Dragonrot（竜咳，Dragon Cough） in Sekiro: Shadows Die Twice affects the NPCs by making them sick, which prevents progression of their Quests. In addition, the more Dragonrot you accumulate, the less Unseen Aid you will have. Each time you die and respawn at a Sculptor's Idol, the player has a chance to receive a Rot Essence item, which means the NPC associated with that Rot Essence now has Dragonrot.
Note: Using Resurrection to revive yourself in battle does NOT cause Dragonrot to spread. Only dying and then respawning at a Sculptor's Idol causes a chance of NPCs contracting the sickness.
Dragonrot Information
What Dragonrot does exactly
Dragonrot is a disease that affects NPCs based on how often the player has died. The player receives an item called Rot Essence (which indicate which NPC has been infected) automatically after a certain amount of deaths.
- Chance to receive a Rot Essence item in the inventory after every death, indicating Dragonrot has now spread to one of the NPCs. Rot Essences are typically received, on average, every 10 deaths.
- Rot Essences carry the name of the afflicted NPC and the tooltip describes where that NPC can be found (see Notes). Dragonrot can be inflicted on any NPC regardless of whether or not the player has met them, and the NPC that will fall ill is selected randomly. The initial first Dragonrot of the game is the Sculptor.
- Multiple NPCs can be affected at any given time.
- Any quests associated with that NPC cannot be continued at that point. An NPC afflicted with Dragonrot will be coughing and wheezing and will appear sick instead of its usual dialogue.
- Dragonrot lowers Unseen Aid (30% with no Dragonrot, halved to 15% for the first Dragonrot, but lowered significantly less for ensuing Dragonrots, all the way down to 3%) (confirmation required if 0% is possible).
- Dragonrot does not seem to permanently kill NPCs. (confirmation required).
How to inflict Dragonrot
- Truly dying and being sent to an Idol (respawning).
- Resurrection (being offered a second chance after the player's death, and not being sent to an Idol to respawn) does not affect the player's chances to get Rot Essences in any way: it is therefore safe to Resurrect and then run back to an Idol to avoid any chance on Dragonrot.
How to cure Dragonrot
Dragonrot Restoration: the Recovery Charm key item allows Dragonrot sufferers to be healed from a Sculptor's Idol by consuming a Dragon's Blood Droplet at any Idol to heal Dragonrot from ALL of those afflicted. Doing so will not only heal all NPCs, but also cause all Rot Essence to disappear from your inventory, and subsequently restore the chance of receiving Unseen Aid to the default value (30%).
How to get the Recovery Charm:
- When the first Dragonrot incident occurs, Sekiro will be teleported to the Dilapidated Temple instead of the last visited Sculptor Idol. There, he will receive the Rot Essence of the Sculptor. By talking with the Sculptor and then Emma, Sekiro will be informed about Dragonrot. Emma will say she will research the disease, and then ask Sekiro to visit her later to see the progress.
- If the player has met another NPCs by the time the first Dragonrot happens, there is a high chance the player will get another Rot Essence of one of those NPCs.
- The player can rest at the nearby Idol or come back later to find Emma inside the temple hunched over the Sculptor, where she reveals she is taking a blood sample for analysis. She then requests the player to procure another blood sample from someone else who is also affected.
- This dialogue will only trigger once the player has acquired at least a second Rot Essence. The Rot Essence's name and tooltip indicates which NPC has Dragonrot (see Notes).
- Travel to that NPC and start a dialogue with it to get a blood sample. Return to Emma and give her the sample, who will then ask the player to return later once she has made progress with the cure.
- Rest at an Idol and talk to Emma again. She will give a Dragon's Blood Droplet and the Recovery Charm.
Dragonrot Lore
SPOILERS AHEAD
Progressing Emma's questline will reveal the reason of Dragonrot. Sekiro's Resurrection power comes from his relationship to the Divine Heir, but his blood is stagnating. The life force to resurrect is thus being stolen from others to make up for it.
The process of losing one's life force is seen as the effects of Dragonrot.
Notes & Tips about Dragonrot
- List of Rot Essence and its associated NPCs and locations go here
- Rot Essence: Crow Mob
- Crow's Bed Memorial Mob can be found at the Outskirts Wall - Gate Path Idol of Ashina Outskirts, on top of a cliff.
- Rot Essence: Wartorn Mob
- Battlefield Memorial Mob can be found just after the Gyoubu Oniwa fight, just above the arena towards the castle.
