So, given a couple of the things
coming from Norman Reedus & Hideo Kojima, while I think we're looking at a setting for this new title, I also think that we're looking at one big message of everything he went through up 'til now.
The shot of the beach is deliberately like the shot of the road from the P.T. reveal cutscene where we last saw his work, but we see something different. There's death everywhere.
Then we have handprints forming in the sand leading to Norman Reedus that get him up. He's covered in the grown handprints that lead him to this spot — lying in the sand, one handcuff still attached to him, and also linked via a mechanical umbilical cord linked to a tiny infant in the stages of development. He probably picks it up and holds it, anguishing and in pain before it vanishes in his hands, leaving nothing but stained black.
(That's Hideo Kojima's work at Konami, being kept a prisoner, and having P.T. stolen out from under him before it could become anything)
He's confused, but then the same marks of the child who vanished touch him and lead him forward. He stands up and in addition to the necklace,
(which likely represents his other games) we see the massive scar that this latest event has left on him. But then his look changes, and he's surveying what lies in front of him with a purpose. We see that there is death all around him, but he's left alive, and five figures floating in the sky watching him as the song's title, "I'll keep coming" is revealed.
(This is him when Kojima Productions was founded and he joined Sony. He's back and he's now completely prepared to face what's here. This matches with the, "I'm back!" statement he gave in person before the reveal).
Then, now that all of that is done, we get the game title, which is apropos to the whole narrative he experienced:
Death Stranding.
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