Long COVID Europe and Saint Elmo's launched Long COVID Mode in 2023, embedding real ME/CFS and Long COVID symptoms into Elden Ring, Minecraft, and The Witcher
ARCHIVELong COVID Europe Turns Game Mods Into a Public Health Statement
Long COVID Mode is a 2023 public service campaign by Long COVID Europe and creative agency Saint Elmo's that transforms popular video games into simulations of chronic illness, using custom game modifications to impose debilitating Long COVID symptoms on in-game characters so that players can experience firsthand what it means to live with ME/CFS and post-COVID conditions.
Launched on May 24, 2023, according to saint-elmos.com, the campaign arrived at a precise cultural moment: the World Health Organization had formally declared the end of the COVID-19 global health emergency at the start of May, and public attention was beginning to shift away from the pandemic. Long COVID Europe, a patient network founded in 2021 according to WHO/Europe, recognised that this institutional closure risked accelerating the invisibility of a condition still affecting millions. The campaign launched in coincidence with International ME/CFS Day on May 12 and just before the European Public Health Week, as documented on longcovideurope.org, to underscore that ME/CFS — Myalgic Encephalomyelitis / Chronic Fatigue Syndrome — is part of the clinical picture of Long COVID. It is estimated, per Long COVID Europe campaign materials, that up to half of individuals with Long COVID also have ME/CFS.
The strategic target was a younger audience less likely to engage with conventional health communications. Saint Elmo's chose three of the most culturally prominent single-player games — Elden Ring, Minecraft, and The Witcher 3 — and produced game modifications that converted real Long COVID symptoms into gameplay mechanics. Exhaustion, reduced concentration, dizzy spells, blackouts, and shortness of breath became in-game effects that slowed characters, drained stamina, blurred vision, and forced involuntary pauses. The result, as reported by It's Nice That, was a new layer of difficulty that spoke directly to the language and values of gaming culture while illuminating a multisystem disorder that mainstream media had largely stopped covering. Clapboard scores Long COVID Mode 80 out of 100, reflecting strong creative ingenuity and cultural precision against a backdrop of limited independently verified effectiveness data.
ARCHIVESaint Elmo's identified a specific communication gap. Long COVID had become statistically significant but experientially abstract for people who had not personally suffered from it. According to the CDC, at least 5.3 percent of U.S. adults were experiencing Long COVID as of October 2023, and the CDC also estimated that at least 1.3 percent of U.S. children had ever experienced the condition as of 2022. Lost wages associated with Long COVID among working-age respondents were estimated at $211 billion in 2022 and $218 billion in 2023, according to thesicktimes.org — figures that situate the condition as an economic and public health emergency even after the formal emergency classification was lifted.
The campaign's insight was that empathy requires simulation, not statistics. Conventional public health advertising relies on testimony and data; gaming offers something rarer: embodied consequence. When a player in Elden Ring cannot regenerate stamina at normal speed or when a Minecraft character is forced into an involuntary rest, the experience is not metaphorical — it is mechanical and immediate. This positions Long COVID Mode against the broader landscape of health awareness campaigns that compete for the same youth demographic, including those from organisations such as the WHO and national health authorities across Europe, which have historically relied on video content and social media graphics to reach younger audiences. Neither approach replicates the experiential dwell time of a game mod that a player engages with for hours.
The campaign was developed as pro bono work, according to reporting by eurogamer.net, created in collaboration with Long COVID Europe patients and Saint Elmo's — a production model that grounded the creative decisions in direct patient experience rather than clinical abstraction. Long COVID Europe's own campaign materials stated that one in ten COVID-19 infections can lead to long-term health problems, and that as diagnostic and therapeutic options remain inadequate, many sufferers could face health limitations for the rest of their lives. That clinical severity, translated into gameplay difficulty, gave the creative its structural logic.
Saint Elmo's coordinated with specialist game modding communities to ensure the modifications were technically credible and experientially accurate. According to clapboard.com, Garden of Eyes served as the game modder and development partner for Elden Ring, while Stellar7Project fulfilled the same role for The Witcher 3. These collaborators are established figures in their respective modding communities, lending the campaign both technical authority and the trust of existing player bases who follow their work.
The creative team at Saint Elmo's was led by Chief Creative Officer Matthias Harbeck, with copywriting by Rasesh Patkar and Swarna Thomas, art direction by Silvia Raquel Vega Bellido, creative intern contribution from Tuleen Zaid Maher Kirresh, and extended reality development overseen by Leopold Ferdinand Lotz as Head of XR Development, all documented on clapboard.com. This cross-disciplinary team structure — combining traditional advertising craft with XR expertise and external modding talent — was essential to producing modifications that functioned as genuine gameplay experiences rather than superficial overlays.
