Pandemic: State of Emergency Rulebook

Table of Contents

Table of Contents

• Contents
• Overview
• New Roles and Events
  • New Roles
  • New Events
  • Event Cards
  • Fine Points
• Quarantines
  • Setup
  • Play
  • Fine Points
• Hinterlands Challenge
  • Setup
  • Play
  • Hinterlands Infections
  • Winning or Losing
• Emergency Event Challenge
  • Setup
  • Play
  • Emergency Event Cards
  • Fine Points
• Superbug Challenge
  • Setup
  • Superbug Bonus Cards
  • Overview
  • Play
  • Superbug Actions
  • Superbug Infections
  • Winning or Losing
  • Superbug Lab Challenge
  • Virulent Strain Superbug
• Roles
  • Colonel
  • First Responder
  • Gene Splicer
  • Pharmacist
  • Veterinarian
  • Medic (reprinted for Superbug challenge)

Contents

• 5 Role cards
• 5 Pawns
• 7 Event cards
• 4 Reference cards
• 6 Quarantine markers
• 2 Hinterlands boards
• 18 transparent disks (5 black, 4 blue, 5 red, 4 yellow)
• 1 Hinterlands die
• 10 Emergency Event cards
• 8 Superbug Bonus cards
• 2 Superbug Infection cards
• 1 revised Role card (superbug version of the Medic)
• 4 Vaccine factories
• 24 Vaccine doses
• 24 Disease cubes (purple)
• 1 Cure Indicator card
• 1 Cure marker

These duplicate some On the Brink and In the Lab components for the Superbug challenge. If you have those Pandemic expansions, do not use these components.

State of Emergency cards have this icon in their lower right corner, so you can easily separate them.

Overview

This expansion adds 5 roles, 7 events, and 4 new ways to play:

• Quarantines: slow down infections to gain time to find cures.
• Hinterlands challenge: can you stop diseases jumping from animals to humans?
• Emergency Event challenge: can you find cures in the face of unpredictable events?
• Superbug challenge: an untreatable disease is spreading; can you find a cure and eradicate it in time?

To get started, play with the new roles and events. Vary play with Quarantines. Then, try the Hinterlands, Emergency Events, or Superbug challenges.

Typically, challenges increase the game's difficulty. Consider playing with 1 fewer Epidemic card than you normally use when trying a new challenge.

This expansion requires only the base Pandemic game to play, but is compatible with both its On the Brink and In the Lab expansions. Rules notes for these expansions appear in sidebars.

New Roles and Events

New Roles

Add the new Role cards to the other Role cards before shuffling and dealing 1 Role card to each player. See the Roles section for role details.

• Use the Colonel role only when using Quarantines.
• Use the Veterinarian role only when playing the Hinterlands challenge.
• Use the Superbug version of the Medic only when playing the Superbug challenge.

New Events

Add the new Event cards to the other Event cards and shuffle them face down. Use 2 Event cards per player (as in On the Brink and In the Lab). This is a rule change from the base game. Play the new Events normally.

Use the Event Local Initiative only when using Quarantines.

Event Cards

Emergency Response (Play after Epidemic. Not an action.) Select a player. Move his pawn (with permission) to the epidemic city and have him Treat Disease there before Infections.

Advance Team (Play any time. Not an action.) Until this player's next turn, ignore 1 outbreak. Put this card in front of the current player. Discard it after preventing an outbreak or when his next turn begins.

Local Initiative (Play any time. Not an action.) Use only with Quarantines. Place a quarantine marker in any city (without one).

Resource Planning (Play any time. Not an action.) Draw, look at, rearrange, and return the top 4 cards of the Player Deck. Do not mix them with your hand.

Sample Delivery (Play any time. Not an action.) Select a player. He may give 1 City card to any other player. (Apply hand limits after doing this.)

Emergency Conference (Play any time. Not an action.) Select a player. Each other player's pawn may move to the city that this player's pawn is in.

Infection Rumor (Play before Infections. Not an action.) Draw as many Infection cards as the current infection rate and look at them. Put 1 in the Infection Discard Pile. Return the rest. Then, infect cities, drawing 1 fewer card.

