Before North Korea had nuclear weapons and an arsenal of increasingly reliable missiles, the estimated casualty count for a war with North Korea was in the hundreds of thousands, but that conflict would at least have been definitive and non-nuclear. U.S. military officials were confident at the time that North Korea’s Yongbyon reactor could be taken out without spreading radiation.

Now the death toll would be significantly higher, and it will continue to rise as North Korea advances its weapons programs. North Korean missiles are flying farther, bringing new targets in range, and the explosive yield has grown with each nuclear test since 2006. The North is processing more nuclear material, developing new launch systems, and readying itself for what could be a catastrophic conflict.

North Korea holds a vast stockpile of chemical weapons as well, and has taken every step to ensure any conflict will exact as much blood as possible. The U.S.’s response, meanwhile, has been limited to sanctions on a regime with little regard for the well-being of its own people.