End of the [Fantasy] World: Pestilence

[Ruin Explorer]

Cure Disease, even assuming a relatively small number of people able to cast it (how many and who depends on the edition and so many other factors), would be extremely effective in preventing most RL contagious diseases from getting very far, as long as it was used aggressively. Given how extreme many medieval reactions were to disease, it's pretty likely it would be used aggressively, too (i.e. with patrols looking for people to cure, etc.). You could stop a lot of outrbreaks before they started by curing often just a handful of people (quarantine the rest, cure if needed).

Cure/Remove Disease would also be very useful in that it would prevent disease from destroying the Command/Control structures of a nation - people who NEED to live could be simply cured, rather than having to flee, or y'know, just dying! There would be a tension where a powerful person might force his friends/relatives to be cured before other important people, but still, with normal diseases, one likely has time (magical diseases... maybe not).

Scrying spells would be huge too - any kind of magical ability to detect disease, or ability to locate people or the like could make a huge difference.

The problem is, whilst real-world-style diseases would likely be less prevalent in D&D-ish world, there is an infinity of magical diseases which one could encounter, and those could be some extreme and aggressive and tricky that even though Cure Disease should probably cure them (it's really really lazy/weak design to have diseases and poisons which can't be cured by the respective spells, imo), they could still be massive problems, because they could do things like infect people silently and without symptom, then make everyone infected symptomatic on the same day - i.e. they could be "smart" in the way RL diseases cannot.

 

[Yora]

What if it's a disease that causes sudden death, rather than a gradual accumulation of symptoms? It infects you with out being readily observable. You can't cast Remove Disease if you don't know you have it.

Once this started spreading around, you might still see an effort to just cast the spell on everyone, but that's a tall order; it's much easier to imagine that failing.

Sudden death would probably be a bit too random.

But a disease in which people can spread the infection before they show symptoms would work very well. The only way to contain these is through vaccination, which even with standard healing magic can't be done in a fantasy setting.
I think the overall social disruptions will actually be worse if there is a decent chance an infected person will survive. If 98% of all infected die, you just put them out of their misery and burn the bodies. But with a of survival chance between 30 or 60%, people will want to do everything they can to help their relatives and friends to make it. That means giving medicine to people who are already very sick and also feeding and caring for those who might still die anyway. When medicine and food is scarce, there will be lots of conflict about who should get these limited resources without them being wasted.

The point of a plague campaign is not to depopulate the setting. Disrupting society is where all the morbid fun lies.

 

[Bawylie]

3 factors in the spread of disease.

Healthcare. We have Clerics, some can remove disease, some can do it more than once in a day. At best, in a medium to large township, clerics can probably cure 3 cases per day. Maybe around 1,000 per year. Maybe.

Poverty. Access to health care is limited. Even getting to the cleric requires resources. And, even if the clerics are unmotivated by money, the rich will find a way to get cured first and most frequently. They may even divert resources from the poor. The poor, meanwhile, also misidentify their ailments and let the disease progress and spread longer than they should. Poverty also means population density. So a disease can reach 3000 people in no time at all. Especially with late detection. After all, they die or get sick all the time. Who's to say its from disease, hunger, thirst, cold or whatever.

Shame. Many diseases are caught or transmitted in a way that people don't want to tell their cleric about. Societal shame could be the cause of people not seeking care or concealing their symptoms so they don't have to cop to bad behavior.

Anyway, no need to invent a new disease. The regular ones work just fine. Just don't assume spells cure all societal ills. Heck they probably exacerbate them. Or at least illustrate them more clearly.

A good cleric might spend his time healing the sick. But a rich man makes a large donation to the church and the hierarchy tells that good cleric to heal the rich man. What's the cleric gonna do? Disobey his order? Maybe. Probably not. Externalities writ large will send your disease wherever you want it to go.