As described by It's Nice That in coverage published on June 13, 2023, the modifications across The Witcher 3, Elden Ring, and Minecraft introduced reduced movement speed, slow stamina regeneration, impaired focus, vision loss, forced rest breaks, fatigue, and shortness of breath as playable conditions. LS:N Global, in coverage published on May 31, 2023, emphasised that the gameplay consequences for exhaustion and impaired concentration were designed to reflect the multisystem character of Long COVID rather than any single symptom. The decision to include Minecraft alongside the more graphically intensive Elden Ring and The Witcher 3 was strategically deliberate: Minecraft's broad demographic reach extended the campaign's audience beyond the core action-RPG player base, ensuring the awareness effort connected with younger and more casual gamers alongside committed enthusiasts.
No published sales lift, market-share change, donation revenue, or independently reported effectiveness metrics for Long COVID Mode are publicly available. The campaign's objective — shifting empathetic understanding of an invisible chronic illness among a younger audience — is not a metric that standard advertising measurement tools readily capture, and no third-party research measuring attitude change or awareness lift has been publicly disclosed.
What is documented is the campaign's industry reception. Long COVID Mode was nominated in the In-Game Advertising category at the 2024 Webby Awards, according to Winners Webbyawards, with Saint Elmo's Germany and Serviceplan Germany listed as entrants. The nomination places the campaign within a competitive international field in one of the most widely recognised digital media awards programmes. Saint Elmo's own case page, as noted on saint-elmos.com, reports two Gold, one Silver, and four Bronze distinctions, though the awarding organisations, categories, and years are not identified on that page. No verified wins at Cannes Lions, Effies, The One Show, D&AD, Clios, or WARC are publicly documented, according to clapboard.com's research.
Editorially, the campaign demonstrates strong structural effectiveness. The choice to make the mods freely downloadable — as reported by eurogamer.net — removed all barriers to participation and extended the campaign's reach through organic distribution within modding communities. The coincidence with International ME/CFS Day and European Public Health Week provided a media-relations scaffolding that amplified earned coverage. Positive editorial coverage from both It's Nice That and LS:N Global, two publications with direct influence over creative industry audiences, confirms the campaign achieved meaningful cultural penetration beyond its immediate target demographic.
Long COVID Mode is a 2023 public service campaign by Long COVID Europe and Saint Elmo's. It uses custom game modifications for Elden Ring, Minecraft, and The Witcher 3 to simulate real Long COVID and ME/CFS symptoms in gameplay. The mods were freely downloadable and launched on May 24, 2023, coinciding with International ME/CFS Day.
Long COVID Mode modified Elden Ring, Minecraft, and The Witcher 3. The mods impose symptoms including exhaustion, reduced stamina regeneration, impaired concentration, vision loss, dizzy spells, blackouts, and shortness of breath on game characters. These effects mirror real Long COVID and ME/CFS symptoms, creating a new difficulty layer that communicates the experience of chronic illness.
Saint Elmo's Germany created the campaign for Long COVID Europe. Chief Creative Officer Matthias Harbeck led the team, which included copywriters Rasesh Patkar and Swarna Thomas. Game modders Garden of Eyes built the Elden Ring modification, and Stellar7Project built the The Witcher 3 version, both documented on clapboard.com.
Long COVID Mode received a nomination in the In-Game Advertising category at the 2024 Webby Awards, according to winners.webbyawards.com. Saint Elmo's own case page reports multiple Gold, Silver, and Bronze distinctions without identifying the awarding organisations. No verified wins at Cannes Lions, Effies, D&AD, or Clios are publicly documented.
Long COVID Europe and Saint Elmo's targeted gamers to reach younger audiences less likely to engage with conventional health communications. Gaming offered embodied simulation rather than statistics, giving players a direct experience of chronic illness mechanics. According to the CDC, at least 5.3 percent of U.S. adults were experiencing Long COVID as of October 2023.
Long COVID Europe campaign materials stated that one in ten COVID-19 infections can lead to long-term health problems. The CDC estimated that at least 5.3 percent of U.S. adults experienced Long COVID as of October 2023. According to thesicktimes.org, lost wages associated with Long COVID among working-age respondents reached $218 billion in 2023.
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