I sorta remember that if you take too long in the first mission on Deus Ex: Human Revolution that hostages get killed. It might be another game, but I think it's DX: HR. In survival mode in the original Division, your agent has an infection and, the phrase I use to describe it, the infection is the drumbeat that drives the game (mode). You can find a warm place that's protected from the elements and keep from feeezing to death, you can avoid enemies and keep from getting shot & killed, food and water aren't necessary to your survival, instead only giving temporary benefits. Bit no matter what, the infection marches on, temporarily abated by medicine or painkillers, but even then it will eventually kill the player.