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Pandemic State of Emergency – How Much More Can You Add?

We’re back to milking the cash cow again! Pandemic took a little break for a while but with Pandemic Legacy on the horizon and now State of Emergency here Matt Leacock is certainly not letting it fall out of your subconscious any time soon.

Now I’m not the biggest fan of Pandemic, I’ll make that clear now and if you’ve seen my previous review of the game then you already knew that, but I still own it as it does scratch that puzzle itch and it can’t be argued that it’s a great gateway game for new players. Hell it worked on my non-gamer girlfriend so it has to be doing something right!

Two expansions have already come out for this game; those being On the Brink and In the Lab. The first added lots of little extra modules to the game whereas the latter was more about one big game-changing module, yet both were very solid expansions for me, adding in a lot of new variety and even some theme to what is otherwise a fairly abstract game. For those not familiar with the term “game-changing” this would be a new element that completely changes the way the game plays and feels whether for better or worst. In The Lab for example introduced an entire new board where you actually felt like you were performing laboratory tasks to cure the virus, something which completely alters the way the game plays.

So with State of Emergency we have a few extra modules but at first glance this seems smaller in scope than previous additions. Is this another must-have remedy for your bursting box or are the cures losing their potency?

ZManGames Pandemic State of Emergency Cover

Designer: Matt Leacock

Publisher: Z-Man Games

# of Players: 1-5

Ages: 8+

Play Time: 45 Minutes

BGG Rank/Rating: 2769 / 7.00

Now if you’re reading this review you know how to play Pandemic already so I’m not going to waste your time going over the basic rules, however you can check out my own personal review of Pandemic on The Broken Meeple. Instead I’m going to give an overview on the components and then speak about each major module in turn. Also note that I have tested these scenarios by themselves with the vanilla game, I don’t feel like granting the world’s death wish by combining too many variables together!

Our Health Services Require More Funding

Component wise I think we’ve taken a bit of a drop here. The new boards are nice and match the newest edition of Pandemic fine but everything else is fairly mediocre – essentially just basic tokens, some translucent disc “strepsils” and a cheap die for the most part. For the price point you’re not getting the best value here when compared to other base games fetching the same amount.

Annoyingly yet again we get the small thin box as with all the other sets and gamers everywhere are still baffled as to why this is the way it is. Time and time again we rant about how hard it is to store this game and yet nothing is done to resolve it. This expansion should have been a big box, large enough to accommodate all previous expansions. Cutthroat Caverns did this before and so has Smash Up recently, come on publishers, wake up! If you have every expansion before this one then you will have no choice but to use two boxes to store the game. If you can do it with one box without using a custom insert or leaving out components I want to see photographic evidence because I don’t believe it’s possible – mine was already brimming with In the Lab. 

Outbreak Without Dustin Hoffman

The first major module in State of Emergency is the Hinterlands challenge. This introduces four new boards each representing a new Hinterland space that is connected to several cities in the corresponding region and an associated animal. Players can travel to this space and vice versa, however at the end of each player’s turn in addition to infecting cities, they must roll a die that shows the animal faces on it. If an animal comes up, a disease cube is placed on the relevant Hinterland space. Should an outbreak occur under the normal rules, the cubes will spread to every city connection it’s linked to. Otherwise the game functions as normal.

This module has two effects on the game. Travel and card exchanges are made a little easier due to the Hinterland city links but in contrast cube mitigation/ treating diseases becomes harder because you have additional locations to worry about. Also the consequences of a Hinterland outbreak can have a disastrous impact as cubes end up spreading to many connected cities which in turn may outbreak themselves.

Other than that though, it doesn’t change much in how Pandemic feels and you still use the same diseases as before so the theme of animal viruses dies out almost instantly. They don’t behave any differently based on the animal type; a missed trick here, it’s purely to separate the colours out. The rules suggest you should place the die on the infection card pile as a reminder to roll it and I strongly advise you do so as well as it’s incredibly easy to forget to roll it on a regular basis. On top of that, those translucent discs that you’re meant to place on each connecting city only succeed in cluttering up the board with very little point to them.

It’s slightly harder overall than the normal Pandemic game, but I can take it or leave it and certainly wouldn’t be fussed if it wasn’t present.