- Rot Essence: Jail Mob
- Dungeon Memorial Mob can be found just before the Abandoned Dungeon entrance when coming from Ashina Castle Idol.
- Rot Essence: Drunk Mob
- Shugendo Memorial Mob can be located by going left and down from the Shugendo Idol in Senpou Temple, Mt. Kongo.
- Rot Essence: Toxic Mob
- Toxic Memorial Mob can be found in the Sunken Valley poison ravine, near the bottom before the Serpent Cave.
- Rot Essence: Pious Mob
- Exiled Memorial Mob can be found by taking the Mibu Village Idol and crossing the flowing stream behind it.
- Rot Essence: Sculptor
- The Sculptor, found inside the Dilapidated Temple.
- Once defeating the Divine Dragon and returning from the Divine Realm, he will leave the Temple, and will no longer be subject to the Dragonrot.
- The Sculptor, found inside the Dilapidated Temple.
- Rot Essence: Timid Maid
- Inosuke Nogami's Mother can be found in Ashina Outskirts, between the Gate Wall and the Stairway Idols, located in a small, damaged house. She is also the NPC who gives you the Young Lord's Bell Charm, which allows Sekiro to visit the Hirata Estate.
- Rot Essence: Faithful One
- Rot Essence: Black Hat
- Blackhat Badger can be found in Ashina Castle, past the Old Grave idol, by dropping into a house with a broken rooftop after defeating the Blazing Bull and attaining access to Ashina Castle.
- After purchasing the Iron Fortress and two other expensive items he has to offer, he will move to the Senpou Temple, Mt. Kongo.
- After raising the kite using the Puppeteer Ninjutsu, he will move to the cave containing the Sunken Valley Cavern Sculptor's Idol across the ravine from the Senpou Temple.
- Once defeating the Divine Dragon and returning from the Divine Realm, he can be found back in Ashina Castle, lying against a tree just left of the building with a hole in a roof where he was met him.
- After raising the kite using the Puppeteer Ninjutsu, he will move to the cave containing the Sunken Valley Cavern Sculptor's Idol across the ravine from the Senpou Temple.
- After purchasing the Iron Fortress and two other expensive items he has to offer, he will move to the Senpou Temple, Mt. Kongo.
- Blackhat Badger can be found in Ashina Castle, past the Old Grave idol, by dropping into a house with a broken rooftop after defeating the Blazing Bull and attaining access to Ashina Castle.
- Rot Essence: Info Broker
- Fujioka the Info Broker can be found at Ashina Castle, on the right side after the first bridge.
- After completing his quest, he will move to the Dilapidated Temple, near the area outside where Emma stays.
- Fujioka the Info Broker can be found at Ashina Castle, on the right side after the first bridge.
- Rot Essence: Charmed One
- Jinzaemon Kumano can be found at Ashina Reservoir when revisiting it, near the exit of the cave where Sekiro was held prisioner at the start of the game.
- After talking to him at the Reservoir, he moves to the Abandoned Dungeon, near the Bottomless Hole Sculptor's Idol and the Shichimen Warrior mini-boss.
- After talking to him in the Abandoned Dungeon, he will move near the Guardian Ape's Burrow of the Ashina Depths.
- After talking to him in near the Guardian Ape's Burrow, he will move to the bridge next to the Water Mill Idol in Mibu Village, near where O'rin of the Water is found.
- After talking to him in the Abandoned Dungeon, he will move near the Guardian Ape's Burrow of the Ashina Depths.
- After talking to him at the Reservoir, he moves to the Abandoned Dungeon, near the Bottomless Hole Sculptor's Idol and the Shichimen Warrior mini-boss.
- Jinzaemon Kumano can be found at Ashina Reservoir when revisiting it, near the exit of the cave where Sekiro was held prisioner at the start of the game.
- Rot Essence: Lost Child
- Kotaro can be found in Senpou Temple.
- Rot Essence: Crow Mob
Rot Essence are special Key Items in Sekiro: Shadows Die Twice that are acquired after Sekiro's death and respawn at a Sculptor's Idol. The chances for acquiring Rot Essence are not specified in-game.
