I've walked on nearly 200 different planets in Starfield in environments ranging from frozen tundra to baking infernos to toxic atmospheres. And in all that time I've only suffered one affliction that I felt a need to rush to a doctor to fix: I contracted a lung condition that eventually got so bad it made sprinting consume my oxygen supply in a matter of seconds, and I didn't have the meds to cure it myself.
Just getting a single severe illness from all of those alien planets is a little weird, and it's surprising how tame the environments on alien planets in Starfield really are—especially when you get regular warnings for hazardous weather, extreme heat and cold, and radiation. Turns out what we're playing with in Starfield are the remnants of a more complex and challenging planetary survival system that Bethesda heavily scaled back before the game launched.
"The way the environmental damage works in the game on planets and on your suit, you have resistances to certain types of atmosphere effects, whether that's radiation or thermal, etc," Todd Howard said during an interview on the AIAS Game Maker's Notebook Podcast. "And that was a pretty complex system, actually. It was very punitive, where you get these afflictions."
To protect players against these harsh environments, Howard said, all those spacesuits you collect while playing were originally meant to serve a bigger role. Players were intended to swap between different spacesuits for high radiation planets, extreme cold planets, and so on.
Apparently, this planetary survival system didn't go over that well during testing, and Bethesda decided to tone down the difficulty so much that it's basically a system you don't even have to think about.
"We hit a point where we're [fine] tuning it, and you're having to heal those [afflictions]," Howard said. "And what we did at the end of the day, it was a complicated system for players to understand, we just nerfed the hell out of it."
Which is why in all my hours scurrying around on alien worlds I only had to rush to the doctor once. You do still get a number of afflictions, including heatstroke, lung damage, and radiation poisoning, along with physical ailments like sprains, contusions, and lacerations. But the effects of afflictions are generally so mild you can ignore them completely, they often get better on their own, and due to the abundance of medical items you collect along your adventure they can almost always be cured instantly by the player.
According to Howard, the affliction system is more about "flavor" now. "The affliction you get is more annoying knowing you have it," he said, rather than it being an effect that makes the game more difficult to play.
I can already hear survival game fans frowning at this revelation—severe and punishing afflictions are precisely the type of things a lot of players would love to contend with in Starfield! There may be some hope for that in the future. These systems "might be something we address going forward," Howard said, and after all both Skyrim and Fallout 4 eventually got official survival modes. Maybe Starfield will, too.
