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Trusted staged publishing helps a lot: you have to independently pwn the workflow _and_ then complete a separate 2FA flow as a maintainer. The workflow never sees any keys that can publish independently.

Keys can be reused from anywhere. Trusted publishing means the attacker must trigger the specific workflow on GitHub, which is more difficult and leaves trace of actions on GitHub itself.

Trusted Publishing pins the publish to the workflow. The next step is to isolate "run untrusted code (`npm build`)" from "publish" in your workflows. Now you have two properties - the publish can only happen from one place and the publish is isolated from untrusted code execution.