Each Rot Essence is an item that tells you who is afflicted with Dragonrot - NPCs inflicted with Dragonrot may be unavailable to interact with normally, stalling their story progression until the Dragonrot is cured by using a Dragon's Blood Droplet at a Sculptor's Idol (one droplet cures all NPCs). Additionally, the more Rot Essence Sekiro has, the lower the chances of receiving Unseen Aid which prevents losses upon death.
Rot Essence in Sekiro: Shadows Die Twice
Name |
Description |
NPC |
Location |
|
The coughing and wheezing comes from a man who wants nothing more than to return to an abandoned place. | Blackhat Badger | |
|
The coughing and wheezing sounds of a man who is enamored with a beautiful melody. | Jinzaemon Kumano | Ashina Castle Abandoned Dungeon Ashina Depths |
|
The coughing and wheezing sounds of a man who takes great pride in memorializing the dead. He holds service somewhere in Ashina Outskirts. | Crows Bed Memorial Mob | Ashina Outskirts |
|
The coughing and wheezing sounds of a drunk who has forgotten the sincerity of offerings, yet offers them regardless. | Senpou Temple, Mt Kongo |
|
|
The coughing and wheezing sounds of an old woman of great faith. Keeping one's faith even when driven mad allows one to see certain things. Thank heavens... | Old Hag | Ashina Castle Senpou Temple, Mt. Kongo Abandoned Dungeon Sunken Valley |
|
The coughing and wheezing sounds of a man thinking only of his sick mother. | Inosuke Nogami | Ashina Outskirts Hirata Estate |
|
The coughing and wheezing sounds of a man who makes his living dealing in information, yet cannot remove himself from compassion. | Fujioka the Info Broker | Ashina Castle Dilapidated Temple |
|
The man who coughs seems to be one who frequently sees those gruesomely abandoned. Even so, he continues to make offerings to the dead. | Dungeon Memorial Mob | Ashina Castle |
|
The coughing and wheezing sounds of one who seems to be a lost child in a large body. | Kotaro | Senpou Temple, Mt. Kongo Abandoned Dungeon Ashina Outskirts |
|
The coughing and wheezing comes from one who travels frequently, looking to expand his business. | Anayama the Peddler | Ashina Outskirts Hirata Estate |
|
The coughing and wheezing sounds of a man who holds memorials for the dead, in a place where Buddha has been forgotten. | Exiled Memorial Mob | Ashina Depths |
|
The man who coughs zealously sculpts statues of Buddha to avoid being consumed by the building flames. | Sculptor | Dilpidated Temple |
|
The coughing and wheezing are coming from a deeply troubled pair of researchers who are nonetheless tireless in their work. | Doujun | Abandoned Dungeon |
|
The coughing and wheezing sounds of a man who is both frightened and thirsty. | Basket Wearer Shosuke | Ashina Depths |
|
The coughing and wheezing sounds of an old woman deeply worried about her beloved master. | Inosuke Nogami's Mother | Ashina Outskirts Hirata Estate |
|
He who coughs finds himself near poisonous pools, He works to make offerings to those Buddha cannot save. | Toxic Memorial Mob | Sunken Valley |
|
The coughing and wheezing sounds of one who is near death. The man who coughs has witnessed endless battles, making offerings to the dead in the battlefield outside Ashina Castle Gate. | Battlefield Memorial Mob | Ashina Outskirts |
AnonymousThe mechanics of how/when Dragonrot is contracted is incorrect. It's given to the last NPC you talked to; and if you haven't talked to anyone healthy, it basically just builds up in the background until there's a new applicable NPC (meaning it can't spread to NPCs you haven't met).
Source: Spent 10 minutes spamming Hidden Tooth without getting a single Rot Essence, then talked to a new NPC and they got sick immediately after dying once.
- Anonymous
i remember thinking that resurrection incurred dragonrot too, so id choose to die instead of resurrect to minimise it.
suffice to say my first playthrough wasn’t much fun.
- Anonymous
I think it's actually a pretty ok mechanic. Effectively it doesn't do much, it's mildly inconvenient, but it makes you worry about dying too much which encourages you to escape from dire situation and find smart ways to deal with obstacles rather than headbutt into them. Basically it encourages you to play like a shinobi, at least it did for me. You understand soon enough that it doesn't have major negative consequences and that it's pretty easy to heal but you still want to avoid it if possible because the way to heal it is like, common enough that you might not worry too much but scarce enough (especially early game) to encourage some caution.
