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That said, I just make recommendations based on what I think is the most useful choice overall. All of the information about all of the starting items is there, so you can pick whatever you think might be best! :)
#1 Coat - seriously OP you'll wear it to the end. Completely blocks many effects and lasts a long time and repairable with leather once you reach copper tier. You can't make anything close to this good. It should probably be nerfed
#2 backpack - large increase in carrying capacity helps with everything lasts a long time. Probably should also be nerfed.
Firestarter maybe #3. I avoid fires, cooking takes too long. But later smelting etc uses fire a lot more although by then you have flint.
If you want a weapon the spear would probably last longer since you tend to use them less. The axe on the other hand won't last more than a few days - you go through a LOT of axes. Same with the knife. The pistol can help you one shot a boar maybe but they're pretty easy to take down once you learn block attack. Food and medicine is easynto make.
As for the fishing rod ... there should be an achievement for picking it
The Scorpions can be a problem if they attack you, but you can kill them in advance and ward away pests by keeping the Campfire lit. More importantly, if you *do* get poisoned, you can use the Scorpion carcass to make an antidote for poison, so it's not that big of an inconvenience.
I think it's probably a good idea to move later after you've collected some resources, but the grotto should be fine for the first few days.