When you spawn, you will always start on the coast. The immediate coastal areas are usually stripped of loot by other players, so your main goal is to secure bare essentials and head inland.
Find a Knife: A sharp object (stone knife, kitchen knife, or screwdriver) is your most vital tool. It allows you to open cans, skin animals, bark trees, and craft fires.
Manage Your Hands: Never eat food or drink water with bloody hands (from skinning animals or fighting). Wash them at a pump or craft hand wrappings from rags to prevent fatal cholera.
Locate Clean Water: Only drink from blue water pumps (wells) found in towns. Natural streams, lakes, and pre-filled bottles can contain cholera unless treated with chlorine purification tablets.
Forage for Food: Do not rely strictly on finding canned goods in houses. Look under fruit trees for apples/pears and search the ground near hay bales for mushrooms.