Healing Blade: Defenders of Soma

Healing Blade: Defenders of Soma Rulebook

Table of Contents

Welcome

How to Win

The Pestilence player wins if they kill three villagers. The Apothecary player wins if the eighth turn ends and fewer than three villagers have been killed.

Notes for the Second Edition

The first edition was released in 2016. Cards have been changed for the second edition to reflect drug recommendations (primarily in the United States) as of 2021. Card images in the rulebook do not reflect the latest updates; play according to what is printed on the physical cards.

New cards added:

Apothecary cards: Ceftazidime / Avibactam, Daptomycin, Doripenem, Fidaxomicin, Omadacycline, Polymyxin, Rifampin
Pestilence cards: Brucella, R. prowazeckii, V. vulnificus, XDR Typhoid (XDR = extensively drug-resistant)
Villager cards: Allergic Villager, Pregnant Villager

New Card Abilities

RIFAMPIN. There can be 1 or 2 attackers in a villager's zone. If Rifampin is indicated on at least one of them, you may play Rifampin, and then play another defender into that zone, even if Rifampin alone would've sufficed (this is an exception to the "Golden Rule"). That defender must still be indicated on at least one of the attackers. If you do play another defender in the same zone as Rifampin, 1) you don't remove a cube for it and 2) attackers in this zone cannot mutate this turn (if they are killed, the Pestilence player does not get a mutant card). Rifampin cannot share a zone with Linezolid.

PREGNANT VILLAGER. The pregnant villager is set aside, face up, at the beginning of the game. During a player's planning phase, if there are at least 2 wounded villagers (and at least one is female), that player may choose to replace a wounded female with this card. This can only happen once per game. The pregnant villager cannot be defended by green Apothecary cards (the Tetracycline family) or the black 5 or 6 (TMP-SMX and Chloramphenicol). If the pregnant villager survives one attack (Pestilence can, of course, choose not to attack it right away), replace it with a new healthy villager and remove the Pregnant Villager from the game.

ALLERGIC VILLAGER. This is a card that gets shuffled into the provoker deck but is not an attacker. Drawing it counts as one of your draws but playing it doesn't count as one of your 3 attackers per turn. When a new villager is spawned, you may slip the allergic villager card underneath it. An allergic villager cannot be defended by red, dark blue, light blue or orange defenders, or the black 4 (Oxacillin). If that villager (when healthy or wounded) is successfully defended (ALL the attackers in that zone are killed) it goes to the bottom of the villager deck and gets replaced. If an allergic villager is killed or replaced, remove the Allergic Villager card from the game. Note that Oxacillin's skill does not count as a successful defense if any attackers remain. Using this card is a risk: is the advantage gained good enough to help kill this villager before Apothecary successfully defends it?

What's in the Box

The box contains the game board, rule reminder cards, Enchantment cards, Study Covers, and the Pestilence, Apothecary, Resistance and Villager cards, cubes and coins described below.

Pestilence Classes

Provokers can always attack healthy villagers, and most of them can also attack unhealthy villagers. Provokers have NON-VIRULENT, MASKED, THIEF, BANISHER, ASSASSIN, CONTAGIOUS, ESCAPE ARTIST, and SPY abilities.
Opportunists are cowardly and can only attack wounded villagers, but they can also join another attacker from the 2nd attack slot. Opportunists have ESCAPE ARTIST, EXPENSIVE, NECROMANCER, and ASSASSIN abilities. Opportunist cards are identified by a small "O" in the corner.
Mutants cannot be drawn. The Pestilence player gains Mutant cards when an attacker with a mutation icon gets killed. Mutants are hard to kill. Some Mutants are Final Bosses. Mutant cards are identified by a small "M" in the corner.
Final Bosses: VRSA and CRE are Supermutants that are very difficult to stop. Cards like these can only be gained after a mutation by a weaker precursor. Once they are gained, they may be played as an attacker (it doesn't have to be the last turn). C. DIFF has special rules. Pestilence can choose to gain the C. DIFF card on the last turn instead of drawing cards.

Anatomy of the Pestilence Cards

Expensive icon (special defense ability): the first defender played that is listed on this attacker costs a coin to play, in addition to any other costs.
Mutation icon (special revenge ability): when this attacker is put in the biohazard after being killed by a defender, search the mutant pile for the named mutant and add it to your hand.
Abilities: the ability icon explains during which phase the ability is relevant, followed by the ability name and description.
- ATTACK ability: during Attack Planning phase.
- DEFENSE ability: during Defense Planning phase.
- REVENGE ability: after the attacker is killed during Battle Resolution phase.
- SUCCESS ability: after the attacker contributes to wounding or killing a villager during Battle Resolution phase.
Attack restrictions (upper right): can only attack healthy; can only attack wounded; can attack wounded or healthy; "+" = can join an existing attacker (in the 2nd slot).
Purple stain: identifies this Lord as belonging to the Stained Legion. This has no effect on gameplay, but is useful info for students of microbiology.
Masked attack restriction icon: shows what kind of villager can be attacked if the card is placed face down.
Rewards: whenever the Apothecary player uses a defender that is marked with a bracket, they immediately gain a coin from the general supply. Make sure you don't accidentally take one of the turn-marker coins.
Cures: the colored banners are a coded list that explains which Apothecary Healers the Apothecary player can use to kill this attacker. Each banner has a color, number and sigil. A star on the banner means that any number can be used against it as long as it matches that banner's color. Example: the cure can be any green, the gray 3, any pink, any light blue, or the black 5.