Fine Points

Advance Team: After it is played, this card does not count against a player's hand limit. If adding multiple disease cubes to a city would produce the next outbreak, bring the number of these cubes in that city up to 3 (but do not do the outbreak).

Emergency Conference: This cannot move pawns affected by the On the Brink Virulent Strain effect Government Interference.

Emergency Response: Finish all Epidemic steps. Then, you may play this before doing the next Infections step. The "epidemic city" is the city of the card drawn from the bottom of the Infection deck during the Infect step of resolving the Epidemic.

Resource Planning: The hand limit does not apply as you do this event.

Quarantines

Quarantines provide players a way to slow the spread or growth of diseases, typically making it easier for players to win. They can be combined with any challenge except the On the Brink Bio-Terrorist challenge.

When using Quarantines, you can use the Colonel role and the Event Local Initiative.

Setup

Put 4 quarantine markers in the supply. If the Colonel is in play, use all 6 quarantine markers.

Play

As an action, a player may impose a quarantine on the city he is in by placing a quarantine marker in that city with its "2" side face up. A player may not put 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 his current city, flipping it to its "2" side if needed.

Each quarantine marker prevents the next 2 attempts to place disease cubes or do an outbreak in that city. When new disease cubes would be placed (or an outbreak would occur), do not add any cubes to the city (or do an outbreak there). Instead, flip the marker over to its "1" side (the first time) and then remove it (the second time), returning it to the supply.

Fine Points

A quarantine marker prevents placing disease cubes (or outbreaks) in the city it is in by Infections, Epidemics, Emergency Events, Superbug Infections (and expansion Virulent Strain or Mutation effects). Instead, flip (or remove) a quarantine marker each time one of these effects would place cube(s) in a city with a quarantine marker.

If the Quarantine Specialist prevents outbreaks or placements of disease cubes in a city with a quarantine marker, do not flip over or remove that city's quarantine marker.

An outbreak in a connected city that produces chain reaction outbreak(s) which would also place cubes in a city under quarantine counts as 1 cube placement (not 2 or more), resulting in a single flip/removal of that city's quarantine marker.

Placing 2 differently colored cubes at the same time in a quarantined city — in the Superbug challenge or the Emergency Event Disease Zones Expand (or the expansion Mutation challenge) — counts as a 1 cube placement (not 2).

The On the Brink Virulent Strain effect Government Interference does not apply to pawns in cities with quarantine markers.

Hinterlands Challenge

This challenge can be combined with Quarantines and the Emergency Event or Superbug challenges (and all expansion challenges). Since this challenge makes the game both easier and harder (in various ways), it can be played as a change of pace, without increasing the overall difficulty.

In this challenge, disease strains are jumping from animals to humans in farm areas, the "hinterlands" beyond the major cities shown on the board. Players must keep these diseases from outbreaking into nearby cities. However, studying these animal disease strains — by visiting the Hinterlands spaces and Sharing Knowledge there — can make it easier to discover cures.

Setup

Set up the game normally, except:

• Place the Hinterlands boards next to the Pandemic board.
• On the main board, place the 18 colored transparent disks on the cities connected to the four Hinterlands spaces, matching disk colors to city colors. The disks allow players to easily see which cities connect to each Hinterlands space.
• In step 3 — Infect 9 Cities — also place 1 disease cube of the matching color in each Hinterlands space. Place the Hinterlands die on top of the Infection deck as a reminder (see below).

Play

Take turns doing actions normally, except as noted below. After each player's turn, before Infections, infect the Hinterlands (see next section).

The Hinterlands spaces behave like normal "city" spaces. Players may move to (or from) a Hinterlands space with a Drive/Ferry action from (or to) any of its connected spaces (with a disk of that color). Players may fly to a Hinterlands space by the Event Airlift or Charter Flight. (Direct Flights are not possible since there are no City cards for Hinterlands spaces.)

As Hinterlands spaces do not have City cards, research stations may be built in them only by the Event Government Grant or the Operation Expert's ability.

A player in a Hinterlands space may Treat Disease there normally (or quarantine the space if playing with Quarantines).

Important: to eradicate a cured disease, all cubes of that color must be removed from both the main board and the Hinterlands board.

