Medical redesign: ideas and discussion-part 2

[Pproy]

With the resurgence in the interest in updating the current diseases system, I though it would be interesting to relaunch this discussion.

Some point from this thread:

-Better disinfection tools: Its sound good on paper to add more dangerous diseases, but we should get better tools to fight it so its not tedious to do so.

-Diseases stages: Can serve as a grace period when a dupe first get sick, with increasing consequences if said diseases are ignored.

-Atmosuit cross contamination: So the solution for entering a highly contaminated area is not as simple as wearing a atmosuit.

Other point I would add:

-Better reward linked to disease: adding a risk vs reward element to diseases so it remains relevent all game and its not just a question of disinfecting everything. For example, more recipe that requires slime, or plants could grow faster when exposed to zombie spore.

-Diseases specific to bionic dupe: Flavor wise, they could get infected with computer virus. They could even get a status where they get "bugged": they would spit out some literal mecha bugs that would chew on power line or something.

 

Edited April 5, 2025 by Pproy

[axxel]

I am still a noob, so I don't account my opinion too much based on my game experience.

When I started the game I thought desinfection was affected by the medicine stat haha. If you are picky with germs you can avoid them almost completely with strategically placed cleaning stations. I think that's the part that's a bit faulty why (normal) diseases are fairly easy to fight.

-Normal water shouldn't be that good to remove germs.  You can basically increase efficency with more wash buildings next to each other. Hand sanitizer should be still the best option.

- Remove the game mechanic that dupes  can safely wash with contaminated water.

-Maybe soap water can be delivered to wash basins, sinks and showers as an upgrade? New apothecary recipe: Soapy water=Egg shell+ water+ Balm Lily. Slippery soap water still turns into poll. water after use.

 

Plants and critters

 -They should be affected by (new) diseases (fungus, fleas, parasites, rabies, stress etc.) and cured by dupes. 

- Morb variants for each germ type!

 

Work safety/others

-Falling...should hurt a bit.

-Noise "pollution" (like snoring) from working buildings.

- Dirtiness on dupes and buildings which decreases decor, helps spreading bad germs and needs to be cleaned/washed off.

-  Culivated Germs needed to be collected for nice resources like new food, oxygen or natural gas.

[Charletrom]

I think that the biggest issues are that diseases automatically cure themselves pretty quickly, and that atmosuits are way too good at preventing infection. These two factors alone are enough to make the current germ system completely irrelevant.

There’s plenty that can be done once these issues are fixed. Personally I’d love to see an expansion of the germs-as-a-resource concept introduced with the biobot story trait

[cyberwarlord]

Still recommend injury and disease stages that progress or may not heal without treatment. 

Runny nose, cold, flue.

Adding material components when using triage bed to heal.

Adding a use for bottled oxygen for hypoxia or similar issue. Also added use for saline solution 

Adding medical treatments that alter dupe traits. Ie, gassy, allergies, narcolepsy. 

Specific experience boosting vitamin. 

[Carib94]

22 hours ago, Charletrom said:

atmosuits are way too good at preventing infection. These two factors alone are enough to make the current germ system completely irrelevant.

Agreed I believe one way to nerf atmosuits is to actually use the suits loss durability as a way of weakening the atmosuits effectiveness. Meaning suits at 100% durability will have maximum protection, max oxygen tank etc, and as that durability goes down so does the suit effectiveness in hot and cold surroundings, less oxygen storage and more vulnerable to diseases. 

So im thinking 100% is max protection and o2 storage, then 70% and below suits will start to degrade(will show signs of tears in the suit basically exposing dupes skin) and lose its effectiveness and less o2 storage, then 50% and below it will get worst, then finally 30% and below will basically be like oxygen mask type in terms of o2 storage(maybe less actually), suits insulation will be worst possibly get toasty surroundings at 100c temps, and vulnerable to diseases when they are touching debris with germs, that also means when dupes takes off the suit germs will still stick to them.

[LaShomb]

I don't feel that germs need to be deadly or purely negative, just that infections have interesting effects. Infections could just cause the dupes to eat more and produce heat from a fever. Some should also affect critters and even some elements or buildings. You could have germs based on things like flees (making critters take longer to go to the grooming station or some aggressive) or termites (turning wood into carbon).

