Personally not a fan of the automated damage and diseases. Feels like it could/would be weaponized and I'm not sure the effort needed is enough to justify the potential reward. Especially as diseases right now tend towards the kind that never go away, are lethal and cost a load to get cured assuming you can find a doc on your schedule.
I personally don't like the idea that I might sign in for one of my limited time sessions, accidentally walk out without my shoes on, then basically be stuck in cure my diseased character before the die mode. Something that could span several play sessions if you aren't someone who can always play eight hours at a go.
I do think it would be nice to have role play prompts as the original poster suggested. This would let me RP my character how I want, just with better situational awareness.I could have them tiptoeing and hopping from clear patch to clear patch. Or wincing with every step. I like the additional situational awareness even if I don't like the auto-damage and auto-disease.