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Mutated Conditions!

• Conditions now randomly mutate, massively increasing their mortality rate and infectiousness – meaning a lot of patients who’re much more likely to kick the bucket
  
• To overcome the mutation, you'll need to treat a large number of affected patients, study the mutation in the Research Lab, or make good use of your consultants
  
• Focus your efforts on these new dangers to keep fatalities to a financially-tolerable minimum while you work on the cure

More Patients!

• In Challenge Mode, you’ll have to cope with many more patients than usual – and their swarms will steadily increase over time, whether you’re ready or not
  
• Patients are more likely to be disruptive and inconsiderate, requiring rooms you haven’t yet built, or rooms that already have heavy queues
  
• Sandbox events will spawn patients in much greater numbers to swarm your hospital

More Death!

• Patients in Challenge Mode can arrive with much lower health, requiring swifter treatment
  
• Patient health deteriorates much faster, and you’ll need your full suite of tools in order to prevent their untimely deaths
  
• Treatment difficulty is increased, requiring the use of happy, high-level doctors to keep patients consistently alive

More Poverty!

• Income from treatments is reduced
  
• The travelling merchant is much less generous with their freebies - no more free holo-docs!
  
• Level 3 doctors can no longer be recruited directly – you’ll have to train them up yourself

More!