- Harsher in Hindsight: The premise of a globally distributed drug turning out to be deadly hasn't aged well since the COVID-19 Pandemic, specifically the paranoia around whether the developed vaccines were safe due to being made relatively quickly.
- Inferred Holocaust: No outcome of this game is actually positive. Even the Golden Ending leaves John and his daughter in a completely dead world, doomed to eventually die of starvation.
- Scrappy Mechanic: The author wasn't kidding when he said he wouldn't put a replay feature in... (There is a workaround for this, though, just like in One Shot.)
- Enjoy the Story, Skip the Game: The gameplay is very simplistic to focus on the deeply tragic and emotional story.
- Too Bleak, Stopped Caring: Just about everyone is going to die, just about every ending is a Downer.
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