspool of anti-vaccine social media, for allegations related to the origins of SARS-CoV-2, to mask mandates, to doctors who treated COVID-19 patients, to teachers who struggled to keep their students safe and their classrooms functioning, to scientists who developed life-saving vaccines - you will find a never-ending stream of open fantasizing about putting the lives of strangers to the sword from the anti-vaccine movement. In truth, these people's morale shattered and are clutching to denial as a coping mechanism; their minds lost to a fantasy in which they get to portray themselves as brave resistance fighters, taking a stand against the tyranny of public health on behalf of a benevolent SARS virus. Of course, realizing this perversely depraved terror campaign, of show trials and mass executions of doctors, scientists, and public health officials would do nothing to prevent future public health crises, or address the fact that yes, children are still being disabled by "mild" COVID-19 in 2025. You will have nothing but a mountain of dead, innocent people and all of society's public health problems primed to become much, much worse.
Our institutions, starting with hospitals and universities, can begin defending the public from Trump & RFK Jr's crusade against medicine, science, and public health by condemning the anti-vaccine movement and purging their loudest champions from their halls. Let the depraved pestilence sycophants cry and moan, claiming victimhood, left to rant in disgrace on social media. It's time to re-establish professional standards in science & medicine, making it unthinkable that someone as childish & depraved as Jay Bhattacharya could possibly be considered for such a crucial role like Director of the National Institute of Health, openly salivating at the opportunity to carry out mass purges & executions of actual scientists & doctors who have made lifesaving contributions to medicine & science, instead of wasting years ranting in front of a camera about the supposed genius of a worthless online petition.
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