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Fortitude is a Survival Skill in The Last of Us, available as a part of the Situational Survival Skills Bundle. The description reads: "Downed? Level up this skill and it will help you survive longer as you'll take longer to bleed out, crawl faster, and have more health when downed. At higher levels you'll start with an extra health pack, and earn extra parts each time you heal."
Level 1 (1 loadout point) - Bleed out time is increased by 25% and slightly increased downed crawling speed. Earn 25 parts after healing more than half health.
Level 2 (3 loadout points) - Start with a health pack. Earn 50 parts after healing more than half health and carry an extra health pack. Downed health is increased and bleed out time is increased by 50% along with much faster downed crawling speed.
Note: The third level of Fortitude was removed and its effects replaced those of level 2.
Fortitude is a good skill for those who often get into the thick of a fight and find themselves downed. Together with teammates that use First-Aid Training 2 and Reviver, players become much more difficult to eliminate.
Particularly early in the game, or when teammates are close by to prevent accidental death, players equipped with Fortitude can deliberately expose themselves to enemy gunfire before healing themselves, earning parts and causing enemies to waste ammunition. In this capacity Fortitude synergizes well with First Aid Training, to facilitate faster use of medkits and allow players to get back into the fray more quickly.
While this skill can increase one's survivability and forces opponents to spend more time and ammunition to execute downed users, it can actually be detrimental in Interrogation mode, where bleeding out is preferable to being interrogated and allows for faster respawning to defend the lockbox. On the other hand, it is perhaps most useful in Survivors mode, where players are not given the opportunity to respawn until the end of a round.
The increase in downed health from the level two variant of the perk usually means that enemies have to hit users an extra time to execute them (a semi-auto usually takes two shots, but takes three against a fortitude user for example).