As a fan of body horror, this is excellent. The idea that everyone around the players is potentially a baddie to be a fun touch.
I like the idea of NPCs moving around but there’s so many options it could be really hard to keep track of who is where.
The time tracker on the inner spread is an excellent touch to help the warden keep track of game state. While reading the Watch the Clock section I was confused at first when seeing “time marches on” (yes, I did accidentally skip the rest of the sentence) and it had me questioning if that was simply when the warden feels like it’s time to move the game clock forward. Emphasizing that (bolds, Title Case, etc) could help there. I understand that it wouldn’t be as evocative with only having “Increment clock by 1” but could eliminate some confusion / extraneous game mechanics.