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The Heal skill check says that someone with ranks in Heal can spend 10 minutes and treat a disease, giving the diseased individual the ability to use the Heal check in place of their own Fortitude save.
First of all, an individual working 12 hours a day (not unlikely given the situation in Korvosa) can provide a Heal check for 72 people per day. The paladin in my PC's party has a Heal check of +15 (or something equally ridiculous). That means using his Heal check instead of a Fort save against DC 16 will always succeed.
What, if anything, did other GMs do about this?
I'm likely to rule that blood veil can't be treated using a Heal check as it's a magical disease but any guidance here would be great...
Creative Director
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There's thousands and thousands of people in Korvosa, first of all, and the disease spreads very fast. Even at a rate of 72 per day, those 72 run the risk of being exposed to the plague the next day if they're not treated again.
I wouldn't say that blood veil can't be treated with a Heal check. Let the paladin do his checks, but if he works 12 hours a day tending the sick, he won't be adventuring. It's arguable that the paladin could be doing much more good acting directly against the plague and its sinister sources than "wasting" his time providing care for those 72 sick folk.
Here's what I would do. If the paladin (or whoever) wants to provide long-term care to the sick, that's awesome. I would tell the player that he needs to devote all of his non-adventuring time each day to that goal, and each day I'd have him make a single Heal check. The result of that Heal check gives you the number of people the paladin has saved from the sickness, and you should add that number to the party's total Body Count of citizens saved.
You'll note that if the PCs do EVERY encounter right, they still won't earn enough Body Count to become Saviors of the City; this is to account for characters, like this paladin, who go above and beyond. The additional lives the paladin saves in this manner could very well push the party up into the next category of saved souls, and is likely to earn that paladin the love and support of a lot of citizens to boot!
The Heal skill check says that someone with ranks in Heal can spend 10 minutes and treat a disease, giving the diseased individual the ability to use the Heal check in place of their own Fortitude save.
First of all, an individual working 12 hours a day (not unlikely given the situation in Korvosa) can provide a Heal check for 72 people per day. The paladin in my PC's party has a Heal check of +15 (or something equally ridiculous). That means using his Heal check instead of a Fort save against DC 16 will always succeed.
What, if anything, did other GMs do about this?
I'm likely to rule that blood veil can't be treated using a Heal check as it's a magical disease but any guidance here would be great...
In 3.5, from the SRD it says: To treat a disease means to tend a single diseased character. Every time he or she makes a saving throw against disease effects, you make a Heal check. The diseased character uses your check result or his or her saving throw, whichever is higher.
It says the same in the PFBeta.
And if you follow the link about disease in the SRD, it says you must be in the healer's care and spend 8 hours resting ... so I would go with the long term care, and the most any one healer could do would be 6 people and the healer is locked down at their ward until all are healed and out.
Treat Disease
To treat a disease means to tend a single diseased character. Every time he or she makes a saving throw against disease effects, you make a Heal check. The diseased character uses your check result or his or her saving throw, whichever is higher.Action
Providing first aid, treating a wound, or treating poison is a standard action. Treating a disease or tending a creature wounded by a spike growth or spike stones spell takes 10 minutes of work. Providing long-term care requires 8 hours of light activity.
The action section makes it pretty clear that it only takes 10 minutes to treat a diseased person. However, if you want to do 72 of these consecutively in a 12 hour period you had best have a darn efficient nursing staff as this means there is not even one minute of efficiency lost.
I would stick with James' suggestion, I like it a lot. Though I might have someone trying to work 12 hours straight with not even a single moment to catch their breath or eat need to make a Con check or something to keep up the pace.
Sean Mahoney
The paladin in my PC's party has a Heal check of +15 (or something equally ridiculous). That means using his Heal check instead of a Fort save against DC 16 will always succeed.
What, if anything, did other GMs do about this?
I'd check his sheet, actually. As a paladin, he'd need a healer's kit (10 uses only), a wisdom bonus (let's make that +1, as paladins really need their higher numbers elsewhere), and a maxed out ranks in heal. To get a +15, then, he'd need to be 9th level, or 11th without the kit. Since he can't be ninth level at this point in the adventure, he's doing either the math wrong or thinking that he can take 10 when he can't. (For me, life-threatening situations are not the time for taking 10.)
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I'd check his sheet, actually. [...] or thinking that he can take 10 when he can't. (For me, life-threatening situations are not the time for taking 10.)
It must be the "take 10" thing. I just checked his sheet (TheTangledWeb.net has a really cool charsheet called "Profiler") and I see a +5 modifier on Heal checks. And I _don't_ see any healer's kit. So with Take 10 he could only get a 15, maximum. The next time it comes up, I'll be sure to ask him about his math. Thanks. :)
Otherwise, I like James' take on it. So far, the paladin has only used this ability on other party members. Prior to the pally showing up (he's a replacement character), the party was spending money on remove disease spells from Pharasma. One of the party's clerics worships Pharasma, but I've told the party that as more and more people get sick, there are fewer and fewer people to cast the spells -- supply and demand dictate that the price of curing will go up. Very soon.
