I'm almost finished with the game, but I can say it's been a great surprise.
For one, it's absolutely consistent with its design. This is a survival game, and it has strict rules -- rules of engagement, rules for how to conserve, climb, and fight if you have to. The game is 90% environmental survival, but that 10% of combat requires you to to be fast, effective, and considerate of your surroundings. Difficult or not (I've died 17 times in my entire play-through, but I've never run out of retries), this is the way it should be. Adapt, or die.
Beyond that, visually, the game is consistent. It's not a beautiful game, but its stark visuals hit the right balance of dreariness and post-apocalyptic fallout. There are harrowing stories being told here if you seek them out, and more than a few surprises if you help other survivors and manage to check in on them in the future.
The climbing is where it's at though. They're mini-puzzles with multiple solutions; with 100% efficacy and grip bar, you can pretty much always pull through without any mess-ups, but making mistakes is where the game shows its true colors by asking the player to juggle reasonable item-usage with careful plotting and re-plotting of the routes you need to take. This is far from Uncharted's auto-tuned platforming -- while you won't be allowed to just randomly walk off a cliff, starting your climb is usually a do or die moment, and you need to prepared to take some chances that end up in "barely escaped death" scenarios. Again, this is the way it should be.
It's a shame the game has a few major problems. The audio cuts out from time to time, the combat itself isn't hugely visually satisfying (but going from third-person to first is a nice change of pace since head-shots start to matter later in the game). Sometimes the post-processing processes a bit too much, making it difficult to see where to go next (a really great Silent Hill-esque map helps out here).
This would be better as a $60 dollar game where more attention could've been paid to the variety of encounters, and help to open it up a bit more (it's linear, but has a surprising amount of opportunities for exploration). I keep feeling like, if there were monsters here, this would be the next Silent Hill / Siren. As it stands, it's the best base "Survival" game I've played. I'll finish it later today, but I'm already thinking about another go-through.
For anyone on the fence: If you want a solid 5-6 hour straight-up survival game that demands attention to detail and quick-thinking, don't mind a little rough-edges, and like the idea of a dark setting, then this is for you. 8/10 is about exactly right.