What about pandemics? (Either natural or engineered.)
That basically leaves the US or Russia (the only countries with the capacity to do so) arbitrarily deciding to nuke most cities in south Asia.
That said, I don't see any objective (rational or otherwise) of either country that would be advanced by such an attack. And again, we're talking about an attack that will kill 1B+ people, not just any nuclear attack -- that's a different story. Still low probability, but at least there are semi-rational objectives that could motivate it.
https://en.wikipedia.org/wiki/China_and_weapons_of_mass_dest...
With regard to climate change: We know the danger is real and thus humanity adapts to prevent the worst.