I'm also reminded of the algae that grows on sloths. Maybe algae releases a spore germ that can infect a critter as a way to produce more algae. Maybe dupes grow it on their heads, but causes them to stop to itch occasionally, and it's removed/harvested through showering. Algae could build on pumps and eventually require a dupe to clean them off gaining algae in the process.

They can think outside of the box and have germs that can infect dupes, critters, or even liquid and make them photophobic. Imagine a liquid not moving into a tile because it was illuminated, or critters staying close to the grooming station because the rest of the enclosure is lit.

The system is an opportunity to do some very interesting things. Medicine could be all about treating ill effects or mutating germs into good ones.

Edited April 9, 2025 by LaShomb

[Pproy]

On 4/6/2025 at 10:22 PM, Charletrom said:

There’s plenty that can be done once these issues are fixed. Personally I’d love to see an expansion of the germs-as-a-resource concept introduced with the biobot story trait

Agreed, but if we get building or other stuff that need germ, I would prefer if it would take said germ from their enviroment instead of being pump in. A issue I have with the biobot story trait is that while it encourage player to use sporekid, its only a matter of building a room with a gas pump, filling it with CO2 and sporekid, seal it then profit, which completely remove the risk of infection.

13 hours ago, LaShomb said:

I'm also reminded of the algae that grows on sloths. Maybe algae releases a spore germ that can infect a critter as a way to produce more algae. Maybe dupes grow it on their heads, but causes them to stop to itch occasionally, and it's removed/harvested through showering. Algae could build on pumps and eventually require a dupe to clean them off gaining algae in the process.

Not sure how easy it would be to code in such mechanic, but the possibility of growing algae which would require a germ rich enviroment would be cool. Basicly, it could be fertilised simply (phosphorite for example) but need to be summerged in polluted water infected with slimelung.

[BezKa]

I feel diseases need to be mid-lategame mostly, otherwise it might be too hard to start on some maps

[gigamoi]

My two cents on the topic.

I don't think atmosuits should be nerfed. Thematically, they are airtight and should protect the dupe from any germ. Nerfing atmosuits would break existing designs and expose duplicants to previously managed risks. If some disease is to bypass atmosuits, it should be a new one in some new biome or other "opt-in" mechanic.

That being said, you can make atmosuits less helpful without nerfing them directly by introducing germs that spread more easily. Dupes would be endangered not by being exposed to a germy environment while in a suit but by their externally contaminated suit as they remove it. You would then need to decontaminate the suit before leaving it to avoid dupe contamination. To that end, perhaps the rarely used decontamination shower from spaced out could make a come back.

If exposure to dangerous disease is to be something you opt-into, use of the mechanic should reward the player accordingly or it will be ignored. Perhaps the two could be linked: The more you do risky stuff with germs, the more decontamination you need, the more you get.

[goboking]

3 hours ago, gigamoi said:

To that end, perhaps the rarely used decontamination shower from spaced out could make a come back.

 

I’d rather risk losing my colony to disease than accommodate the decontamination shower’s lack of a liquid output port.

The above may or may not be hyperbole.

[Doctor Why]

In my opinion, if you really want to make a plague insidious, you need to do so by adding another plague which is currently not present in the game:  insects.

Yes... I know.  There are shine bugs and the like.  But I'm not talking about macroscopic critters that are easy to see and track.  In fact, I'm not sure we need to represent them as objects at all, per se.  But it is insects which can make the best of countermeasures completely pointless, because it is they which CARRY the disease TO YOU.

Washing your hands regularly?  It's too bad that there's a fly hitch-hiking on your back which will seek out any food or water to contaminate as soon as it can.  In fact, that fly will fly off and land again if you try and brush it away or walk through a shower.  And it's small.  So small you probably won't even notice it.  And so small it can go through the tiniest gap.  No shine bug does that!

In fact, the flies that you encounter outside - which bite you and give you a disease - don't even have to have any direct contact at all with the flies you encounter inside - which bite you and get the disease which they can then spread to other people.

Basically, what we need are 'vectors' which can carry germs long distances without any apparent direct physical contact.  The 'vectors' will themselves seek out certain kinds of things which turn out to be handy ways for disease to spread.  Imagine seeking a dupe climbing a ladder in 'germ view' and having a small ball of germs just shoot off him straight into the kitchen during the second that the door happens to be open.  And the 'vectors' could also avoid countermeasures meant to sterilize them, zipping away from a spray of antiseptic.