Personnally what it did for me was make me use consumable more cause it was preferable to dying and I think that's a very good thing, in souls game I tend to have a major hoarding mentality with consumable since I can't keep them if I fail, and it's a bit of a shame cause consumable are pretty fun to use.
- Anonymous
I actually thought when playing the first time.;"If I die too many times, my whole playthough will be ruined and a bunch of NPC will die because I suck.
- Anonymous
- Anonymous
- Anonymous
OK I have a bit of a situation, I have the dragonrot items for crow mob, and fine son.
The problem is they won’t give me a blood sample.
The sun is worried about the mom who is completely fine. She was the first one I cured.
So how do I acquire blood samples from these guys? Is there some sort of pre-requisite to get them to do it?
- Anonymous
- Anonymous
I just got like four different rot essences from one death, and I had just died a couple minutes before, i'm fighting the monkey boss and suddenly got slammed with four rot essences when I had none
- Anonymous
How do you get all of them? After 9 i dont get any more, no matter how many times i die
- Anonymous
If you get Timid Maid's Rot Essence before speaking to her, does it prevent her from giving you the bell? Then, say, if you were to intentionally waste all of the Blood Droplets in the game, could you get locked out of Hirata Estate?
That's a very unlikely situation to have occur unintentionally, but it seems like the only significant negative consequence Dragonrot could possibly have. All of the other NPC quests have very minor and not mechanically-unique rewards, and you only really need to spend one Blood Droplet about halfway through the game to finish them all.
- Anonymous
Ey what if Emma’s already in Kuro’s Room by the time the Sculptor initially gets Dragonrot?
- Anonymous
Whoever came up with this BS at fromsoft should be fired immediatly. I dont care if it was miyazaki.
- Anonymous
Why do you have to redo this ****ing tedious **** every ng+ cycle, why can’t you just keep the recovery charm every time and not be forced back to dilapidated temple, load the cutscene, and travel back to where you were because you died twice. I want to pick myself up and fight a boss again, not be forced into loading screens and extra loading time to be introduced to a mechanic a already have known about for the past 10 playthroughs.
- Anonymous
- Anonymous
- Anonymous
This would be a better mechanic if they could eventually die, except maybe not the Sculptor. This way as you improve going through ng+ cycles you would get to see more quest lines completed from not dying as much.
- Anonymous
I got gud and Still have to die in order to unlock the ressurrection ability, I wanna see what happens if you don't die at all, playing carefully with backups after each area.
- Anonymous
Started a new playthrough today, Sculptor and Timid Maid got Dragonrot while I was fighting Lady Butterfly. When I finished Hirata Estate, Emma needed blood samples. Went to the Timid Maid and she was dead. I hardly died that many times. Maybe 3 more times after it said they had dragonrot. I have played through this game like 9 times, platinumed it and never saw an npc die to dragonrot. Didn't even know it was actually possible.
- Anonymous
The only npc I talked to that wasn't a merchant was the old timid maiden, I died to owl and got dragon rot. Problem is that she died as soon as Emma asked for a sample. This locks me out of re-running the estate and speaking with the sculptur. Am I S.O.L. or is there anything else I can do?
- Anonymous
can anyone confirm if this system increase the damage you receive if you die alot and don't cure the dragonrot? On my first NG+7, I try to do the no resurrect run and perma-die alot, at sword saint fight, he just one shot me with 2 hit. But on my 2nd NG+7 run, I just do a normal run, at the fight, that move just took like 2/3 my HP.
- Anonymous
So I'm on NG+ and I'm stuck with the Peddler's quest, I can't get the last store upgrade because he's got the dragonrot, Emma moved to Kuro's room already and she only mentioned once the dragonrot saying that Doujun might know more about it but she hasn't told me how to cute it no matter how much I try. Does anybody know how to make Emma ask you for the blood samples at this point?
- Anonymous
I find this system to be a pain but i guess it does limit how well unseen aid works (not that i ever get it lol) that said i really dont need it since i have 1 solid coin from getting my ass handed to me by isshin
- Anonymous
Confirmed: you need to interact with NPC's in order for them to get dragonrot. I just ran through the game and died after getting the prosthetic arm so sculptor got dragonrot. I didnt talk to any broker/merchant/npc as i wanted to run through quick to get to a higher NG. Endgame i wanted to cure sculptors rot but couldnt take a bloodsample so i died and died without getting any dragonrot. Then i talked to the info broker, died and boom. Info broker dragonrot essence.
