It's easy if you're politician that's up to reelection. If it's your base voters, then pull it, it's 100K of potential voter. If it's not your base voters then let them perish.
If you're enterpreneur, see whether 100K people is more beneficial than the other 1K. For example if you have a factory that needs many workforce and can utilize the 100K, save them.
If somehow you pull the lever, make a press conference showing sorrow and guilty face telling it's inevitable. If you don't pull the lever, don't expose the info until asked.
If you're not a decision maker, leave it to your supervisor. If somehow you have the loved one in 100K, pull the lever anyway.
Sadly this is the shape of our world right now.