Space Corp Directive 595 – Quarantine!

Not really a major change in gameplay, more of a tiny mechanic. These allow you to suppress disease cubes by spending actions on cities to place a marker. The next two times that a disease has to be placed there, you don’t! Again, it doesn’t really add much to the game and just makes it a little easier, but it’s probably worth using if you’re going to try out the seriously hard scenarios or difficulty levels.

Awooga! Awooga! We’re All Going To Die!

Third on the list are the Emergency Events. These negative events allow you to step up the challenge in smaller increments than simply bolting on another epidemic card. You include as many in the player deck as there are epidemics and resolve each one as they appear.

ZManGames Pandemic State of Emergency Events

You get 10 events in the box and are going to be using 3-5 per game so there’s a good amount of variety present for multiple plays. Even though this isn’t a major change, it is actually my favourite addition to Pandemic in this set. Even though it prolongs the game length by adding cards to the deck it still increases the difficulty overall and not in such a giant leap as another epidemic card would. Plus the variation in the events used helps to make each game a bit less repetitive and if you make sure you don’t see which events you put in you kind of get a short story being told as the game progresses.

Fighting Off A Real Disease Would Be Easier

Now this last module really is for those who are Pandemic experts. I admit it freely, I suck at Pandemic, I just can’t seem to be “aggressive” enough with my hand in Pandemic, but even with that considered, the Superbug challenge is Expert mode pure and simple.

This takes the purple virus mutation variant from Pandemic: On the Brink and adds a new layer where you can’t treat the purple disease from the start. You have to first cure it, then wait for vaccines to spawn at newly converted research stations then deliver those vaccines to the purple cubes to treat them. To win the game you have to fully eradicate it on top of doing the normal requirements to win. That’s insanity! You get quarantine markers to help with the cube spawning but even with that, this is a beast of a challenge and certainly worth looking at if you’re one of these Pandemic gurus that continuously beat the game on Hard mode.

That being said, it’s not a major change. As stated, this is merely a small tweak on a variant from On the Brink that already existed, but with added green buildings and vaccine “pellets”. So again nothing particularly new here but again this might appeal to the hardcore players out there. For me however it’s too much when In the Lab already provides a significant challenge but with theme added in that board.

ZManGames Pandemic State of Emergency Superbug


The main appeal of this expansion will be the difficulty aspect. The Quarantine rules make it easier for casual players, the Hinterlands is slightly harder, but the Vaccine Superbug mode is one for the Masochists among us. It’s incredibly hard and will put off all but the most adept of Pandemic players which I’m certainly not one of I’ll be the first to admit.

The variety isn’t as strong here as with other expansions and nor is any addition here particularly ground-breaking. It’s more of the same with some subtle tweaks only. The Hinterlands for example can be summed up as 4 extra cities that spawn cubes with a slightly more drastic outbreak effect. The animal theme is almost completely obsolete – contrast this to In the Lab where the laboratory mechanics really upped the theme and made it my favourite expansion to date, but you know me, I love theme.

Overall I’m a bit underwhelmed with this expansion and I fear we might be reaching a limit for the franchise. On the Brink and In the Lab were very solid expansions for different reasons and the upcoming Pandemic Legacy looks like the big change that this series needs. This expansion however just feels like a bolt-on only for the completionists and die-hard Masochist Pandemic fans out there – it’s not bad, just not essential. If you’re starting out on the game stick to grabbing the expansions in release order and see how you feel before grabbing this one.

You Will Like This Game If:

  • You want the ultimate challenge in Pandemic.
  • You’re a Pandemic enthusiast and want a complete collection.
  • At least 3 of the 4 modules above take your fancy for the price point.

You Will Not Like This Game If:

  • You were hoping for something as game changing as In the Lab.
  • You think Pandemic is a hard enough game already – Vaccine mode is sick.
  • You can barely fit Pandemic in the box you have and won’t like using two.
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Luke Hector

I'm known as The Broken Meeple, a blog, podcast and YouTube channel devoted to board and card games. I live in Portsmouth, UK, working as a Chartered Tax Advisor and I enjoy playing games of many genres and varieties with as many people as possible.