Resistance Cards

Resistance cards are the key weapons in the Pestilence arsenal. Resistance cards can protect an attacker from a given defender or family of defenders. They begin the game locked (with cubes). As Apothecary plays defenders, cubes get removed. Once they become unlocked (no more cubes), they can be attached to attackers during the Attack Planning phase. There is no matching resistance card for red defenders, orange defenders, or black defenders, although there is a resistance card specifically for the black 5 and the black 6.

Whenever Apothecary plays a defender, remove one cube from a matching resistance card, if there is one.
A resistance card with no cubes is now unlocked for the rest of the game.
When an attacker is played from hand, Pestilence can attach any number of resistance cards to it as long as the resistance card is unlocked and is not already attached to another attacker.
When an attacker goes to the biohazard, its resistance cards return to their original place on the game board, ready to be used again in the future.

Apothecary Families & Occupations

The Apothecary Healers belong to many different distinguished families: Tetracycline, Macrolide / Lincosamide, Fluoroquinolone, Aminoglycoside, Carbapenem, Penicillin, Cephalosporin, B-Lactamase Inhibitor.

The black sigil is a collection of Apothecary Healers who are the only members of their families. Oxacillin also flies the black sigil, even though he is technically a member of the Penicillin family, because he is unaffected by penicillinase, tools of resistance the Lords of Pestilence use against the Penicillin family.

Some Healers have occupations, and some of those occupations give the Healers special skills.

MERCENARY: costs coins to play but doesn't remove resistance cubes
RESEARCHER: skill: can search for cards
TEACHER: skill: can help prevent resistance
GUARDIAN: skill: can save a villager in any zone from being killed

Anatomy of the Apothecary Cards

Sigil / Number: the colored sigil and number of the Healer. This point will match to the bottom of the Lord of Pestilence card and can help determine if it's a viable defender.
Cost: coins are required to play this card.
Name and drug family, flavor text.
Occupation / occupation skill: some cards have occupations. The MERCENARY occupation indicates a cost must be paid to play the card. Other occupations give the player optional skills (such as TEACHER or RESEARCHER). Occupation skills may be used once, before the next defender is played and before the turn ends.
Card statistics: P: the % of Provokers this defender can kill. O: the % of Opportunists this defender can kill. M: the % of Mutants this defender can kill. R: number of Lords of Pestilence cards that give a reward if this defender is played.

Villagers

Innocent villagers are being ruthlessly attacked by the Lords of Pestilence. Can the Apothecaries save them?

If a healthy villager is attacked and the attack is successful, the villager becomes wounded and flips to its wounded side. The successful attacker remains on the board.
Villager benefits: the newly wounded villager gives Apothecary a benefit (for example, a rule that reduces the cost of playing orange defenders: "Orange Defenders cost 1 less in any zone").
- Ongoing benefits change the rules of the game for as long as the wounded villager remains wounded and in play.
- Just-flipped benefits happen once only, immediately after the villager is flipped.
When a wounded villager is attacked, and the attack is successful, the villager is killed. Pestilence claims that villager as a trophy and any successful attackers go to the biohazard during Cleanup.
A villager cannot go from healthy to killed in a single phase.

Setup

Board Setup

Resistance cards: place Resistance cards in their designated spots and place the resistance cubes on them. Three on the blue one, two on the rest.
Biohazard: when Lords of Pestilence succeed at their mission, or get killed, they end up here.
Mutant deck: place all Mutant Lords of Pestilence in a pile face up here. Any player may see these cards.
Provoker deck: place all Provoker Lords of Pestilence in a pile here.
Opportunist deck: place all Opportunist Lords of Pestilence in a pile here.
Villager card deck: place all villager cards, healthy side up, in a pile here. The Pregnant Villager is set aside.
Turn marker: place 8 coins in the designated spaces. During the game you will begin each turn by moving one of these coins to the coin purse.
Apothecary deck: place all of the Apothecary Healer cards in a pile here.
Discard: Apothecary Healers who must be discarded go to the Discard pile.
The general supply of coins is held off board.
Lords of Pestilence are played in the zones above the villagers; Apothecary Healers are played below.

Pestilence Setup

Spread out the 7 Resistance cards (green, blue, yellow, pink, gray, black 5 and black 6) face-up. The blue resistance card starts with 3 cubes. The rest start with 2.
Shuffle the Provokers and place them face-down. This is the Provoker deck.
Shuffle the Opportunists and place them face-down. This is the Opportunist deck.
Make a face-up pile of Mutant cards. The order is unimportant. Any player may examine this pile at any time.
Starting hand: 3 Provokers. Before the game begins, draw 3 Provoker cards. After drawing cards during the first Draw phase, you will have 6 cards.

Apothecary Setup

Apothecary starts the game with 0 cards. Cards are drawn at the beginning of the turn. However, if this is your first time playing, add Pen, Clindamycin, and Tetra to your hand, then shuffle the deck.
Discard: face up. Any player may look through the Discard pile. When possible, spread out the cards in the Apothecary discard so Pestilence can easily glance at them.
Shuffle the villagers and make a pile of villagers, healthy side up. (Set the Pregnant Villager aside, face up.)
Put 3 villagers in the center of the board: two healthy, and one wounded. Note: if the wounded villager has a just-flipped ability, ignore it.
Set aside any remaining coins to the left side of the board. This is the general supply. Reward coins are taken from the general supply. When costs are paid in coins, those coins return to the general supply.

