Yes. Exactly. Pay double. That is what all the blogs say. But no, when a region goes down everything is hosed. Give it a shot! Next time an entire region is down try out your apis or give AWS support a call.
No. We don't have an active deployment in that region at all. It killed our build pipeline as ECR was down globally so we had nowhere to push images. Also there was a massive risk as our target environments are EKS so any node failures or scaling events had nowhere to pull images from while ECR was down.
Edit: not to mention APIGW and Cloudwatch APIs were down too.