What we know (and don’t know) about the Covid outbreak in North Korea

North Korea reported 21 more deaths and 174,440 new “fever cases” on Friday, according to state media KCNA, though it did not specify how many of the deaths and cases were related to Covid, likely due to the country’s extremely limited testing capacity.

But given the opaque nature of the regime and the country’s isolation from the world — a trend that has only worsened since the pandemic — it is extremely difficult to assess the real situation on the ground.

But North Korean state media reports have been vague and many important questions remain unanswered, including the country’s vaccination rate and the impact of the lockdown on the livelihoods of its 25 million people.

Here’s what we know and what we don’t know about the outbreak:

How did the outbreak start?

North Korean authorities have not disclosed the cause of the outbreak.

North Korea’s borders have been sealed off since January 2020 to keep the virus at bay, making the so-called “hermit nation” even more isolated from the world. It even declined invitations to send teams to participate in the Tokyo and Beijing Olympics, citing the threat of Covid-19.
And as new variants emerged, it stepped up those efforts, cutting off nearly all trade with China — the country’s largest trading partner and economic lifeline for the Kim regime — cutting imports from Beijing by 99% from September to October 2020. fell .
North Korea declares 'major national emergency' as first case of Covid-19 identified, state media reports

It remains unclear how the virus slipped through the tightly sealed national borders.

When KCNA reported on Thursday about the first identification of Covid-19 in the country, it didn’t even mention how many infections had spilled over. It simply said that samples collected from a group of people who had a fever on May 8 had tested positive for the highly contagious Omicron variant.

On Friday, KCNA reported that 18,000 new “fever cases” and six deaths had been registered on Thursday, including one that tested positive for Omicron’s BA.2 subvariant.

“A fever, the cause of which could not be determined, has spread explosively across the country since the end of April,” the newspaper said. “Right now, up to 187,800 people are being isolated.”

On Saturday, KCNA said a total of 524,440 people had reported “fever symptoms” between the end of April and May 13. Among them, 280,810 people were still being treated in quarantine, while the rest had recovered.

Can North Korea handle a large-scale outbreak?

An outbreak of Covid-19 could be disastrous for North Korea. The country’s dilapidated health care infrastructure and lack of testing equipment are unlikely to be up to the task of treating a large number of patients with highly contagious disease.

North Korea’s lack of transparency and unwillingness to share information also poses a challenge.

North Korea has never formally acknowledged the deaths of a devastating famine in the 1990s, which experts suggest killed as many as 2 million. Those who fled the country at the time shared horrific tales of death and survival, and a land in chaos.

“North Korea has such a limited supply of basic medicines that public health officials should focus on preventive medicine. They would be ill-equipped to deal with any kind of epidemic,” Jean Lee, director of the Hyundai Motor Korea Foundation Center for Korean History at the Woodrow Wilson Center in Washington, CNN told the start of the pandemic.

All of its neighbors have it, so why hasn't North Korea reported any cases of coronavirus?

Doctors who have defected in recent years often speak of poor working conditions and shortages of everything from medicines to basic health care.

Choi Jung-hun, a former doctor in North Korea who fled the country in 2011, said North Korea lacked the resources to work in 24-hour quarantine and isolation when he helped fight an outbreak of coronavirus. measles in 2006 to 2007 facilities.

He recalled that after identifying suspected cases, doctors’ guides said patients should be transferred to a hospital or quarantine facility for checkups.

“The problem in North Korea is that manuals are not followed. When there was not enough food for the people in hospitals and quarantine facilities, people escaped to look for food,” Choi said in a 2020 interview with CNN.

How is North Korea reacting so far?

North Korean state media called the situation a “major national emergency” after admitting the first officially reported Covid infection.

On Thursday, Kim placed all cities on lockdown and ordered “people with a fever or abnormal symptoms” to quarantine; he also directed the distribution of medical supplies that the government reportedly stockpiled in the event of a Covid emergency, according to KCNA.

Kim later chaired a meeting of the country’s powerful politburo, which agreed to implement “maximum” emergency measures against epidemics. The measures include isolating work units and proactively conducting medical checks to find and isolate people with “fever and abnormal symptoms,” the KCNA reported Friday.

“Practical measures are being taken to maintain production in key sectors of the national economy and to stabilize people’s lives to the maximum,” KCNA said.

North Korea announces first Covid deaths amid

According to KCNA, the politburo criticized the country’s anti-epidemic sector for “carelessness, laxity, irresponsibility and incompetence”, saying it was “not responsive” to the increasing number of Covid-19 cases around the world, including in neighboring regions. .

A reporter for Chinese state media CGTN released a rare video from Pyongyang on Friday, detailing his experiences on the ground.

“As far as we know, not many people in Pyongyang have been vaccinated, and medical and epidemic prevention facilities are scarce,” reporter Zang Qing said in a Weibo post.

“Because the capital is locked, the food I have at home is only enough for a week. We are still waiting to see what policy the government will announce next.”

At a meeting Saturday, Kim inspected the country’s epidemic emergency measures and medical supplies. He also urged North Korean officials to learn from China’s “advanced and rich quarantine results and experience they have already gained in their fight against the malignant infectious disease,” according to KCNA.

What about North Korea’s vaccination rate?

North Korea is not known to have imported coronavirus vaccines, despite being eligible for the global Covid-19 vaccine-sharing program, Covax.

Assuming most North Koreans are unvaccinated, an outbreak in the country — which has limited testing capabilities, inadequate medical infrastructure and has shut itself off from the outside world — could quickly turn deadly.

Calls for access to vaccines are mounting in the country’s leadership.

“There is no evidence that North Korea has access to sufficient vaccines to protect its population from Covid-19. Yet it has turned down millions of doses of AstraZeneca and Sinovac vaccines offered by the WHO-led Covax program,” Amnesty International’s East Asia researcher Boram Jang said in a statement.

“With the first official news of a Covid-19 outbreak in the country, continuing down this road could cost many lives and would be an unscrupulous disregard for the right to health.”

According to Reuters, Covax scaled back the number of doses allocated to North Korea in February because the country had not arranged transportation.

A spokesperson for Gavi, the Vaccine Alliance, said Covax has moved to “need-based vaccine allocations” and “has not currently committed any volume” for North Korea.

“In the event that the country decides to initiate a Covid-19 immunization program, vaccines could be made available based on Covax target criteria and technical considerations to enable the country to catch up with international immunization targets,” the statement said. spokesman.

CNN’s Joshua Berlinger and Yoonjung Seo contributed to this report.

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