Enchantments and Study Mode

Enchantment cards add variety to the game. If it is your first game, give the Apothecary player the BEGINNER enchantment. (The beginner enchantment helps a player start with 3 good cards. When the game begins they will fill their hand to 8 cards total.) If a side lost the previous match (Apothecary or Pestilence), that side gets a random enchantment during setup. Pestilence enchantments are only played by the Pestilence player, and benefit that player. Apothecary enchantments are only played by the Apothecary player, and benefit that player. Enchantments are played face up next to the board. Some of them change the rules of the game, others offer a one-time effect that can be used at some point during the game. If an enchantment card has a flip icon on the card, the enchantment is a one-time effect that can be used at some point during the game.

CRAZY MODE is optional. If both players agree, then both players can start with an enchantment. Enchantments are also used in Solitaire mode.

Study mode. If you are trying to memorize which antibiotics are recommended for which bacteria, you can try Study mode.

Two-player Study mode: Pestilence: when you play an attacker, with or without an attached resistance card, cover up the cure banners on the card with one of the included study cover cards. That way Apothecary will not be able to see the list of cures, and will have to proceed from memory. Apothecary can play any 2 defenders for each attacker, and use occupation skills, but will not know for sure if they chose correctly until the study covers are removed. Remove the study covers during the "reveal masked" step at the start of Battle Resolution.

Solitaire Study mode (see Solitaire rules): every time you add an attacker, try to cover the cure banners with a study cover card so that you never get a glimpse of the list of cures. You may play any 2 defenders for each attacker, and use occupation skills, but you will not know for sure if you chose correctly until the study covers are removed. Remove the study covers during the "reveal masked" step at the start of Battle Resolution. Wait to attach resistance cards to new attackers until the study covers are removed, with the same usual priority: left to right by zone, 1st slot before 2nd slot within a zone.

How to Play

The game consists of a series of turns. Once Pestilence has killed 3 villagers total, the game ends early and Pestilence wins. If the last turn (the 8th turn) ends and Pestilence has not killed 3 villagers, Apothecary wins.

Each turn has these phases: Draw Phase, Attack Planning Phase, Defense Planning Phase, Battle Resolution Phase, Cleanup.

Draw Phase

Apothecary takes 1 turn-marker coin and adds it to the coin purse.
Apothecary draws cards until there are 8 cards in hand.
Pestilence draws 3 cards during the Draw phase. Pestilence can draw one at a time, in any combination, from either the Provoker or Opportunist deck (as long as there are cards left to draw). This is in addition to the starting hand during setup. Pestilence should have 6 cards after the first Draw phase.
If it is the last turn (the 8th turn), Pestilence can get C. DIFF from the Mutant pile instead of drawing 3.

Attack Planning Phase

Pestilence may play up to 3 new attackers, if able. There are 3 zones, one for each villager. Each attacker commits to one of those zones. Each zone has two attack slots. The first attacker always uses the first slot. Attackers with (+) can use the 2nd slot if the 1st slot is taken. There can never be more than two attackers in one zone.

Some attackers can only attack healthy villagers, or only attack wounded villagers. Check the attack restrictions listed on the upper right of the card.

Play an attacker. a. If it has MASKED, you may play it face down. b. You may attach unlocked resistance cards. c. Attack abilities take effect: SPY, BANISHER, THIEF, or BETRAYER.
Play another attacker if able.

When you lay down an attacker, turn the card so that the Apothecary player can read it.

MASKED: rewards for face down MASKED cards are not given until that card is revealed. Any single defender may be played to fight a MASKED attacker.
Pestilence can choose not to attack a villager.
Beware! Two attackers in one zone can both be killed by one defender if they are both vulnerable to it.
Resistance cards grant an attacker immunity from a kind of defender. Locked resistance cards (with cubes) cannot be used yet. You may attach any number of unlocked resistance cards.

Attack Abilities

Attack abilities only have an effect when the attacker is first played from hand.

BANISHER: Name a defender listed on this card. The named card cannot be played this turn. (Example: "the green 3." You can't just say "green.")
BETRAYER: Immediately wound any healthy villager. Any illegal attackers (such as NON-VIRULENT) are sent to the biohazard.
MASKED: You may play this face-down when attacking a healthy villager. Reveal the card at the beginning of Battle Resolution and give any rewards at that time.
SPY: Look at the top card of any deck (yours or your opponent's). You may put that card on the bottom.
THIEF: Apothecary discards a random card.

Defense Planning Phase

Apothecary plays defenders, one at a time, if able. At any time during this phase, as many times as desired, Apothecary may also pay to use a default skill.

Default skills (listed on the game board): Research (pay a coin: draw cards; the walkthrough uses "Research 1" for 1 coin) and Teacher (pay a coin: the next defender you play doesn't remove a cube). See the walkthrough and the TEACHER glossary entry.

Play a defender to a specific zone. Costs include EXPENSIVE and MERCENARY costs. a. Pay the cost (if it has a cost). b. Pestilence player removes a resistance cube if able. c. Apothecary player gains a reward (if listed in brackets). d. Apothecary may use that card's occupation skill, if it has one (for example, a Researcher paying a coin for "Research 2: Draw 2 cards").
Play the next defender (repeat list above).

Removing a resistance cube. Whenever a defender is played that has a matching resistance card, remove a cube from that resistance card (if one remains). Once a resistance card has had its last cube removed, it is unlocked and can never have a cube added back.

