How to Play Pandemic: State of Emergency

Game Objective

In Pandemic: State of Emergency, players race against time to save humanity from drug-resistant diseases, animal-borne diseases, and unpredictable crises. The main objective is to discover cures for all 5 diseases and eradicate the purple Superbug disease. Players lose if they fail to achieve these objectives or if the usual base game defeat conditions are met.

Setup

Set up the game as usual, but with the following additions and modifications for the Superbug Challenge:

• Add 24 purple cubes to the supply and use the purple Marker and Cure Indicator for the disease caused by the Superbug.
• Place the Vaccine Doses and the 4 Vaccine Factories near the supply.
• In step 3 — Infect 9 Cities — replace 1 disease cube with a purple cube when placing cubes for the first, fourth, and seventh cities drawn.
• Place 1 Superbug Infection Card in the Infection Discard Pile and 1 on top of the Infection Deck.
• Give each player a Superbug Reference Card.
• If the Medic is in the game, make sure you are using the Superbug Challenge version.
• Add 4 Quarantine Markers to the supply (use all 6 if the Colonel is in the game).
• Shuffle the 8 Superbug Bonus Cards face down and use the same number of Epidemic Cards. Keep unused Bonus Cards without looking at them. When preparing the Player Deck, shuffle 1 Bonus Card into each pile of Player Cards (along with the Epidemic Card).

For the Hinterlands Challenge:

• Place the Hinterlands boards next to the Pandemic board.
• On the main board, place the 18 translucent colored discs on the cities connected to the four Hinterlands, associating the disc colors with the city colors.
• In step 3 — Infect 9 Cities — also place 1 disease cube of the corresponding color in each Hinterland. Place the Hinterlands die on top of the Infection Deck as a reminder.

For the Emergency Event Challenge:

• Shuffle all 10 Emergency Event cards face down. Use the same number of Emergency Event Cards and Epidemic Cards. Keep unused Emergency Event Cards without looking at them.
• When preparing the Player Deck, shuffle 1 Emergency Event Card into each pile of Player Cards (along with the Epidemic Card).

For Quarantines:

• Place Quarantine Markers in the supply. If the Colonel is in the game, use all 6 Quarantine Markers.

Game Flow

Players take turns and perform actions as usual, with some exceptions depending on the active challenges.

Hinterlands Challenge

After each player's turn, before Infections, infect the Hinterlands. To do this, roll the Hinterlands die. If a colored face is rolled, place 1 disease cube of the same color in the Hinterland (or perform an outbreak if 3 cubes of the same color are present, placing a cube in each connected city). If the white face is rolled, there is no effect. Draw and resolve Infection Cards normally. Then, place the Hinterlands die on top of the Infection deck as a reminder.

Superbug Challenge

After the purple disease is cured, at the end of each player's turn (after Infections), each built Vaccine Factory produces vaccines. Indicate this by placing 1 Vaccine Dose in each area with a Vaccine Factory. If the number of Vaccine Doses in the supply is less than the number of Vaccine Factories, the player ending a turn decides which factories will produce a dose.

Emergency Event Challenge

When drawing an Emergency Event, immediately read the card aloud and follow its instructions. Some Emergency Events have ongoing effects until they are discarded or postponed. Place them face up next to the Player Deck as reminders until they are discarded. These cards do not count towards players' hand limits. If a player draws an Epidemic Card and an Emergency Event, resolve the Emergency Event first. If a player draws 2 Emergency Events, they choose the order in which they take effect.

Superbug Infections

When a drawn Infection Card (for Infection Events, Epidemics, or Emergency) is a city with 1 or more purple cubes, add 1 purple cube to it (in addition to the card's normal effect) or perform a purple outbreak if that city has 3 purple cubes. Add 1 purple cube if the disease color of the City Card has been eradicated.

During Infections, whenever a Superbug Infection Card is drawn, it does not count as drawing an Infection Card. Draw another Infection Card and apply the effect of the Superbug Infection Card to it. If you draw two Superbug Infection Cards in a row, apply their effect as soon as the next Infection Card is drawn.

If the next city on the Infection Card has no purple cubes (and the disease of that color has not yet been eradicated), add 1 purple cube instead of 1 disease cube of the card's color. Otherwise, the Superbug Infection Card has no effect; perform the Infection normally (adding 1 cube of the city's color and 1 purple cube). In both cases, discard the Superbug Infection Card to the Infection Discard Pile. Once the purple disease is eradicated, remove Superbug Infection Cards from the game when they are drawn.