The Share Knowledge action works differently: a player in a Hinterlands space with another player may either give any City card matching the color of this space to that player or take any City card of the matching color from the other player.

The Regional Response Team Bonus cards in the Superbug challenge (and In the Lab's Team game) can go to the matching colored Hinterlands spaces. The In the Lab Pilot may fly in or out of a Hinterlands space, but cannot fly through a Hinterlands space (in a single action). In the In the Lab Team Game, team research stations may not be placed in Hinterlands spaces.

The In the Lab Field Director may Treat Disease in adjacent spaces using Hinterlands connections.

This less restrictive Share Knowledge action in the Hinterlands spaces represents the benefits of studying the related animal disease strains.

Hinterlands Infections

Before drawing Infection cards, roll the Hinterlands die. If a colored die face is rolled, place 1 disease cube of that color in that Hinterlands space (or do an outbreak if 3 cubes of that color are present, placing a cube in each connected city). If a blank die 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.

Do not roll the Hinterlands die if the Event One Quiet Night is played to skip Infections. Roll the Hinterlands die twice after the Emergency Event Logistics Failure. Infection effects from the On the Brink Virulent Strain Chronic Effect or, if present, Mutation cubes, also apply to Hinterlands die infections.

Hinterlands spaces receive cubes from any outbreaks in their connected cities (which might result in a chain reaction outbreak in the Hinterlands space).

Winning or Losing

The Hinterlands challenge is won or lost as in the base game (or any challenge it is combined with).

Emergency Event Challenge

In this challenge, players must contend with Emergency Events, which have nasty, unpredictable effects. (Since these events add extra player turns and space out epidemics a bit more, they also make the game slightly easier in other ways.)

This challenge can be combined with Quarantines and all other challenges. When you're considering adding another Epidemic card to make the game more challenging, adding Emergency Events instead will increase both its difficulty and variety.

Setup

• Shuffle all 10 Emergency Event cards face down. Use as many Emergency Event cards as Epidemic cards. Put unused Emergency Event cards away without looking at them.
• When preparing the Player Deck, shuffle 1 Emergency Event card into each Player card pile (along with its Epidemic card).

Play

When you draw an Emergency Event, immediately read the card aloud and follow its instructions. Some Emergency Events have continuing effects until discarded or delayed effects. Place them face up near the Player Deck as reminders until discarded. These cards do not count against players' hand limits.

If a player draws both an Epidemic card and an Emergency Event, do the Emergency Event first. If a player draws 2 Emergency Events, the player chooses the order that they take effect.

When combining this challenge with the On the Brink Mutation challenge, if you draw both an Emergency Event and a Mutation Event, do the Emergency Event first.

Emergency Event Cards

CDC Planes Grounded (Play immediately when drawn. Continuing effect.) Players cannot move by Direct, Charter, or Shuttle Flights (or the Event Airlift). Put this card face up. Discard it after playing the next Emergency Event.

Containment Failure (Play immediately when drawn.) When doing the next outbreak, add 2 (not 1) disease cubes to each connected city. Put this card face up. Discard it after the next outbreak.

Disease Hot Spot (Play immediately when drawn.) Draw 1 card from the Infection deck bottom. If this disease is not eradicated, add 3 cubes of this color to its city. Discard the Infection card to the Infection Discard Pile.

Disease Zones Expand (Play immediately when drawn.) Add 1 cube of every non-matching color, except purple, to each city with different colored cube(s). (If this would add a 4th cube of a color, do an outbreak instead.)

Limited Options (Play immediately when drawn. Continuing effect.) Reduce players' hand limits to 6 cards. Discard cards or play Events as needed. Put this card face up. Discard it after playing the next Emergency Event.

Patient Zero (Play immediately when drawn. Continuing effect.) Draw 1 card from the Infection deck bottom. Add 1 disease cube of this color to this city every turn before Infections. Put this card and its Infection card face up. Discard them after playing the next Emergency Event.

Widespread Panic (Play immediately when drawn.) When doing the next outbreak, move the outbreaks marker forward 1 extra space. Put this card face up. Discard it after the next outbreak.