 

[Shiroiken]

Heh. I just remembered an old L5R adventure where spelcasters were the harbingers of a virulent plague. They were immune, but were carriers. When they cast spells (including those to cure disease), it would spread to infect others and make those already infected worse. The trick (besides stopping the demon that was causing the whole thing) was to stop casing spells. If someone wasn't exposed to spellcasting, they never got any worse than the original symptom. Of course, the area was politically controlled by the spellcasters, so THAT wasn't going to happen

 

[Ahnehnois]

[MENTION=6670763]Yora[/MENTION]
I think the idea of bringing social issues into it is interesting. If it's "fantasy AIDS" or something, the issue might not be merely whether one will get cured, but whether one is willing to admit having it. If it's a disease that pertains to conduct that the good clerics are opposed to, maybe they refuse to heal it (or at least make it difficult).

 

[(Psi)SeveredHead]

D&D has always used "Disease" as a potential threat for PCs. Rats, I believe originally, had a percentage to infect those bitten with some kind of debilitating disease that wasn't really specified, but somehow could kill you eventually (iirc).

Then there were the (infinitely more interesting for many, I'm sure) "magical" diseases/curses, like lycanthropy, "ghoul fever", and the variety of other undead creatures who, if they damaged you enough could/would turn you into one of them.

Some games this was fixed with a Cure Disease...some even just handwaved low level players with a Cure X Wounds to remove the disease as well. Generally speaking, the more magicky/undead stuff would require a bit more attention, such as a Remove Curse.

I just started thinking about/wondering...how bad/what happens in a world where "Cure Disease" and "Remove Curse", while certainly not necessarily "common" in all campaign worlds, might not be that uncommon either...and in the face of an outbreak of a killer disease, squads of "healer" clerics (and paladins) could just go and zap it all away in a few days? What happens in the world? Do religions start to fall apart because the cleric's magic can't cure it?

What would it take (in a world of moderate numbers of spell-casting clerics who could, conceivably, cast a Cure Disease) for there to really be a "plague" of threatening proportions? What would the world look like in a disease panic?

I mean, other than DM fiat "It's a special [magic/demon-created/supernatural/otherworldly] disease so Cure Disease won't work." Which seems, to me, kinda ****ish. How do you make a "real-feeling" pestilence that can both freak out the PCs and seem to be a true threat for the world?

Legitimate threatening pestilence in a magical fantasy world. Go!

This is hugely edition-dependent. In 4e, Cure Disease is a ritual that costs components, and also requires a Heal check that can damage or even kill the recipient on a failed skill check. In 4e, a noble family might have an item that can cast that ritual once per day (there's no official item like that, but I think that's reasonable) and if there's a big epidemic going around, could make offerings to get rituals to perform it a few more times. Or just hire a confessor, and pay the extra service charge.

In 3e, it's pretty easy. Every church probably has a Wand of Cure Light Wounds, and as far as I can tell even a 1st-level cleric can use it, despite not having the skill to cast the spell themselves. Noble families probably keep a few potions in stock (provided you don't have to choose the disease ahead of time). Still, a typical village might have a single 4th-level cleric and 2 2nd-level clerics, which isn't that many clerics and not that many Cure Disease spells (in fact none, since none of those clerics can cast 3rd-level spells). I think epidemics might be controllable, but pandemics would still sweep nations. The nobles would be more likely to survive, of course.

Note that even in 3e, spells cost money (per spellcasting services rules), but good-aligned clerics would probably cast Cure Disease for free during an epidemic, and evil clerics would jack up the price. (So NPCs go to the good temples first, then the neutral, then the evil... That's actually a great way to recruit the poor if you're an evil cleric.)

And what effect do diseases have on PCs? IMO, diseases should only be a threat to PCs if it's plot-relevant. Diptheria is the kind of disease that was common, but to a PC that's just flavor text. Even smallpox, with a 50% death rate, is probably killing off 60% of the 1st-level commoners, with Fort DCs of only 13 or so. An outbreak of the Black Death is plot-relevant, and so is facing new diseases when visiting the fantasy tropics for the first time. I wouldn't expect most real-life diseases to lay PCs low unless you're running a very grim-and-gritty campaign.