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Death Stranding's multiplayer takes place in a shared online world that lets players interact with--but not directly play with--one another.

Hideo Kojima's new game is all about connections. It's online multiplayer binds players together via the Chiral Network, but it's not a live service game with tons of engagement-driven goals. Instead Death Stranding uses an indirect way of player interaction with a shared world that melds directly with the narrative-driven storyline.
Death Stranding's multiplayer won't let you team up with people across the world and go gallivanting across the deep sci-fi futurescapes. There's an indirect communal focus to multiplayer called the Social Strand System that allows players to share items and pepper gifts all throughout the world. Once someone picks up your gift, you get a kind of in-game karma. It's kind of like paying it forward or being generous to help someone out that you've never met.
But you'll never actually directly see any of the other players in your game. You'll only see what they left behind, creating a presence of connectivity without actually bumping into them.
There's lots of Sams out there (every player is a Sam) and each one is doing different things, but they can all help one another. Place a nice little stash of grenades right before a boss fight, or leave some blood packs by an enemy base. Gamers can actually call for help from nearby players, too, confirming the aid system is also proximity-based.
In the Tokyo Game Show 2019 gameplay demo, Sam calls out for help: "I sure could use a hand!" Then we see a digital projection of another player dropping boxes on the ground to aid him.

In this way and more, every Sam can change the in-game world.
The in-game world is absolutely huge, and takes players East-to-West across a bizarre fractured United States.
The geography and world-state can actually be changed and shaped by specific actions. Peeing, for example, can grow mushrooms in the game (we're not joking), and if enough people pee in one spot, something interesting will happen.
"You saw the mushroom growing, so if everyone does it in the same spot, something good will happen later on. Of course that's not the main part of the game, okay? The main part is to connect the world together," Kojima said at Gamescom 2019.
Players also share safe houses. There's lots of bases set throughout Death Stranding, and each one of them can be upgraded in different ways. These upgrades are universal and anyone can enjoy them, making the safe houses into shared communal areas.
But there's responsibility in this too and you'll need to repair and maintain the bases to keep them functioning properly. Everyone has to come together to keep things in tip-top shape. The more the Timefall rain comes down, the more time accelerates, and the quicker these repairs will need to be made.

In a recent interview with GameInformer, Hideo Kojima discussed more about Death Stranding's Social Strand System:
"But today's games, you're playing by yourself in your room alone usually. Then suddenly, you open to a world like "Oh, I'm not the only one." And I'm really happy a lot of people understood that, and I think that was the most successful part. Of course, you can't see other people's faces, but you can see the tracks and traces, so you can feel or think about the other people.
"This is about caring for people. It's not direct; I wanted to do that with the internet we have today. If someone puts a cup there in Death Stranding, you might think to yourself, "Did that person deliberately put it there? Did he just have to throw away the load? But you think about it. It's like the letter theory. In this direct communication era, I wanted to create an indirect communication using the technology of today so you feel for others more."
Death Stranding's multiplayer is definitely unique and should make for a very symbiotic kind of experience among players. I can see lots of people laying out random gifts left and right to help out their fellow Sams, and I really want to know what happens if millions of gamers pee in the same spot...
Death Stranding releases on November 8, 2019 on PlayStation 4.
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