Gaining a reward. If the number or star allowing the defender to fight is listed in brackets, Apothecary gains a reward (1 coin from the general supply) before playing the next defender.

Playing defenders. There are three zones, one for each villager. Each defender commits to one of those zones, and during Battle Resolution fights all attackers in that zone that it can. Each defender has a color and a number. Each attacker has a list of cures: colored banners with either stars or numbers. A defender can only fight an attacker if it is listed on that attacker. Defenders can only be played if they can fight at least one of the attackers in their zone. Banners with a star mean any defender of that color can fight the Lord of Pestilence.

Resistance cards grant immunity from a kind of defender and effectively remove that defender from the attacking card's list of cures. If a defender is listed on an attacker, but the resistance card grants immunity, the defender cannot fight that attacker.

Paying costs. Orange defenders, red defenders, Tigecycline, and Linezolid are mercenaries and have costs shown on the upper left of the card. You cannot play these defenders unless you can afford to pay their cost.

ESCAPE ARTIST. Apothecary is allowed to play an additional defender to fight an ESCAPE ARTIST. There are only 2 ways to kill an ESCAPE ARTIST:

With a defender that gives a reward (defenders that give a reward are listed in brackets).
With two defenders, each a different color.

EXPENSIVE. The first defender that fights an EXPENSIVE attacker has an additional cost of 1. When paying coins, put the coins back in the general supply.

DUO. If the defender played completes a duo, Apothecary gets a special reward of 3 coins. (Example: the yellow 3 and the blue 2 were played; Apothecary gets a 3 coin reward.)

OXACILLIN'S GUARDIAN SKILL. Pay to choose a wounded villager that cannot die this turn. Attackers that would've killed the villager stay there and try again next turn. They are not successful this turn.

Battle Resolution Phase

During battle, defenders kill attackers, then any remaining attackers wound villagers (and stay in play to attack again) or kill villagers (and go to the biohazard, their mission accomplished).

Reveal MASKED attackers. Flip over any face-down MASKED attackers. Any rewards given by a MASKED attacker are given now.
Defenders strike. Defenders kill attackers. Defenders can only kill attackers in the same zone. All zones are resolved simultaneously. If a defender is listed on an attacker, that attacker is killed. A single defender can kill two attackers, if listed on both. Pestilence picks up all the killed attackers and decides what order to put them in the biohazard.
Revenge abilities take effect only when the attacker is killed.
- ASSASSIN: Pestilence chooses a defender in any zone and kills it. (ASSASSIN affects defenders that are currently on the board and have not gone back to the Apothecary player's hand yet. Assassinated defenders are put in the discard.)
- NECROMANCER: Choose a Pestilence attacker card in the biohazard and return it to your hand. You may only choose a card that was already in the biohazard when the turn began.
- MUTATE: Look through the Mutant pile and add the named Mutant to your hand. The MUTATE ability is listed on the left of the Pestilence card.
Wound/kill villagers. If there are any attackers remaining in a zone, the villager in that zone is harmed: a healthy villager becomes wounded; a wounded villager is killed.* A villager cannot go from healthy to killed during the Battle Resolution phase. Villagers are wounded or killed simultaneously. Killed villagers are removed from the board. Pestilence keeps them as a trophy.
Just-flipped benefits. Some villagers have an effect that happens when they are flipped to their wounded side. (These effects are ignored during setup.) Apothecary decides the order of villager benefits. Ongoing benefits change the rules of the game for as long as the wounded villager remains wounded and in play.

* If Oxacillin's occupation skill was used, the villager stays wounded instead of being killed, attackers are unsuccessful and the attackers remain to attack next turn.

Cleanup

Return all defenders to hand. Apothecary can reuse defenders again and again. After battle, any remaining defenders return to the Apothecary hand.
Clean any kill zones. No attackers can remain in a zone if the villager was killed. (Attackers that wounded a villager remain on the board.) Successful attackers that merely wounded a villager stay in play, with any resistance cards still attached, and attack next turn. Once there is no villager left because it was just killed, the attackers from that zone all go to the biohazard, their mission complete. These attackers are not considered killed, thus their revenge abilities have no effect. Resistance cards from the cleaned zone return to their starting positions on the board and can be used again.
If an attacker remains in the 2nd slot but the 1st slot is free, move that attacker to the 1st slot.
Spawn new villagers. Add a new healthy villager to each empty zone.
Apothecary: reduce hand to maximum hand size of 7 cards. Put extra cards on the bottom of the deck in any order. Apothecary may not end the turn with more cards in hand than allowed by the maximum hand size. (In Solitaire mode, or with the SMALLER HAND SIZE enchantment, the maximum hand size is 6 instead.)

The Golden Rule

YOU CANNOT PLAY UNNECESSARY DEFENDERS. You cannot play irrelevant defenders solely to use their occupation skills; playing defenders must be justified by combat implications or abilities.

You play each defender one at a time. The order you play them in matters. When you play a defender to a zone, it must be listed in the cures of at least one attacker in that zone, and it must meet at least one of the following requirements:

Playing it will kill an attacker that was not already going to die.
It is the first defender played against an ESCAPE ARTIST.
It completes a DUO (the other part of the DUO has already been played).
It is played in the same zone as Rifampin, which was just played.

"Unnecessary" is only judged by what cards have already been played. Example: there are 2 attackers in a zone, and you have a defender that could kill both. You can play a different defender that kills one attacker, use its occupation skill, THEN play the one that kills both.

