Epidemiology is not a very common theme for a board game. Real-world public health menaces such as influenza varieties and other infectious diseases have garnered little attention from game designers who usually opt for Orcs, Nazis, or inefficiency as their in-game antagonists.

I have to admit that to me the concept of a game featuring public health researchers traveling the world to research, contain, and cure infectious diseases is actually a pretty interesting one if only because I was a Centers for Disease Control (CDC) archivist and public health research fellow for a number of years. I spent all of my time at the CDC in the libraries and information centers so I never got to go visit some “patient zero” in a remote corner of the world or engage in laboratory derring-do, but being in that environment and in contact with folks on the frontlines of the war against infectious disease was pretty interesting to say the least. Designer Matt Leacock appears to share my interest in the subject and his game PANDEMIC, newly published by Z-Man Games, is one of few games that I know of to really tackle a medical theme- OPERATION notwithstanding. But if OPERATION is an episode of ER, then PANDEMIC is THE HOT ZONE.

PANDEMIC is a cooperative game, so if you can’t brook a game that requires cooperation rather than crushing then you may as well stop reading now. Each player takes on the role of one of five specialists, each with a unique special power. Setting out from the CDC Headquarters in Atlanta (literally a mile from my house), the players must leverage their special abilities and budget their limited actions to contain and control four unnamed infectious diseases that are springing up in major cities and spreading along vectors to make the world a pretty sick place. Failure means nothing less than the drowning of the human race in a tide of coughed-up blood, the pus drained from a million sores, and illimitable gallons of mucus.

Fortunately for the players and humanity alike, real-world hamstrings like FDA approval and government funding cuts aren’t represented in the game and all that it takes to cure a disease is a set of five cards. Over the course of the game the players will use a hand of research cards, each marked with a city and its corresponding disease color, to move around the board and attempt to collect these sets. Along the way, players will also need to stop to administer cures to dangerously infected cities, build research centers, and trade information with their fellow disease-fighters. Once a player has a complete set of five like-colored cards, he or she must return to a research station where they can turn the cards in and cure the disease. If the players have managed to remove the disease from the board, then the virus makes like smallpox and is permanently eradicated- definitely a goal worth striving for.

Time is definitely of the essence in PANDEMIC as disease left untreated spreads and can cause extremely dangerous outbreaks- eight of which end the world. Additionally, the players only get one pass through the research card deck and on top of that, the infection rate increases as the game wears on. The game is very much about players discussing their actions and determining what the smartest course of action would be and the level of collusion is very high throughout. There is also an economical element since cards spent moving and building research centers are out of the game- and toward the end, it’s not uncommon to find yourself wishing that you’d not used up all the black cards when the black disease is threatening to annihilate the Middle East. Although luck is a huge factor since the game is primarily card driven, smart play that makes the best use of careful coordination and calculated risk-taking will give the players a fighting chance to outsmart the microbial menace.

Fortunately, disease is stupid- a thematic truth that works nicely with the “dumb AI” that drives the game system. Like most cooperative games, an automated system provides the challenge for the players and Mr. Leacock has devised a very ingenious system that not only completely works thematically, but it also makes for a very difficult game to win. Cities are infected at the beginning of the game and throughout via a stack of city cards. The board is seeded with nine randomly infected cities at the beginning of the game and at the end of each player’s turn they must draw cards to infect other cities. When a city has three disease cubes, it becomes extremely dangerous as another addition instead results in an outbreak. Cubes are added to each adjacent city, and if any of those already have three than another outbreak happens. And that outbreak could cause another. The trick is that when a city becomes infected, it remains a “hot zone” for the rest of the game- hidden in the research card deck are “epidemic” cards that not only add a newly infected city, but they call for the player to shuffle the discard pile and put it back on top of the draw deck. So that means that infected cities keep cranking out infection and what’s worse is that a newly infected city can outbreak right after it gets its first taste of sickness.

Sometimes this system does feel a little ruthless and I’ve seen a few games where the players are doing well but then it all goes south in a single turn due to a couple of ill-timed city card draws. However, the game is very much about avoiding situations where a single outbreak can turn into a game. If players are smart and divide work, discuss their plans, and make sure that both long and short term goals are met then the big game-ending disasters can be avoided. PANDEMIC is a game that rewards replay and skill development and even though at times it comes dangerously close to an optimization/efficiency exercise the game provides plenty of drama, suspense, tension, and surprise thanks to the randomness and variability the mechanics provide.

Because of the variety afforded by not only how the diseases spread but also by the different combinations of roles available, PANDEMIC is going to keep players coming back for more- the game even allows for shifts in difficulty to ramp up or decrease the spread of disease and since the game plays in under an hour, repeat plays are almost always prescribed. There’s a real sense of challenge, of wanting to beat the game that becomes infectious itself- particularly when your team keeps losing and is therefore continually responsible for the end of the world. The game also scales perfectly from 2-4 players and offers a different challenge for fewer players since the special abilities are more limited. It’s the kind of game- a very nearly great one- that I’d feel comfortable recommending to almost anyone interested in board gaming in any capacity, provided that they don’t mind cooperation in lieu of competition.

PANDEMIC is definitely a simpler game, which is to my mind kind of disappointing in the end given the potential that the theme suggests. Despite an amazing box that looks like one of those old 1960s-era 3M games and a very nicely executed graphic design approach, it’s really a shame that these terrible diseases are given generic monikers such as “red disease” and “blue disease” and are represented by wooden cubes. I would love to see the same theme and even some of the same mechanics deployed in a more detailed, simulation-oriented game that has a more epic scope and a deeper level of gameplay. That being said, it’s hard to seriously fault the game along these lines because Mr. Leacock’s creation is one of those rare instances in the “family game” design paradigm where abstraction is used judiciously and the game’s mechanics are distinctly informed by and illustrative of the theme. PANDEMIC is one of those games that doesn’t try to do too much but it also does just enough for what it ultimately is- an easy, accessible game that offers plenty of fun and challenge.