Probably, that seems to be the case with a lot of medical issues. It’s not that they are becoming more frequent, it’s just that we are getting better at diagnosing them.
Most private trackers allow VPN usage. They track ratio through your unique key that is part of every torrent you download. Yes you have to maintain ratio (up to a certain point, and it heavily depends on the tracker). See Private Tracker List by -HDVinnie- for details on trackers.
I use Mullvad because I don’t need port forwarding. If you are using a VPN specifically for piracy I would use a seedbox, cheap ones aren’t that much more expensive.