It doesn't force consequences on you - it reacts to your choices, you made some unfortunate choices in your playthrough and teh game reacts to that. And what about 'Depending on your choices, the state of the region could change and some active quests may become unavailable' is not to understand? I really don't get it. WHen I got that message, I looked through my journal, made sure, I had seen every part of the map and then moved on. I found it pretty clear tbh.
What unfortunate choices did I make? You haven't answered any of my questions. "What exactly does 'the state of the region' mean? Which region given that you are about to step into Shadowfell? There are also a lot of choices in the Nightsong sequence - Which party member does the talking; what you do about Balthazar; what you do with Nightsong and what happens with Shadowheart afterwards if she is present. That's a lot of permutations involving a lot of information that you are unaware of when you get the warning. You cannot make choices about things you don't know - that is guesswork not choice."
We could add: why is the warning at that point rather than before you start the Gauntlet? Or why is it possible to reach this point with so much of Reithwin still unexplored?
The warning at the end of Act 1 is exactly that a warning that you are about to leave Act 1. I left Act 1 having chosen not to bother with the owlbear, the kuo toa or the mad monk. I had no intention of retuning at some point to do them. The warning just outside the Shadowfell transition is not about leaving Act 2.
I made choices with Yurgir (ignoring dire warnings from Shadowheart about crossing a devil) which I know will have consequences with Raphael and I am happy enough with that - I'll cross that bridge when I get to it.
I hate to bring up logic again but given the context of where the warning occurs and what the Nightsong is, any consequences would, to me at least, be with things connected to the Nightsong and not some feverish guy in an inn several miles away. I'm happy with my choices regarding the Nightsong and I'm fine with the fact that certain plot elements will have changed to reflect my choices.
And once more from the top - failing the find a cure quest was not a choice - it was a consequence of losing a fight. Once I spoke to Halsin and the cutscene started, I think I am correct in saying that there is no way out of the fight.