How many defenders is Apothecary allowed to play?

Normally you play a single defender in each zone. But there are exceptions:

Two attackers, ganged up: You may play an additional defender to kill an attacker with (+) in the 2nd slot. But you might not need to. A single defender can often kill both attackers, provided that the defender is listed on both.
ESCAPE ARTIST: You may play an additional defender for each attacker with ESCAPE ARTIST.
DUO: You may play an additional defender if it completes a DUO to get a special reward of 3 coins.
RIFAMPIN: Allows you to play another defender (see Notes for the Second Edition).

Walkthrough

(Apoth = Apothecary player, Pest = Pestilence player.)

During setup, Apoth ignores the just-flipped benefit of the wounded villager. Since it is his first time playing, he adds Clindamycin, Pen, and Tetra to his hand. Pest draws 3 Provokers.

Turn 1. The game begins. Apoth gets a turn-marker coin and fills his hand to 8 cards. Pest also draws cards. She draws an Opportunist first, Staph aureus. She figures she will attack the wounded villager with Staph aureus this turn, so she doesn't need any more Opportunist cards, and draws 2 more Provokers. Pest attacks with Pertussis, Staph aureus, and Anthrax, all in the 1st attack slot.

Apoth defends villager 1 with TMP-Sulfa. Pest removes a TMP-Sulfa Resistant cube. Apoth defends villager 2 with Tetra. Pest removes a Tetracycline Resistant cube. Apoth then pays 1 coin to also defend with Meropenem because of the ESCAPE ARTIST ability. He is now out of coins and cannot use any default skills. Apoth defends villager 3 with Clindamycin. Pest removes a Macrolide Resistant cube. Apoth cannot afford to use Clindamycin's occupation skill, but probably would've declined anyway.

All attackers are killed during the fight. Pest puts Pertussis in the biohazard. The CONTAGIOUS ability never takes effect. Pest then puts Staph aureus into the biohazard and looks through the Mutant pile and adds MRSA to her hand, because Staph aureus has the mutation icon. Pest puts Anthrax in the biohazard and then chooses who to kill for the ASSASSIN ability. Pest chooses Tetra. Apoth puts Tetra in the discard.

Apoth returns TMP-Sulfa, Meropenem, and Clindamycin to his hand. During Cleanup, Apoth has 7 cards so he doesn't need to put any extras on the bottom of the deck. He ends the turn with 0 coins.

Turn 2. Apoth takes a turn-marker coin and fills his hand to 8, drawing a card. Pest draws 3 more cards, this time 1 Opportunist and 2 Provokers. Pest decides to save the MRSA in her hand for a later turn. Instead she plays a face down MASKED creature in zone 1. She attacks the other zones with Shigella and Gonorrhea. Shigella has the THIEF ability, so Apoth shuffles the cards in his hand and Pest picks one. Clindamycin is discarded.

Apoth plays Ceftriaxone to defend villager 3, and gains a coin from the general supply as a reward, because of the bracket listed on Gonorrhea. Pest removes a Pen/Ceph Resistant cube. Apoth spends a coin to use the "Research 1" default skill and draws Chloramphenicol. Apoth can play any card to try and fight the MASKED attacker. He chooses Chloramphenicol. Pest removes a Chloramphenicol Resistant cube. Apoth tells his opponent he is using the TEACHER skill on Chloramphenicol, which is free, and prevents a cube getting removed when he plays TMP-Sulfa in zone 2.

The MASKED card is revealed: Mycoplasma. Apoth got lucky; Mycoplasma is susceptible to Chloramphenicol. During the fight, all attackers are killed. Pest adds Resistant Shigella to her hand from the Mutant pile. Apoth returns the defenders he played to his hand. He has 8 cards during Cleanup, and has to put a card on the bottom of the deck. He ends the turn with 7 cards and 1 coin.

Turn 3. Apoth takes a turn-marker coin and now has two coins. Apoth fills his hand to 8, drawing 1 card. Pest draws 3 Provokers. Pest chooses not to attack villager 1 because she wants to gang up with two attackers against the wounded villager. Villager 2 is attacked by Syphilis from the 1st slot and Staph epidermidis from the 2nd slot, which is allowed because Staph epidermidis has the (+) ability. Villager 3 is attacked by Resistant Shigella.

In this case, Apoth can play up to two defenders in zone 2. He would like to play one that kills both, but there is no overlap between the lists on Syphilis and Staph epidermidis. He defends villager 2 against Syphilis with Pen and gets a reward coin from the general supply. Pest removes a Pen/Ceph Resistant cube. Apoth spends a coin to use Pen's occupation skill, and draws 2 cards. Then he pays another coin to use the TEACHER default skill so he can play Ceftriaxone in zone 3 without removing the last Pen/Ceph Resistant cube. Apoth wants to save his last coin. He plays TMP-Sulfa to stop Staph epidermidis, and Pest removes the last TMP-Sulfa Resistant cube. That resistance card is now unlocked and will be available to use next turn.

All attackers are killed during the fight. Syphilis's ASSASSIN ability sends Ceftriaxone to the discard, and Pest adds MRSE and CRE to her hand from the Mutant pile. Apoth returns Pen and TMP-Sulfa to his hand. He now has 9 cards and has to put 2 on the bottom of the deck so he ends the turn with 7 cards. He has 1 coin when the turn ends.