This would prevent germs from being 'contained' completely on the outside of suits.  It could even add whole new kinds of macroscopic tasks, such as having to clean out the ventilation system instead of ignoring it for the rest of the game once its set up, or sterilizing rooms nobody uses because a colony might have set up housekeeping there.

[cyberwarlord]

Interesting.

Infestation conditions for pests??

Too much food on the map. (Not deep frozen)

Leaving leftover food piles.

Wild critters being near beds cause fleas.

Animal bites could cause infections, or worse. You take some damage with each so maybe a very small chance with tame critters.

Work accidents at low skill level? Burns, cuts.

Tripping or falling may cause minor penaltie injuries. 

Germs infecting through liquid contact would be one thing I'd like added. Watching dupes play in dirty germ water and walk out clean always felt off. Then the suits would get contaminated at least. 

[Pproy]

On 4/16/2025 at 3:59 AM, cyberwarlord said:

Interesting.

Infestation conditions for pests??

Too much food on the map. (Not deep frozen)

Leaving leftover food piles.

Wild critters being near beds cause fleas.

Animal bites could cause infections, or worse. You take some damage with each so maybe a very small chance with tame critters.

Work accidents at low skill level? Burns, cuts.

Tripping or falling may cause minor penaltie injuries. 

Germs infecting through liquid contact would be one thing I'd like added. Watching dupes play in dirty germ water and walk out clean always felt off. Then the suits would get contaminated at least. 

Having rot pile give a chance of spawning pest could be neat. I always felt that exuberant plants were too powerfull without any down side (food poisoning germ just dies instantly due to the radiation). Making the pest resistant to radiation would also mean that we would have to find other solution to keep the plague under control.

With this in mind, I have other ideas to share:

-Germ sensor should look for germ in a room instead of a single tile. Having a outbreak just because the germ just went around the sensor would just feel bad.

-Removing the plastic requirement for all germ related sensor. If we nerf atmosuit so it can actually cross contaminate if not disinfected, delaying automation with plastic make it more difficult than necessary to prevent outbreak.

-New disinfection relqted building. Something akin to the radiation lamp were we can feed it ethanol and, when it receive a green signal, spray its surounding and disinfect in an area.

[cyberwarlord]

Bump

[Charletrom]

My current fantasy for the booster pack later this year: new diseases and contagion mechanics, injury/malady system related to lifetime stress accumulation (or a moving average), new treatments to buff dupes, and a late-game resource sink that lets you permanently alter dupe/critter DNA to give them weird and powerful new abilities. Crucially in this fantasy there would be a new difficulty option to make diseases truly punishing. 

[Mementh]

On 4/10/2025 at 10:10 AM, BezKa said:

I feel diseases need to be mid-lategame mostly, otherwise it might be too hard to start on some maps

agreed, should be a challange for when things are useful, i like the idea of the suits being 100% protective, but transferable and cleaned on refreshing /repairing them. 
the insects and such add to doing things right!
Chlorine should not clean some things unless in for a while then! 
 

lots of other good ideas but need balance to not cause issues.

[cyberwarlord]

Germs are something I like as a small obstacle or challenge. 

Having certain plants or animals that create them is always interesting (like morbs). Few more types using the negative dupe traits as effects would be welcomed.

Narcolepsy spraying critter?

Suits should definitely work on germs but (cuts/burn/animal bite) could cause infection, sickness. Beware the venom.

Though, I would love to see more useful germs that could be transferred to different materials.

Maybe manipulate animal or dupe behavore. 

Creating cheese?

Floral scent could technically be added to water and many solids but it has no use and dies quickly. It could be a fun challenge to manipulate germs through different materials for bonus effects or more controlled use.

 

Infecting a algae terrarium to drop slime instead of p water?

Food bacteria culture/ transition shift materials.

 

Edited June 10, 2025 by cyberwarlord

[Pproy]

Medical rework update incoming?!?
 

[Sanchozz]

1 hour ago, Pproy said:

Medical rework update incoming?!?
 

LOL, it just unfinished unused thing from Space Out DLC early access time.

[Pproy]

12 minutes ago, Sanchozz said:

LOL, it just unfinished unused thing from Space Out DLC early access time.

Doh, saw Luma video and it mention it and jumped to the conclusion.