I've recently bought Pandemic and I'm going to play it for the first time tomorrow. Having read the rules I wasn't quite sure how to interpret:

The player who was most recently sick goes first.

Does this mean the person who most recently vomited? Or just generally ill? What about long-term / chronic conditions such as asthma or diabetes?

Given that it's a co-operative game, does it actually matter who starts?

  • 9
    It means the person who has most recently been a victim of bioterrorism. Commented Feb 24, 2012 at 14:59
  • Roll a dice. Six makes you sick. If more than one people is sick, reroll.
    – SteeveDroz
    Commented Feb 24, 2012 at 15:37
  • Voting to close as primarily opinion based; any play group can decide what they want to consider "sick" for these purposes. Though the latest answer is actually correct and objective; but it's mismatched with the question which is based on older rules.
    – GendoIkari
    Commented Oct 26, 2015 at 17:18

3 Answers 3


They mean (infected) since the game is about infectious diseases (viruses probably, but possibly also bacteria), not physically ill such to induce vomitting. Long term conditions such as diabetes, heart conditions, or alcoholism are not what they are referring to.

It doesn't actually matter who goes first (because of the games co-operative nature), unless the cards that each person has in hand is open information to other players.


The most recent Pandemic rules now read:

The players look at the City cards they have in their hand.

The player with the highest City population goes first.

  • 1
    Good find! Answers to old questions with new information helps keep the site relevant and is encouraged.
    – Samthere
    Commented Oct 26, 2015 at 16:24
  • I'm very confused by this rule. I would think that the vast majority of the time, all players sitting together to play the game are going to be from the same city.... Either way, I always ignore silly things like these in rulebooks and randomly determine the start player.
    – GendoIkari
    Commented Oct 26, 2015 at 17:14
  • 1
    I see now that it's referring to in-game mechanics of City cards; which makes it actually (slightly) relevant, and not just random. Will edit answer for clarity.
    – GendoIkari
    Commented Oct 26, 2015 at 17:16
  • Thank you for editing the answer, I was confused by this yesterday, and now I get it. Totally makes sense now, though I must say I still like the "last person to be sick" way to determine first player.
    – John
    Commented Oct 27, 2015 at 14:34

I agree with user1873 on what they were getting at.

As a general answer for most board games, what they're usually getting at is to choose the start player randomly. Many games, like Pandemic, use a thematic method to do so. I think Pandemic's actually works well, since that will change over time with a static group; Ticket to Ride uses something like "the most well-traveled player", which is less likely to change if you always play with the same people.

I generally try to keep a die around even if no games I'm playing use one to determine start player. That way, even if there are some interpretation disagreements over the start player rule (which I'm certain was not intentional), we can still determine it randomly and relatively quickly.

  • You can always use a system that involve the current game.. for pandemic, although is really not that important who plays first, We usually pick city cards before the whole deal, and the southest one go first...
    – gbianchi
    Commented Feb 29, 2012 at 15:10
  • 2
    Just as a side-note.. Start Player (a card game from Ted Alspach) is specifically designed to determine the starting player of any other board game. Commented Apr 5, 2012 at 13:19

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