- Anonymous
Useless game mechanic that does nothing. Dragon aids doesnt happen that often, it barely affects anything important, and you can always heal it as soon as it pops, you will get more healing droplets than you'll ever need.
- Anonymous
Hidden tooth (and presumably other forms of self damage) do not increment dragonrot
- Anonymous
Option to give Sculptor sake (for additional dialogue) is gone when he's under the effect of Dragonrot. Not noticed if it does anything else to him beside give him a cough, as he still fits and upgrades prosthetic tools and offers to give you Kuro's Charm back (NG+) if he has it.
- Anonymous
Does Dragonrot prevent merchants from selling to you or anything like that?
- Anonymous
Goddamn, that's a lot of text for a mechanic that honestly barely effects anything (unseen aid capping at 30% regardless of how many people you've met means it's never a mechanic you can rely on), especially as (spoiler alert) a large number of the game's NPCs die by the end of the game for story-related reasons. Possibly worth giving the page some kind of cleanup so the actual "you honestly don't need to worry about this" and "resurrection does not cause dragon rot, only true death" core messages aren't drowned in minutiae? Most of the "notes and tips" section is just NPC locations which could honestly just be moved into the rot essence table.
- Anonymous
Fun fact: if you never got dragonrot when the second Ashina invasion happened (yes I’m a save sum), talk to Emma where next to the dead body of Isshin, there will be a new dialogue “About Dragonrot”, and she will give you both Dragon droplet and Recovery Charm. And Treat Dragonrot option will be unlocked in Idol’s menu.
- Anonymous
Wish I would have read this first. I kept letting myself die instead of reviving and running because I thought it was spread by reviving and dying again before reaching an idol so I figured it was safer to just die.
- Anonymous
I wanna know how she can 'analyze' this given the level of magic and technology humans have direct access to in this world. I mean*****s pretty fantastic in this mythological sengoku era japan. but... I dont think they have microscopes or anything. Whats she gonna do? look at them and be like 'yup, same bad color.'
- Anonymous
I definitely got the Rot Essence for Inosuke (I think; the guy dying outside his old mom's house in early Ashina Outskirts) before I'd met him. I remember trying to puzzle out who it was. Maybe it's a location progress trigger instead?
- Anonymous
i have the take blood quest but only the sculptors rot essense, so this 'This dialogue will only trigger once the player has acquired at least a second Rot Essence. The Rot Essence's name and tooltip indicates which NPC has Dragonrot (see Notes).' can't be true, though i suppose it may be a bug
- Anonymous
I am pretty sure npc can get it before sekiro meets them but I cant say for 100% Certainty .
- Anonymous
***** this game. Lmfao jk I just die...a LOT. *****in WOLF killed me. A single, solitary, wolf I had the drop on. I am The Yamcha.
- Anonymous
NPC that you havent met can also be afflicted. I tested it today, old lady in the temple got sick before I got there
- Anonymous
If you complete game without rot essence and cant take blood samples, dont worry. Emma will give you charm after game ending in kuro room.
- Anonymous
If you complete game without rot essence and can’t take blood samples, don’t worry.Emma will give you charm after game ending in kuro room.
- Anonymous
Something I realized after hearing from someone else, phantoms start to show up if you have a lot of dragonrot on npcs. I ran into two at one point and thought it was because I killed a specific boss. However, I now realized I had a ton of dragon rot because I was saving my cures for it. Two phantoms I saw were samurai types that you'd see inside Ashina castle.
- Anonymous
Resurrection does increase the chances to get Dragonrot. I died a lot against a boss and resurrected like crazy. Once I respawned I got 3 essences at once.
- Anonymous
There is a lot of false information that if you dont resurrect before true death dragonrot does not occur. I had to test this out as many sources are saying this. I just started a new game from scratch to test this, let myself get killed by mobs 4 times WITHOUT resurrecting and dragonrot still occurred. So I can 100% confirm that the above statement in the Wiki is correct : "Things That Increase Dragonrot-Truly dying and being sent to an idol, whether you resurrected or not. "
- Anonymous
The sculptor isnt the firs tto be affected it is usually the mobs
- Anonymous
So if in ds dying just ment that you have to pick up your souls here you just get punished for each and every time you die...that sounds like a fun mechanic
- Anonymous
Do NPCs ever die from Dragonrot? If not, then I don't need to worry about dying to the same boss again and again.
