This card seems to be the reason why Distributed Tracing exist. If you go for in faction card, once you have Distributed Tracing and Hypoxia in hand, after the runner has stolen an agenda, then you can spend you entire turn to give a tag, do a Core Damage and take a click off the runner. For a cumulated price of 4. It is worth it, if done in this fashion? Probably not.

But, if you are running a tag based HB deck, with tools like Public Trail, End of the Line, Hard-Hitting News and other cards like those, then Hypoxia could be worth it. It would allow you to diminish the handsize of the runner, making the runner more vulnerable to getting killed by your other out of faction tools.

Or, if you go for maximum Core Damage, especially with Thule Subsea: Safety Below, using Nightmare Archive and tools like Djupstad Grid or Mr. Hendrik, to put the runner at having no handsize and possibly die on a Snare! or from Anemone, this could also work. In those cases, maybe Dr. Vientiane Keeling could be used with that strategy. Then maybe it is worth it to use Hypoxia with Distributed Tracing.

But, every other Core Damage tools from Haas-Bioroid have either more utility or are more reliable. I do not see any use of this card out of faction, since at 3 influences, you will get better tools.

The graphic exactly represent what Hypoxia is all about. I enjoy the double meaning of the quote (related to the effect of the card and to a famous phrase from The Matrix movie). Well done.