While playing Death Stranding, you will notice the importance of the so-called strand theme - the connection between the player and the NPCs as well as other players. The following chapter will help you with this aspect of the game.
The game's world is built in such a way that all non-player characters live their own lives, and time flows continuously. This means that if you have a specific task to perform, postponing it can lead to failure.
Spoiler: The strand theme was explained by Hideo Kojima during a discussion organized by the Garage Museum of Modern Art. As an example, he cited the task of delivering medicaments to a sick man. If you don't deliver them fast enough, that man will die.
This means that the plot will evolve depending on which characters survive.
The same goes for the connections between players. Death Stranding doesn't offer a standard multiplayer mode. The presence of other players, however, is visible in the game world. They leave behind different traces.