Turn 4. Apoth gets a turn-marker coin and now has 2 coins. Apoth draws a card to fill up to 8. Pest draws 2 Provokers and 1 Opportunist. Pest attacks with Tularemia in zone 2, forcing a discard with the THIEF ability. Amp/Sulbactam gets discarded. Then she adds Staph Sapro and a MASKED Pest as attackers. Now that the TMP-Sulfa resistance card is unlocked, she can attach it to Staph Sapro.

Apoth plays Chloramphenicol in zone 2. Pest removes the last Chloramphenicol Resistant cube. That resistance card is now unlocked and can be used next turn. Apoth plays TMP-Sulfa in zone 3. There are no cubes left to remove, since the TMP-Sulfa Resistant card is already unlocked. Next, Apoth spends a coin on the RESEARCH default skill and draws 1, but the new card is no help. He decides to save his last coin and let villager 1 get wounded.

The MASKED card is revealed: B. burgdorferi. During the fight, Tularemia is killed and goes to the biohazard. Staph Sapro and B. burgdorferi survive the fight and are successful in their zones. Villager 1 and villager 3 are both wounded. Villager 1 is flipped over, revealing a new rule: new attackers played here cannot have resistance cards. Villager 3 is flipped over revealing a just-flipped benefit: Research 2. Apoth draws 2 cards. Next, Staph Sapro is put in the biohazard, because of its NON-VIRULENT success ability. The TMP-Sulfa Resistant card returns to its starting place. B. burgdorferi, however, remains in zone 3 to attack again next turn.

During Cleanup, Apoth returns Chloramphenicol and TMP-Sulfa to his hand and now has 10 cards, so he puts 3 on the bottom of the deck to end the turn with 7. Apoth has 1 coin.

Turn 5. Apoth takes a turn-marker coin and now has 2 coins. Apoth draws a card to fill up his hand to 8. Pest draws 1 Opportunist and 2 Provokers. Pest attacks villager 1 with E. coli and names the yellow 3 for the BANISHER ability. (The yellow 3 is an allowable choice because it is listed on the E. coli card.) The yellow 3 (Gent) cannot be played this turn. Next, Pest plays MRSE in zone 2. She can play up to 3 new attackers, so she also adds MRSA as a second attacker in zone 3 slot 2, above B. burgdorferi. Finally, she adds TMP-Sulfa resistance to MRSA. There are now 4 attackers because B. burgdorferi remained from the previous turn.

Apoth pays 2 coins so Tigecycline can defend villager 3 and is now out of coins. He defends villager 1 with Ceftazidime but cannot afford the occupation skill. Pest removes the last Pen/Ceph cube. It is now unlocked.

During the fight E. coli, MRSA, and B. burgdorferi are killed. The TMP-Sulfa resistance card returns to its place on the game board. Pest gets ESBL E. coli and VRSA from the Mutant pile. Pest now has a lot of cards in her hand due to all the Mutants she's gotten. MRSE is successful, and villager 2 is killed. Pest takes the villager card and sets it near her side of the board. During Cleanup, MRSE goes to the biohazard. A new healthy villager is spawned in zone 2. Apoth returns defenders to his hand then puts 1 card on the bottom of the deck to end the turn with 7 cards. He has no coins.

Turn 6. Apoth takes a turn-marker coin, then draws a card to fill his hand up to 8. Pest draws 1 Opportunist and 2 Provokers. Pest attacks villager 1 with V. cholerae and the SPY ability takes effect. She looks at the top card of any deck (she chooses the Apoth deck) and decides to put that card on the bottom. Then she attacks with Typhoid and Listeria. She attaches 3 resistance cards to Typhoid: TMP-Sulfa, Chloramphenicol, and Pen/Ceph.

Apoth plays Amp to fight Listeria, then plays Gent to also fight Listeria, which is allowed because it completes the listed DUO on Listeria. (He had to play Amp first, since Gent is not listed in Listeria's banners, then play Gent later in the turn to complete the DUO.) Pest removes an Aminoglycoside Resistant cube. Apoth gets 3 coins from the general supply as a reward. He now has 4 coins. Apoth spends a coin on the RESEARCH default skill, draws a card that isn't useful, then pays to RESEARCH again, drawing another card: Erythro. Next he pays to use the TEACHER default skill, and plays Erythro in zone 1 without removing a cube. He has no answer for zone 3. (Erythro's TEACHER skill is wasted; it doesn't last across turns.)

During the fight, Listeria and V. cholerae both are killed, and they go to the biohazard. Typhoid is successful, and villager 3 is killed. Pest takes that villager. Since Typhoid has the CONTAGIOUS ability, and Typhoid was successful, villager 2, which is healthy, becomes wounded. The villager is flipped over and Apoth gets a card back from the discard, choosing Tetra. During Cleanup, Typhoid is sent to the biohazard when the kill zone is cleaned, its resistance cards return to their place on the board, and a new healthy villager is spawned in zone 3. Apoth returns Gent, Ampicillin, and Erythro to his hand, then puts 4 cards on the bottom of his deck to end the turn with 7 cards. He has 1 coin.

Turn 7. Apoth takes a turn-marker coin and draws a card. Apoth now has 2 coins. Pest draws 3 Opportunist cards. Pest attacks villager 1 with P. mirabilis and villager 2 with VRSA and Acinetobacter, attaching TMP-Sulfa resistance to VRSA and Pen/Ceph resistance to Acinetobacter. Apoth plays Cipro to fight P. mirabilis. Pest removes a Fluoroquinolone Resistant cube. Apoth pays 2 to play Tigecycline which can fight both VRSA and Acinetobacter. Tigecycline is allowed by itself versus Acinetobacter because Tigecycline is listed in brackets, which nullifies the ESCAPE ARTIST ability. Apoth gains 1 reward coin.