Transcriber's note: the source PDF does not print the text of all 10 Emergency Event cards. The seven above are transcribed from their printed card faces and the rules text. Logistics Failure (named in the Hinterlands section) and two further cards are shown only as "..." on the component page and their text is not in this PDF, so it is not transcribed here. Read those cards from the physical deck.

Fine Points

CDC Planes Grounded: This does not prevent the Dispatcher from moving pawns to other pawns; the Operation Expert's discard to move ability; or — in other expansions — the Pilot from flying or the Bio-Terrorist's Flight or Escape actions.

Containment Failure: If a connected city has 2 cubes of this disease's color, add 1 cube and then do a chain reaction outbreak there. (The On the Brink Virulent Strain effect Highly Contagious does not add to Containment Failure.)

Disease Hot Spot: If any cubes of the drawn card's color are in this city, adjust their number to 3 and then do an outbreak there.

Limited Options: If several players wish to play Events (instead of discarding), do so in any order. This event does affect the CDC (in the In the Lab Solo game), but not the On the Brink Bio-Terrorist player. The On the Brink Archivist's hand limit is reduced to 7, not 6.

Patient Zero: This can affect an eradicated disease. It will continue to do so until this event is discarded. After it is discarded, discard its Infection card to the Infection Discard Pile.

Widespread Panic: In On the Brink, this effect does add to the Virulent Strain effect Slippery Slope.

Emergency Events are not Event cards.

Superbug Challenge

In this challenge, players contend with a 5th disease that cannot be treated. Instead, players must cure it, produce vaccines, and deliver them to the infected cities to eradicate the superbug disease.

Quarantines (see the Quarantines section) must be used with this challenge (so players have a way to slow infections of the superbug disease). This challenge can be combined with Emergency Events or the Hinterlands challenge if desired. This expansion is quite a bit harder than the previous two challenges.

This challenge cannot be combined with the expansion Mutation or Bio-Terrorist challenges. See the separate sections below for how to combine this challenge with the expansion Virulent Strain or Lab challenges.

Setup

Set up the game normally, except:

• Add 24 purple cubes to the supply and use the purple cure marker and indicator for the superbug disease.
• Put 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 1st, 4th, and 7th cities drawn. Put 1 Superbug Infection card in the Infection Discard Pile and 1 on top of the Infection Deck.

This challenge begins with 18 disease cubes on the board, 3 of them purple, plus 10 Infection cards in the Infection Discard Pile (the 9 City cards drawn in step 3, plus 1 Superbug Infection card).

• Give each player a Superbug Reference card.
• If the Medic is in play, use the Superbug version of the Medic.
• Add 4 quarantine markers to the supply (use all 6 if the Colonel is in play).
• Shuffle the 8 Superbug Bonus cards face down and use as many as Epidemic cards. Put away unused Bonus cards without looking at them. When preparing the Player Deck, shuffle 1 Bonus card into each Player card pile (along with its Epidemic card).

Superbug Bonus Cards

Each Isolated Disease Sample card is a Superbug Bonus card that reads:

• Blue: Use this card as a blue City card for: Share Knowledge (matches any blue cities); Discover a Cure.
• Red: Use this card as a red City card for: Share Knowledge (matches any red cities); Discover a Cure.
• Yellow: Use this card as a yellow City card for: Share Knowledge (matches any yellow cities); Discover a Cure.
• Black: Use this card as a black City card for: Share Knowledge (matches any black cities); Discover a Cure.

Transcriber's note: the source PDF shows only these four Isolated Disease Sample faces. The other four Superbug Bonus cards (the Regional Response Team Bonus cards named in the Hinterlands section) are shown only as card backs and their text is not printed in this PDF, so it is not transcribed here. Read them from the physical deck.

Overview

To win, players must discover cures for all 5 diseases and eradicate the purple Superbug disease.

The Treat Disease action cannot be used to remove purple disease cubes.

Purple disease cubes can be prevented from being placed on the board normally (by quarantine markers, the Quarantine Specialist's ability, various Events, or — once the purple disease is cured — by the Medic.)