- Anonymous
it's okay guys, don't worry about it, curing is is really easy later on, so all this amounts to is basically a story element, plus, you have to die a lot for it to activate, i died at least twice to every mini-boss (except the centipedes, which where too easy) and still had enough to spare
- Anonymous
Can I resurrect on a spot then run to an idol to rest to prevent sickness from spreading?. It is kinda confusing. Some say resurrect at idol, some saying totally opposite. You people are very confusing. IMO FROM games have almost none existing storylines to begin with and then by some reason FROM likes to make storylines even worst by killing or making NPC"s sick. I had to play through each DS game at list twice to be able to follow each NPC line. Kinda annoys me.
- Anonymous
Is it really confirmed that Dragonrot's only real downsides are lowering unseen aid and halting questlines? Will no one die from it? Other than Inosuke Nogami and his Mother who die after getting cured, I guess, but those two don't seem all that important and they were dying either way.
- Anonymous
This mechanic has ruined this game for me. Now instead of feeling a sense of accomplishment when I die, learn from my mistakes, and succeed, I now just feel a constant sense of dread hanging over me.
- Anonymous
This incorrectly states that you can CONSUME a Dragon's Blood Droplet to cure NPCs. Consuming it prevents you from using it at a Sculptor's Idol along with a Recovery Charm to heal NPCs of Dragonrot.
- Anonymous
Can NPCs die from dragonrot? Or is it caused by the progress? Because I saw Anayama the Peddler died after or before fight with the Owl.
- Anonymous
It's an interesting mechanic. You only get it through resurrection, so those who use their second life every death spread it at a much faster pace than those who use the resurrection sparingly. It makes you a little more hesitant to pop rez all the time and instead pick and chose your battles.
The acquisition rate seems to be heavily randomised, or have some underlying hidden mechanic. I have logged all my deaths so far, at which intervals I got dragonrot essences and for which NPCs. The # of deaths to trigger another rot essence are completely different between me and a friend who has done the same - I got the sculptor at 6, the memorial mob in ashina outskirts at 12 and the newcomer at 35. Meanwhile, my friend got the sculptor at 6, the old lady with the bell at 12 and the newcomer at 17. We've both been using the resurrection mechanic pretty much everytime we died.
- Anonymous
Sounds like a lame mechanic. Why not just lose items instead of losing NPC quests upon death?
- Anonymous
While resurrecting doesn't cause Dragonrot, I think it does increase the chance someone will contract it. While playing the game I would run back to the idol and rest whenever I resurrected, doing so at least 100 times while brute forcing my way through mini-bosses. On my third 'respawn at idol' death both the Sculptor and another NPC contracted the disease.
- Anonymous
So what exactly does increasing resurrection power by consuming a droplet mean.. consume enough of them and u get more resurrections or does it res u with more life or does it jus give u a res back if u used it while fighting I mean these are important. Sigh.
- Anonymous
- Anonymous
Well, i must hand it to FROM software for this one, not only do we get a protagonist who has the personality of a piece of drift wood and a living macguffin who really needs to be sacrificed to a dragon so I can get a shinier sword, but we also get punished for dying by making it less likely that we get to see any real story from the NPC's. Bravo FROM, Bravo
- Anonymous
its simple people. IF YOU RESURECT WHERE YOU ARE AT youre good IF YOU GET SENT BACK TO AN IDOL TO RESURECT you're a plague spreader
- Anonymous
Can somebody answer please: How many times you can die before any NPC dies? Do you get any information like: X is about to die, use your Dragon's Blood Droplet asap? Just want to stack up on Dragon's Blood Droplets and use them only when needed, considering how rare they are.
- Anonymous
the page both says "It does not matter whether you Resurrect or not, you can still gain Dragonrot if you respawn at a Sculptor's Idol, so there is no point in not Resurrecting if you can." and "Dragonrot is increased by : Resurrecting". Which one is it? Does resurrecting increase dragonrot or not?
- Anonymous
Would choosing to die once I'm downed cause dragon rot to not become an issue then?
It's not a BAD mechanic, it's just kinda stupid. Especially if you're doing NG+'s you just rack up dragon blood droplets so it's a drop in the bucket to cure it. Compared to previous Fromsoft games that punish you for dying repeatedly this is a light tap on the wrist and really, I'm glad they didn't push it further for Sekiro. Making new players feel bad for dying is already enough I'd say.
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