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APKs can be end-to-end signed with keys under developer control. You can move between app stores or no store (data is preserved on update with same key). And Google can't fuck with it. (Well, they can fuck with the entirety of the rest of the phone, so that point's kinda moot.)
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Developers should release their apps outside the Play Store too rather than only on Play Store. The OS package manager pins the key after the initial install but you still always trusted the Play Store for the initial install and they had Play Store App Signing before bundles.
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Stuff like the package installer / permission controller, app runtime, etc. on their partner devices are provided via APEX components built by Google and shipped via the Play Store. Only people truly impacted by this are people using devices without Play getting apps from Play.