Death is all they have. And even then, it's limited. They are trying to scare US the people in the bleachers watching. They want a mass death event to scare us into submission, but they can't get it. They're just about out of moves.

The Q team likely seized control of the nuclear arsenal very early in the plan. Like during Obama and maybe even Bush. This is why things had to be so precise: to get the nukes OUT of derp state control. This is probably why Ukraine is the last phase: they are disarming the derp state's death arsenal.