Perhaps this wasn't about us. Maybe we were running cover for the operations to rescue cabal prisoners. If so, then I regret nothing. The nuclear standoff is still there, except we snuck behind enemy lines and rescued innocents. The side who blinks first, loses.
It can be synthesized. But extracting it from their victims are part of their rituals, it has more meaning to them. They "like" the natural stuff better, but will fallback on degraded epipens when in a jam.
Roughly 20 million. But remember, this will be ww.