Hektoen International

A Journal of Medical Humanities

Preparing for a zombie apocalypse

Larry Kerr
Carlisle, Pennsylvania, United States

Pieter Bruegel the Elder created this apocalyptic view of a world in 1562 unprepared to handle a pandemic. The painting has been in Museo del Prado in Madrid since 1827.

What can we learn from a Zombie Apocalypse?

The first thing to learn? It could happen.

Anyone who has been on this earth for a length of time knows that when a person says something cannot possibly happen, it almost certainly will. Even more worrisome is the disclaimer that if an event that cannot happen does occur, it will not affect us.

We hear that and alarm bells go off in our heads knowing that sooner or later, we will be up to our necks in whatever it was that could not happen, but did.

The most famous example of tempting fate was the “unsinkable” Titanic. A brochure issued in 1910 by White Star Line, owner of the ship, said the Titanic and its sister ship Olympic were designed to be unsinkable. Although, after Titanic sank, White Star claimed it never said Titanic was unsinkable. Just that it was designed that way.1

The argument over the semantics of “unsinkable” did not matter to those who died in 1912 when the iceberg ripped through the hull like a can opener.

Of course, if the attitude that the ship was unsinkable permeated the company, there was no reason to adequately outfit the ship with rescue equipment for something that could not happen. Because of that decision and similar ones, many people died.

Just short of a century later, one US government agency apparently learned from history. The Center for Disease Control and Prevention (CDC), in May of 2011, issued a warning about preparing for a zombie apocalypse. Dave Daigle, then lead man in the CDC’s communications department, told The Atlantic he was seeking a method by which he could get an old message across in a new way.2

The message was preparation. In this case, for hurricane season, which starts in June. The new way to get people to read another hurricane warning was by enlisting zombies. Some complained about trickery, but gimmick or not, it worked. The next ten days saw three times the normal traffic on the CDC website. The agency still maintains the information on its site.

The US Department of Defense (DOD) seems to be of two minds about zombies. It created a training course around the ZA, although comments from DOD indicate it may not have a strong belief in zombies. DOD says it named its plan so as to avoid any confusion. In other words, instead of using a scenario called “Invasion of NYC” that someone could mistake as true, DOD referenced a zombie invasion. However, DOD adds that a ZA is a “completely-impossible scenario” that could not be mistaken for a real one.3

What would it take for an actual ZA? First, we must define a zombie and then determine what could lead to an apocalypse involving zombies. Finally, what can we learn from it, and what should be medicine’s role?

There are many versions of zombies that have developed over the years and different causes for their condition (zombieism?). According to the CDC’s “Preparedness 101: Zombie Apocalypse,” zombies are “mysteriously reanimated corpses.” Note the phrasing. Zombies are not people brought back to life. They are dead and remain so, but something takes over the body and what remains of the mind to allow the body to move again. The zombie has one thing on that bit of mind that is left: eat living things.

Zombies are on the low end of the supernatural creature spectrum. They are not like the vampires, who look like they stopped at the tailor’s shop and the hairdresser on the way back from Hell. Zombies do not care about personal grooming or fashion. They do not seduce members of the opposite sex: they eat them.

What made them that way? Again, several possible causes emerged over the years. However, it appears to behave most like a virus spread through bodily fluids. In the case of zombies, that exchange is nearly always accomplished through bites. There are other means of sharing bodily fluids. Sex is one. However, sex does not seem to be on the minds of zombies, sex-deprived as they may be.

To make this more palatable to the hardcore non-believers in zombies, say one of our known viruses, diseases, or conditions mutates and creates a zombie-like state. Maybe a variation of Mad Cow Disease, which creates holes in the brain. If the prions that cause this disease are capable of targeting brain tissue, can they fine tune their attack and create a mad human instead?

Perhaps the victim lapses into a coma and appears dead, then revives in the last stage when the brain is all but gone. Don’t scoff. We know that even in this modern age, people declared dead still wake up in the morgue. Take it a step further. The attack on its brain tissue means it has one thought left: satisfy its hunger.

This would not be a true zombie according to the definition, but close enough to kill people and scare the bejesus out of the rest. The point is that something could emerge, a brand new or an old but deadlier foe, and create the zombies. Maybe not the zombies of stories, but close enough to scare the world.

Now we have the zombies. Next, the apocalypse. That arises when the zombies hit the streets after they escape confinement from which escape was thought to be impossible. Nevertheless, they get out and the apocalypse is on. In months, most people on the planet are gone, either zombies or zombie food. That would qualify as an apocalypse.