In the future, I will require the pally to make his Heal check before knowing the outcome of the PCs Fort saves. This will require him to invest his 10 minutes up front. Then after he rolls the Heal check, the player can roll the Fort save and the better of the two can be used.
But that doesn't explain how an "unnatural disease" (page 9, sidebar) that is magically based and says can be mitigated by remove disease on a daily basis (page 12, sidebar) can be cured with a single Heal check. That flies in the face of the numbers given in the sidebar on page 20, as well as the statement that, "To a certain extent, wands and potions and scrolls can bolster these numbers, but only as long as supplies hold out." There's never any mention of Heal checks.
I'm thinking that the Heal check doesn't cure blood veil but rather controls the symptoms, perhaps reducing the ability score damage to a maximum of one point each. This reinforces how dangerous the blood veil really is and requires the paladin to continue to make Heal checks each day for people who are sick, and reinforces the need for a true "cure" and not just a bandage.
All of this is probably moot for my group as they've discovered the source of blood veil and are currently rooting out the evil. One more game session and it'll likely be over for the cult. Of course, the disease doesn't immediately stop spreading, though...
I think you are misunderstanding how the Heal skill treats disease a little bit. To fight off a disease you need to make make multiple saves. Here is how the SRD breaks it down:
When a character is injured by a contaminated attack, touches an item smeared with diseased matter, or consumes disease-tainted food or drink, he must make an immediate Fortitude saving throw. If he succeeds, the disease has no effect—his immune system fought off the infection. If he fails, he takes damage after an incubation period. Once per day afterward, he must make a successful Fortitude saving throw to avoid repeated damage. Two successful saving throws in a row indicate that he has fought off the disease and recovers, taking no more damage.
These Fortitude saving throws can be rolled secretly so that the player doesn’t know whether the disease has taken hold.
So in the case of Blood Veil, there needs to be a Fort save made when the PC has the potential to catch the disease through exposure. In this case either contact or injury. So if the PCs touch an infected person they will be needing to make a save (or have a save made for them in private). Shouldering their way through a crowd of people, some of whom are certainly affected, would be another way. Handling infected coinage.
Basically there are so many ways that you should be making this check once per day for your PCs. Since in the case of so many exposures it is very tough to know when you were infected and there for receive medical aid via the Heal skill, it is unlikely that the PC will be able to use the heal check to prevent initial infection.
One day (the incubation period) after failing the initial fort save, the infected person needs to start making fort saves to resist the daily effect of the disease. On any day that this save is missed the infected person receives the damage listed for the disease.
If the save is made then no damage is received for that day. If two days worth of saves are made consecutively then the disease is fought off and the person is cured of the disease. It is these saves that Heal skill can be used for. So to heal someone of a disease using the Heal skill they would need to continue treating that person for two consecutive days.
Interestingly, even though the text mentions that one of the issues with magical healing is that it confers no immunity to the disease, there is nothing in the text that states that fighting off the disease naturally does. In real life it depends on the agent of infection (virus, bacterial, etc.) as well as the mutation rate of that agent as to whether or not immunity can be acquired. So, it is kind of your call as DM if someone who runs a course of the disease naturally acquires permanent immunity from this strain of the disease (or perhaps just a +2 save bonus or no additional resistance at all).
Sean Mahoney
Sean broke it down correctly. It takes two consecutive saves to cure disease. (Though I thought it was three, and that's how I ran it for my healers.)
This changes the dynamic as presented from 72 a day to 72/2 days (or 3 days if you want three saves). 72/2 days being treated while hundreds more being infected each day... some of them on purpose, mind you.
And treating that many people in a day requires help and supplies. You don't just walk in and roll a die. That's fine for a once-in-a-while check, but if you're treating hundreds of patients a week, you need to consider the cost of the herbs, sterile bangades, etc. as more than the neglible cost of doing one heal check per week. Add the cost of healers kits, if used.
My clerics and alchemists handled the situation in a superb manner. They went above and beyond, treating people, creating alchemical cleansers, and ultimately creating a cure, becoming heroes of the city.
It was a great piece of the AP.
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In my case, the PC's were staying in a house with about 10 NPCs. There was one cleric among them, but only level 4 for most of the adventure, so he had no access to Remove Disease. He had to use the Heal skill.
Every day, rolls would be made to see if a given PC or NPC had a risk of being infected.
Then, for those people at risk, a saving throw was made to see if they were affected by the disease (stat losses).
For those who were affected by the disease, starting the next day, the cleric could use his heal skill to treat them. Thus, they had their own fortitude save and his heal checks to rely on. They could take the better result of the two.
I might also have put a cap on the number of people he could treat per day (2 people per day, so it wasn't too easy for him to cure the plague?)... That, I don't remember for sure.
It might not be a solution that fits the rules perfectly, but in my adventure, I found that it gave a good balance between people falling sick (so the plague seemed very dangerous), yet not dying from it. Otherwise, since I stretched the adventure to last over a month, there would have been too many casualties among the PC's closest friends and relatives.
So for the course of the adventure, the cleric was able to keep those ~15 people alive, but no more (until he gained level 5, at which point things got a lot easier - but by that time the adventure was almost over).