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I started following ToA back at the start of January, at first I was very skeptical and hostile to the permadeath concept. But seeing as how there are no other MMOs worth playing, I did have a lot of time on my hands to consider it. I now think it is a great concept for reasons that the other posters have said here, no need to restate it all myself.
There's a lot more to ToA than permadeath - that is not the point of the game. The innovation and discovery system sounds very fun. It has not been discussed much, but once someone invents / discovers something, only they have that knowledge. BUT they can either 1) teach that knowledge to their friends in case it is useful, or 2) someone can 'loot' that info from their head if they successfully beat them in combat.
So say you discover an improved sword technique - do you keep it to yourself and be a lone badass? or do you teach it to your settlement friends - so EVERYONE in the settlement is now better and can defend better?
Or do you discover an improved fortification? or potion forumula? etc. Check out the website for more details on this - it's really cool.
Exploration and chance are also a big feature of ToA, there won't be set "raid" dungeons like in other MMOs. They will spawn and then go away, and they won't be easy or structured like you are used to. Think of it more as if you found a cave in the Lord of The Rings novel - they didn't pull 50 packs then kill a boss. It is more of an adventure.
Settlements are probably the biggest draw for many people interested in ToA. The biggest misconception people seem to be having about "open world, pvp always on, permadeath" concept is they lack how the devs have given the settlements the upper hand in defense. The way I see the game playing out is sort of like EVE, except instead of one giant safe zone in the middle, you have smaller isolated safe zones with lots of defenseless wilderness in between. It's 100% possible to die anywhere in both ToA and EVE from pvp, it's just a lot less likely, and less rewarding (usually), to do so in the zones set up for defensive players. You put the good valuable stuff out in the dangerous areas, and game reaches equilibrium.
If you're a cautious gamer, you can take less risks and live longer (it's not a game where you only play to see how many creative ways you die, or how fast). If you like to take risks and charge in swords blazing - then go for it. It just has consequences.
Just like in EVE, the game can cater to people who both hate risk and love risk. These people need each other, just like in all aspects. The more diverse types of players who can find a home in an MMO, the better the experience gets for everyone.