I feel like the game gave away a twist fairly early.

Ok, so I’ve reached the Tusks, but I’ve had this feeling ever since very early in third area, and it only became more prevalent as we go. There’s this cave in the Scarp where you find some non aggressive Dreamthralls locked in a cage. If you kill them like any sane person would at that point in the story, your little friends berates you for doing so. Not just berates though, it acts like you killed their children, or at least a loyal pet.

That combined with the various memories and paintings leads me to believe that our patron is the true bad guy, and is causing the plague either willingly out of a temper tantrum, or is doing so subconsciously in rage against their cage.

That or Woedica is poisoning them with a Maegfolk. Stupid having to work for a living and need to explore.

No overt endings spoilers, please.