During the fight, Tigecycline kills both attackers in zone 2, and Cipro kills P. mirabilis. Because P. mirabilis was killed and it has the NECROMANCER ability, Pest gets a card back from the biohazard. She chooses MRSE. During Cleanup, Apoth returns Tigecycline and Cipro to his hand, then puts 1 card on the bottom to end the turn with 7 cards. He has one coin.

Turn 8 (last turn). Apoth takes the final turn-marker coin and draws a card. Because it is the last turn, Pest forgoes drawing cards and gets C. diff from the Mutant pile instead. Pest plays CRE in zone 1, then C. diff in zone 2, choosing to wound villager 3 with the BETRAYER ability. Villager 3 flips over. Apoth uses the "just flipped" benefit and adds a cube to the Tetracycline Resistant card. Finally, Pest plays MRSE to zone 3.

Apoth plays Metro in zone 2, and uses Metro's occupation skill. He decides not to shuffle his discard into his deck, but does research 2. He gets lucky and draws the card he needs, Vanco. He spends a coin to play Vanco in zone 3, then gets a reward coin. His last defender is Gent in zone 1. During the fight, all attackers are killed. The game ends. Pest was only able to kill 2 villagers, which was not enough to win. Apoth wins.

Solitaire Rules

To play a Solitaire version, play as Apothecary. Set up the board as if playing a normal game, but do not draw any cards for Pestilence. Pestilence will not draw cards or have a hand, and instead will play on autopilot according to the algorithm below.

Pestilence gets 2 enchantments: put the SMALLER HAND SIZE enchantment into play. Shuffle the remaining Pestilence enchantments and add 1 more to play.

1) Draw phase

Pestilence does not draw cards.

2) Attack Planning phase

For each villager, add one new attacker, if there is room. (There are two attack slots per villager.)

If the villager is healthy, and slot 1 is empty, attack it with the top card of the Provoker deck.
If the villager is wounded, and there is at least one empty slot, attack it with the top card of the Opportunist deck, adding the attacker to slot 2 if slot 1 is taken. If there are no cards left in the Opportunist deck, turn over the top card of the Provoker deck. If that card can attack wounded villagers, attack with it, otherwise discard it to the biohazard and do not add an attacker for this villager this turn.
Ignore the MASKED ability. Play those cards face up. Ignore SPY and ATTRACTOR. For THIEF, discard a random card.
Play ALLERGIC VILLAGER when drawn if it makes that villager harder to defend, otherwise save it for the next relevant villager and play it then. Either way, draw again for an attacker.

Pestilence Solitaire Algorithm

Add new attackers. (See "Attack Planning phase" above.)
If there are wounded villagers with open attack slots, and Pestilence has not played 3 attackers yet, start this process again from left to right, only for zones with wounded villagers, until Pestilence has played 3 new attackers or cannot play more.
Each time you play a new attacker, or a Mutant is placed on the board, add as many resistance cards as possible to it. If multiple Mutants enter play at the same time, add resistance to attackers in the leftmost zone first, 1st slot before 2nd slot.
Only add a resistance card if it helps that attacker. Resistance cards that are still locked or still attached to another attacker cannot be moved.
If the Provoker deck runs out, shuffle any Provokers in the biohazard into a new Provoker deck.

3) Battle Resolution phase

Some abilities are changed for Solitaire.

ASSASSIN: Kills all defenders in its zone.
BANISHER: Same effect as THIEF.
REINFECT: When this attacker dies, replace it with the topmost Mutant card from the Discard pile. If there is no Mutant in the Discard pile then play the topmost attacker. The new card does not attack until next turn.
MASKED: Has no effect. Always play face up.
MUTATION: When an attacker with a mutation ability is killed, replace it with the named Mutant card. The new card does not attack until next turn.
NECROMANCER: Same as ASSASSIN.
SPY has no effect.
C. DIFF is not played.
Do not use Pestilence promo/expansion cards (Allergy, Pregnant Villager).
E. FAECALIS (a Provoker) always mutates into VRE.

One of the main differences from the two-player version is that mutation abilities bring cards immediately onto the board rather than into a player's hand. The new Mutant card is now on the table but waits to attack until next turn. If two attackers both mutate in the same zone, there will be two Mutants attacking the same villager next turn. These mutants may attack regardless of attack restrictions.

Exception: Do not replace an attacker with a Mutant when the villager it was attacking gets killed. (It is possible for one attacker to kill the villager while a second attacker is killed by a defender and mutates. Ignore the MUTATE ability in this instance.)

Q & A

Q: A.R.E. is attacking with aminoglycoside resistance added. A.R.E. has the DUO ability: any aminoglycoside + Vanco. Can I still play the DUO? A: No.

Q: Two ESCAPE ARTISTS are in one zone. Attacker A lists the pink 2 and the gray 2. Attacker B lists the pink 2 and the yellow 2. None of those give rewards. I play the pink 2, the gray 2, and the yellow 2. Did I just kill two ESCAPE ARTISTS with only three defenders? A: Yes.

Q: Apothecary uses Oxacillin's GUARDIAN skill. A CONTAGIOUS attacker would've killed the villager but was prevented by Oxacillin's ability. Does CONTAGIOUS still happen? A: No. Attackers are only declared successful if they wounded or killed a villager.

