Yes, htaccess is ugly but at least a server operator can restrict the users from pwning the machine and only allow rewrite-configs.
Seems like NGINX logic should be, if the path exists, it must have correct permissions already. If not, just fail to start.
I am sure there are other ones but I have not had a chance to investigate further. Another commented mentioned this particular problem is in ngx_create_paths so that would be a good place to start looking.
The key is to find paths that happen in the master process, not the workers.
Does SElinux mitigate this? App armour? Dockerised WP and NGiNX?