A projection for this scenario was proposed by students at University of Leicester, in England. They used SIR (Susceptible, Infected, and Recovered or Removed), a method used to calculate the spread of infectious diseases. The first projection assumed a world population of 7.5 billion. Another assumption was that a zombie could infect but not kill a person. Other factors were included, but the bottom line was not good. After 100 days, they estimated only 181 uninfected people would be left.

Another simulation, which included geographical elements that might slow the rate of infection, found slightly better odds for mankind after 100 days; 273 survivors.

Their third scenario hit the jackpot for humans. It assumed people would avoid zombies and get better at it as they survived. It also factored in people fighting back and not passively accepting their fate. Get your katana ready. Perhaps most important in this model was that it included sex. No, not zombie sex. Sex for reproductive purposes. Humans made babies, which counteracted some of the losses.

After 100 days in this apocalyptic world, 200 million would survive. Expanding the length of time to 1,000 days finds 67 million uninfected. Six years later zombies fade away and nine years after Z Day, the human population increases.4

Anyone who wants to try the SIR process can find one example here.

Still think an apocalyptic disease event could not threaten to wipe out humanity?

Consider: HIV, the virus that causes AIDS.5 Arguably the most dangerous of all, it does not kill directly. It strips the victim of his defenses then watches while even a common cold can overwhelm the now helpless infected person. It has been responsible for approximately 36 million deaths since its identification in 1978. The true total will never be known. Because of the stigma associated with it and because it let other deadly conditions do the actual dirty work, AIDS was rarely reported as the cause of death.

Flu. A three-letter word much worse than any four-letter words. Variations of this one have killed thousands annually and millions over the years. Particularly nasty was the version that struck between 1918 and 1920 with a mortality rate of 10-20%. The reason that mortality rate was so high was that it took not only the weak or already sick people, but also healthy ones. During its two-year reign, it claimed 20-50 million lives.

Plague. Rats carried fleas, which carried bubonic plague. Millions died in outbreaks in the early 500s and the mid-1300s. Of note in the earlier event, 40% of the residents of Constantinople died.

It seems someone or something is testing us. God, the devil, the roulette wheel of life. We don’t know who or why, or what form the killer may take. AIDS was a sly one. Zombies could be next. Such an outbreak would be especially deadly because its victims aggressively seek more victims. In other diseases, the victims are too sick to wander around looking for people to eat, thus reducing the spread. In Constantinople, 5,000 people a day died. Imagine if each of them infected five more. Using simple math it is easy to see what could happen.

What should medicine learn from this? Be prepared to not only react, but to act. Assume the impossible is possible. Challenge conventional wisdom. Medicine will need to take charge and lead the way in the event of any apocalypse.

Remember the scenarios. It was the one where mankind was not passive, but rather fought back, that we overcame the apocalypse.

Image Credit

  • The Triumph of death. Pieter Bruegel the Elder. C. 1562. Museo del Prado.


  1. “Why Did People Consider the Titanic Unsinkable?”, History on the Net. https://www.historyonthenet.com/the-titanic-why-did-people-believe-titanic-was-unsinkable
  2. Khan, Ali, S. “Preparedness 101: Zombie Apocalypse.” Public Health Matters Blog. May 2011. https://blogs.cdc.gov/publichealthmatters/2011/05/preparedness-101-zombie-apocalypse/
  3. Morgan, Thad. “Are You Prepared for a Zombie Apocalypse? The U.S. Government Is.” History.com. October 2017. https://www.history.com/news/are-you-prepared-for-a-zombie-apocalypse-the-u-s-government-is
  4. Murnane, Kevin. “Guess How Many People Will Survive A Zombie Apocalypse.” Forbes. January 2017. https://www.forbes.com/sites/kevinmurnane/2017/01/08/guess-how-many-people-will-survive-a-zombie-apocalypse/#69f0a6005e40
  5. Staff. “Outbreak: 10 of the Worst Pandemics in History.” MPHOnline. May 2011. https://www.mphonline.org/worst-pandemics-in-history/

LARRY KERR was born and grew up in western Pennsylvania. He graduated from Lock Haven University and attended graduate school at Penn State. He worked various jobs before beginning his newspaper career. Larry was a reporter/photographer at two small newspapers in western Pennsylvania prior to taking a position as a copy editor at a newspaper in south central Pennsylvania. He held that job for nearly ten years until moving into web programming. Always interested in fiction, Larry began writing in earnest in 2004. His first novel, By the Light of the Moon, was published in March 2011.

Highlighted in Frontispiece Volume 11, Issue 4 – Fall 2019

Spring 2019



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