3 purple cubes begin play in cities. More enter play when these cities are re-infected or when Superbug Infection cards convert regular infections into purple infections. Purple disease outbreaks occur normally.

After the purple disease is cured, players remove purple cubes by collecting vaccine doses from vaccine factories and delivering them to purple infected cities.

Each vaccine factory produces 1 vaccine dose when built and after every player's turn. The research station where the purple disease is cured converts into a vaccine factory. Players can convert other research stations into vaccine factories.

Purple cubes can be removed in other ways, by certain expansion roles and Events; and — once the purple disease is cured — by the Pharmacist's or Medic's abilities (if the Medic can discard a vaccine dose) or the On the Brink Event Rapid Vaccine Deployment. However, the On the Brink Field Operative may not sample purple cubes.

If fewer vaccine doses are in the supply than the number of built vaccine factories, the player ending a turn decides which factories produce a dose.

Play

Take turns and do actions as in the base game.

Important: The Treat Disease action cannot remove purple cubes.

Once the purple disease is cured, at the end of every player's turn (after Infections), each vaccine factory built produces vaccine. Mark this by placing 1 vaccine dose on each space with a vaccine factory.

Superbug Actions

Discover a Cure (superbug disease only): At a research station, discard 5 City cards — 2 (or more) of these cards' cities must have at least 1 purple disease cube — to cure the purple superbug disease. Remove this research station from the game, replacing it with a vaccine factory and 1 vaccine dose.

Build Vaccine Factory (after superbug cure): At a research station, replace it with a vaccine factory and 1 vaccine dose, removing it from the game.

Once all 4 vaccine factories have been built, this action may not be done.

Players may do Shuttle Flights between a vaccine factory and a research station or two vaccine factories. Players may not Discover a Cure at a vaccine factory. A research station can be built in a city with a vaccine factory.

When playing the In the Lab's Solo game, the CDC actions Reassign Role and Exchange Data cannot be done at a vaccine factory. When playing the In the Lab Team game, a team research station may be converted to a team vaccine factory; mark this by standing the former team research station on edge, next to it.

The Operations Expert, First Responder, and Veterinarian can use their special movement ability from a vaccine factory.

When playing the In the Lab Team game, only the owning team's players can collect doses from a team vaccine factory.

Collect Vaccine: At a vaccine factory, transfer any number of its doses to your Role card.

At any time, players may return vaccine doses from their Role cards to the supply.

Distribute Vaccine: Return 1 vaccine dose from your Role card to the supply to remove all purple superbug cubes from the city you are in.

The In the Lab Field Director may Distribute Vaccine to a city connected to him.

The Medic does this automatically (without using an action) whenever he is in a city with at least 1 purple cube, if the Medic has a vaccine dose on his Role card to discard. The Medic automatically prevents placement of new purple cubes in his city — once the purple disease has been cured — without using vaccine doses.

Superbug Infections

When an Infection card drawn (for Infections, Epidemics, or Emergency Events) is a city with 1 or more purple cubes, add 1 purple cube to it (in addition to that card's normal effect) or conduct a purple outbreak if this city has 3 purple cubes.

Add 1 purple cube even if the City card's disease color has been eradicated.

During Infections, whenever a Superbug Infection card is drawn, it does not count as an Infection card draw. Instead, draw another Infection card and apply the Superbug Infection card's effect to it.

Do not draw any additional Infection cards when Superbug Infection cards are drawn when resolving the Event Forecast (or the On the Brink Troubleshooter's ability).

If you draw both Superbug Infection cards in a row, apply their effect once to the next Infection card drawn.

If the next Infection card's city has no purple cubes (and its disease is not eradicated), then add 1 purple cube instead of 1 disease cube of the card's color. Otherwise, the Superbug Infection card has no effect; do the Infection normally (adding both 1 cube of the city's color and 1 purple cube).

In either case, 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.

This rule is different from the other expansions' Mutation challenges.

Winning or Losing

The players win immediately if they cure all 5 diseases and eradicate the purple superbug disease. They lose normally.

Tip: use quarantine markers to slow the growth of the purple disease, as purple cubes cannot be treated and your team will lose if you cannot place the number of purple cubes actually needed on the board.