Actions and How to Play

In addition to the basic Pandemic actions, the following special actions and abilities are available:

Superbug Actions

• Discover a Cure (for Superbug Disease only): At any Research Station, discard 5 City Cards - including at least 2 cities with purple cube(s). Remove the Research Station from the game and replace it with a Vaccine Factory and 1 Vaccine Dose.
• Build a Vaccine Factory (after Superbug cure): When at a Research Station, remove it from the game and replace it with a Vaccine Factory and 1 Vaccine Dose. Once all 4 Vaccine Factories are built, this action can no longer be performed.
• Collect Vaccines: At a Vaccine Factory, transfer any number of Doses to your Role Card. At any time, players can return vaccine doses from Role Cards to the supply.
• Distribute Vaccines: Return 1 Vaccine Dose from your Role Card to the supply and remove all purple Superbug cubes from the city you are in.

Quarantine Actions

• A player can impose a Quarantine on the city they are in, placing a Quarantine Marker face up with the "2" side showing. This counts as one action. A player cannot place a Quarantine Marker in a city that already has one.
• If all 4 (or 6, with the Colonel) Quarantine Markers are on the board, the player moves a Quarantine Marker to the city they are in, with the "2" side up, if necessary.
• Each Quarantine Marker prevents the next 2 attempts to place disease cubes or an outbreak in the city. If new disease cubes are placed (or an outbreak occurs), do not add cubes to the city (nor perform an outbreak there). Instead, flip the Marker to the "1" side (the first time) and then remove it (the second time), returning it to the supply.

Role Abilities

• Colonel (Use only with Quarantines):
  • When you enter a city with a "1" quarantine marker, flip it to the "2" side.
  • You can discard a City Card to place a quarantine marker in any city. This counts as one action.
• Paramedic:
  • You can move to any city with a research station. This counts as one action.
  • Immediately after an Epidemic, you can – even if it's not your turn – move to the city with the epidemic and Treat a Disease there (before Infections).
• Pharmacist:
  • You can reveal a City Card to Treat a Disease (or Distribute Vaccines) in that city. This counts as one action.
  • As an action, remove 1 cube of a cured disease from any city to the supply.
• Veterinarian (Use only in the Hinterlands challenge):
  • You can move to any Hinterland. This counts as one action.
  • In a Hinterland, remove 2 cubes of an uncured disease when you Treat a Disease.
• Gene Splicer:
  • You can Discover a Cure at a Research Station – in a city of the color to be cured – by revealing 2 City Cards of the cure's color plus 1 City Card of each of the 3 other (standard) disease colors.
• Medic (Superbug Version - Use only in the Superbug Challenge):
  • Remove all cubes of one color during Disease Treatment.
  • Automatically remove cured disease cubes from the city you are in – to remove Superbug cubes you must also discard a Vaccine Dose – and prevent them from being placed there.

Event Cards

• Emergency Response: Play after Epidemic. Not an action. Choose a player. Move the chosen player's pawn (with their permission) to the city with the epidemic and have them treat a disease in that city before Infections.
• Advanced Team: Play at any time. Not an action. Use only with Quarantines. Place a quarantine marker in any city (that does not have one).
• Local Initiative: Play at any time. Not an action. Draw, look at, reorder, and return the top 4 cards of the Player Deck. Do not mix them with the cards in your hand.
• Resource Planning: Play at any time. Not an action. Choose a player. They may give 1 city card to any other player. (After doing so, apply the player's hand limit).
• Sample Delivery: Play at any time. Not an action. Choose a player. Each player may move their own pawn to the city where the chosen player's pawn is located.
• Emergency Conference: Play at any time. Not an action.
• Infection Rumor: Play before infections. Not an action. Look at a number of infection cards equal to this turn's infection rate. Place 1 in the infection discard pile. Return the remaining cards. Then, infect cities, drawing 1 less card.

Emergency Event Cards

Play immediately after drawing. Some have Ongoing Effect:

• CDC Planes Grounded: Players cannot move by direct, charter, or shuttle flights (or by the Airlift Event). Leave this card in play face up. Discard it after playing the next Emergency Event.
• Containment Failure: On the next outbreak, add 2 (not 1) disease cubes to each connected city. Leave this card in play face up. Discard it after the next outbreak.
• Active Disease Focus: Draw 1 card from the bottom of the Infection Deck. If the disease is not eradicated, add 3 cubes of that color to the city. Discard the card to the Infection Discard Pile.
• Disease Area Expansion: In cities that have diseases of colors that do not match that city's color (excluding purple), add 1 cube of each non-matching color. (If the fourth cube of a disease would be added, instead perform an outbreak).
• Limited Options: Reduce players' hand limit to 6 cards. Discard cards or play Events if necessary. Leave this card in play face up. Discard it after playing the next Emergency Event.
• Patient Zero: Draw 1 card from the bottom of the Infection Deck. Add 1 disease cube of that color to that city every turn, before infections. Leave this card and the drawn infection card face up. Discard them after playing the next Emergency Event.
• Widespread Panic: When performing the next outbreak, advance the outbreak marker 1 additional space. Leave this card in play face up. Discard it after the next outbreak.