So after spending all morning on this, it seems to be some weird coil whine issue. Good news is, it's not the game! The effect is for some reason far more noticeable in this game than in any other program.
Yeah, it's not the drivers. I run many, many, many programs on this PC. I don't have sound issues with any of the others. And the drivers are up to date in any case.
When I play the game with headphones there is an unbearably loud buzzing or hissing noise in the background of the main menu and shipyard. It's still there when I take off the headphones, though not quite as bad.
Just bought the Limited Edition. But when I try to launch, I get a message saying
"The game crashed.
The crash report folder 2020-04-11_210952 next to game executable".
Another user with a similar problem was asked if he had Citrix; I have no Citrix products on this computer.