But the clue is in the name: eventually you'll get to a point where you have to scale.Isn't that the conceit underlying this whole argument, though? Many systems won't ever get to the point where you have to scale in that way, if you build them efficiently in the first place.
Perhaps more importantly, for many applications, you'll be able to see the limit coming some way ahead, and if you've reached a size where you do need a fundamental restructuring in order to start scaling horizontally, that's going to be a nice problem to have and you'll also have the resources to do it.
I know several online systems that are handling significant traffic volumes perfectly well on a simple, single-server basis. They don't get bogged down in infrastructure and tooling issues, ever. They don't get confused by complicated cloud hosting issues, ever. They are free to spend almost their entire development budget on actually developing useful functionality, which is like a breath of fresh air in today's dev culture.
Obviously in the more serious cases they probably also have some redundancy for backup/failover purposes, but even that is simple and if necessary can probably be handled manually when you only have a handful of servers to manage. Here I do slightly disagree with one of Carmack's later tweets, in that I would argue 100 servers instead of 1000 is just accounting, but 100 down to 10 or fewer is also more of a qualitative change (albeit not exactly the same qualitative change as 10 down to 1).