When playing the In the Lab Team game, players can either win as indicated or by curing and eradicating 4 diseases, including the purple superbug disease.

Superbug Lab Challenge

To combine this challenge with the In the Lab Lab challenge, during setup place 1 purple cube on the treat symbol next to the two sample dishes on the lab board. Before doing a Process a Sample lab action, a player may immediately add this cube to either sample dish.

The Superbug Lab Challenge is quite hard, since both challenges place additional time pressure on the players. Do not attempt it until you have succeeded with both the Superbug and Lab challenges separately.

Do not Process a Sample in ways that remove this purple cube, as it is needed to sequence the purple disease. Without it, it is impossible to cure the purple disease, as purple cubes cannot be treated (and placed in the lab sample dishes).

The City cards used to Characterize a Disease and Test a Cure for the purple disease must be cities with at least 1 purple cube (at the time these actions are taken). Any 3 City cards can be discarded to cure the purple disease; they need not be cities with purple cubes.

A Superbug Bonus Isolated Disease Sample card can be used to either Characterize a Disease or Test a Cure when developing a cure of that color in the Superbug Lab challenge.

Lab actions cannot be done at a vaccine factory (only at research stations).

Virulent Strain Superbug

When combining this challenge with the On the Brink Virulent Strain challenge, the purple superbug disease can become the virulent strain. If it does, several Virulent Strain Epidemic card effects are modified:

Chronic Effect: This applies only when a Superbug Infection card converts a disease cube into a purple cube.

Complex Molecular Structure: The additional City card must be a city with at least 1 purple cube.

Hidden Pocket: This has no effect.

Rate Effect: This applies only when a Superbug Infection card converts a disease cube into a purple cube.

Resistant to Treatment: This has no effect.

Roles

Each player has a role with special abilities to improve your team's chances.

Colonel

Use this role only with Quarantines. During setup, add 2 more quarantine markers to the supply.

• When he enters a city with a "1" quarantine marker, flip it to its "2" side.
• As an action, he may discard a city card to place a quarantine marker in any city.

First Responder

• As an action, she may move to any city with a research station.
• After resolving an Epidemic, she may – out of turn – move to the epidemic city and Treat Disease there (before Infections).

The "epidemic city" is the city matching the card drawn from the bottom of the Infection deck during the Infect step of resolving the Epidemic.

Gene Splicer

She may Discover a Cure at a research station in a city of the color being cured by turning in 2 City cards of the cure color, plus 1 City card each of the 3 other (standard) disease colors.

She may, instead, Discover a Cure normally. The Gene Splicer's ability cannot be used to cure the purple disease (in any challenge). When playing the In the Lab expansion's Lab challenge, the Gene Splicer needs to discard 1 card each of the (standard) non-cure colors to Discover a Cure (in a research station located in a city of the cure color). If affected by the On the Brink Virulent Strain effect Complex Molecular Structure, the Gene Splicer needs to discard 1 additional card of the cure color to Discover a Cure.

Pharmacist

• As an action, he may reveal a city card to Treat Disease (or Distribute Vaccine in the Superbug challenge) in that city.

He must discard a vaccine dose to Distribute Vaccine.

• As an action, he may remove 1 cube of a cured disease from any city to the supply.

Cured Superbug disease cubes may be removed by this action (without a vaccine dose).

When playing the Superbug challenge (or the In the Lab Team Game), the Pharmacist may reveal an Isolated Disease Sample card to remove 1 disease cube of that color from any city of that color.

Veterinarian

Use this role only in the Hinterlands challenge.

• As an action at a research station, he may move to any Hinterlands space.
• In a Hinterlands space, he removes 2 cubes of an uncured disease with Treat Disease (if 2 or more cubes are there).

Medic (reprinted for Superbug challenge)

Use this version only in the Superbug challenge. When automatically removing cubes of the cured superbug disease in a city, the Medic must also return 1 vaccine dose (or else no cubes are removed). Otherwise, this role is unchanged.

• Remove all cubes of one color when doing Treat Disease.
• Automatically remove cubes of cured diseases from the city you are in – to remove superbug cubes you must also discard a vaccine dose – and prevent them from being placed here.