Q: Klebsiella shows that an aminoglycoside (yellow) can be part of a DUO, but no aminoglycosides are listed below as cures. Can I play an aminoglycoside by itself? A: No. You may only play the aminoglycoside as a second defender if it completes a DUO. There is always one half of the DUO that can be played alone, so in this case play the light blue 4 first, then play the Aminoglycoside.

Q: Do I ever have to pay 2 extra coins when fighting EXPENSIVE attacker Nocardia? A: No, only the first defender played that is listed on Nocardia requires the extra payment. However, if you are playing a defender that has its own cost, such as Meropenem, you will need to also pay that cost.

Q: Can a resistance card end up with more cubes than it started with? A: Yes, there's a just-flipped villager ability that adds a cube, that could result in the card having more cubes than it started with.

Q: What happens when a deck runs out of cards? A: Keep playing, but you can no longer draw cards from that deck.

Q: If there are 2 attackers in the same zone, and one has resistance from fluoroquinolones (pink) am I allowed to play a fluoroquinolone in that zone to kill the other attacker? A: Yes, although it will not affect the resistant attacker.

Q: If I use a TEACHER occupation skill (the next defender played doesn't remove a cube) does that still work if the next defender I play is in a different zone? A: Yes.

Q: Do the Apothecary cards stay on the table if they've defeated an attacker? A: They stay on the table until Cleanup phase, then are returned to the Apothecary player's hand.

Q: Do you always get a reward when you play a defender? A: No, only if it is listed in brackets on the attacker that it will be fighting.

Q: Do turn-marker coins ever get added back? A: No, they make sure the game always lasts a specific number of turns.

Q: Who chooses the order that defenders strike attackers? A: There is no need to choose an order; they all happen simultaneously. Revenge effects then happen AFTER all defenders have struck attackers.

Q: If an assassin kills a defender, does that make an attacker that would've been killed now a successful attacker? A: No, it doesn't work that way. The ASSASSIN ability only happens after all defenders strike attackers. Defenders kill attackers simultaneously, THEN revenge effects happen, in an order Pestilence chooses as Pestilence puts those cards in the biohazard.

Q: Is there any way to add resistance cubes back once they've been removed? A: Once ALL the cubes have been removed, no. There is a just-flipped ability that adds a cube but only if the card has not been unlocked yet.

Q: What happens when a Pestilence attacker is not killed? A: If it wounded a villager, it stays on the board, keeping any attached resistance cards, and attacks again next turn. If its villager was killed, its mission is complete and it goes to the biohazard during Cleanup, without any revenge abilities taking effect.

Q: Where do the coins go after you spend them? Back to the common bank, or completely out of the game? A: There is an unlimited supply of coins. Keep a "general supply" off to the side, and when spending them, return them to the general supply. If you run out, you can use pennies for additional coins.

Q: If you gang attack with two attackers in one zone, can you kill a healthy villager outright? The first attacker wounds then the second attacker kills, or is it still considered a single attack? A: A villager cannot go from healthy to killed in the same phase. The only way to kill a healthy villager in one turn is by using C. DIFF's BETRAYER ability during Attack Planning, then killing it during Battle Resolution.

Q: I don't have the two defenders I need to kill an ESCAPE ARTIST, but I have one, and it has a RESEARCHER skill. Can I play it and hope to get lucky and draw the other card I need? A: Yes. But if you aren't lucky, the ESCAPE ARTIST is not killed, even though you played one defender.

Q: How do I use the GUARDIAN skill on Oxacillin, and what happens to the attackers? A: Oxacillin must be already on the board because you were allowed to play it. Then you can pay for the ability, once, to keep 1 wounded villager in any zone from dying this turn. Any attackers that were not killed, however, remain and try again next turn.

Q: Can I put any resistance card on a MASKED attacker when it is face down? A: Any resistance cards you play must be legal, and when the MASKED card is revealed, if you played an illegal resistance card, you lose the game for cheating!

Q: Can you attach resistance to a Pest that is still on the board from a prior turn? A: Resistance can only be added when an attacker is first played. That resistance card must also be unlocked and available; it can't be moved from another attacker that already has it. Resistance cards become available again after the attacker they were attached to dies.

Glossary

ALTRUIST: A special card in the Apothecary deck. It cannot be used in battle; it can only be discarded for one of three possible effects, listed on the card.
APOTHECARY HEALER: The characters that defend the villagers of Soma from attack. These are based on real-world antibiotics.
ASSASSIN (revenge ability): If this attacker gets killed, kill a defender in any zone.
ASSASSINATED: A defender that was discarded because of an ASSASSIN ability.
ATTACK ABILITY: BANISHER, BETRAYER, MASKED, SPY and THIEF are attack abilities; they happen during the Attack Planning phase.
BANISHER (attack ability): Name a listed defender (number and color). It cannot be played this turn.
BETRAYER (attack ability): When played, wound a healthy villager in any zone.
BIOHAZARD: The Discard pile for the Pestilence player. Attackers that are removed from a zone are sent here. Cards discarded from the Pestilence player's hand are also sent here.
CONTAGIOUS (success ability): If successful, wound all healthy villagers at the end of the Battle Resolution phase.
DEFAULT SKILLS: The two skills listed on the game board that Apothecary may use during Defense Planning, as many times as desired, as long as each use is paid for.
DEFENDERS STRIKE ATTACKERS: The step during Battle Resolution when defenders kill all the attackers they can, simultaneously.