North Korea reported an additional 21 deaths and 174,440 new “fever cases” on Friday, according to state media KCNA, although it did not specify how many of the deaths and cases were linked to Covid, possibly due to the extremely limited testing capacity of the. country.
But given the regime’s opaque nature and the country’s isolation from the world – a trend that only worsened after 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 coverage and the impact of the blockade 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 epidemic emerge?
North Korean authorities have not announced the cause of the outbreak.
It is unclear how the virus slipped through the country’s hermetically sealed borders.
When KCNA reported on Thursday about the first identification of Covid-19 in the country, it didn’t even specify how many infections had been defected. It simply said that samples collected from a group of people suffering from fevers on May 8 had tested positive for the highly contagious variant of Omicron.
By Friday, KCNA reported that 18,000 new “fever cases” and six deaths were recorded on Thursday, including one tested positive for Omicron’s BA.2 sub-variant.
“A fever whose cause cannot be identified has spread explosively nationwide since the end of April,” the newspaper said. “At the moment up to 187,800 people have been isolated.”
On Saturday, KCNA said a total of 524,440 people had reported “fever” symptoms between late April and May 13. Among them, 280,810 people were still being treated in quarantine, while the rest had recovered.
Can North Korea cope with a large-scale epidemic?
A Covid-19 outbreak could prove disastrous for North Korea. The country’s crumbling healthcare infrastructure and lack of testing equipment is unlikely to be up to the task of treating large numbers of patients with a highly infectious disease.
North Korea’s lack of transparency and reluctance to share information also poses a challenge.
North Korea has never formally acknowledged how many died during a devastating famine in the 1990s that experts suggest killed up to 2 million. Those who fled the country at that time shared horrific stories of death and survival and a country in chaos.
“North Korea has such a limited supply of basic medicines that public health officials have to 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 La Korean history at the Woodrow Wilson Center in Washington, told CNN at the start of the pandemic.
Doctors who have deserted in recent years often speak of poor working conditions and a shortage of everything from medicines to basic health supplies.
Choi Jung-hun, a former North Korean doctor who fled the country in 2011, said that when he was helping fight a measles outbreak in 2006-2007, North Korea lacked the resources to quarantine. and 24 hour isolation facilities.
He recalled that after identifying suspicious cases, physician manuals stated that patients should be transferred to a hospital or quarantine facility for monitoring.
“The problem in North Korea is that the manuals are not followed. When there was not enough food provided for people in hospitals and quarantine facilities, people fled to look for food,” Choi said in an interview with CNN in 2020.
How is it responding so far?
North Korean state media have declared the situation a “major national emergency” after admitting the first officially reported Covid infection.
On Thursday Kim placed all cities in solitary confinement and ordered the quarantine of “people with fever or abnormal symptoms”; He also directed the distribution of medical supplies that the government would provide 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 anti-epidemic measures. The measures include isolating work units and proactively conducting medical checks to find and isolate people with “fever and abnormal symptoms,” the KCNA reported on Friday.
“Practical steps are being taken to keep production at a high pace in major sectors of the national economy and to maximize people’s lives,” said KCNA.
According to KCNA, the politburo has criticized the country’s anti-epidemic sector for “carelessness, laxity, irresponsibility and incompetence”, saying it “has not responded sensitively” to the rise in Covid-19 cases worldwide, including neighboring regions.
A reporter for the Chinese state media CGTN released a rare video from Pyongyang on Friday, recounting his experience in the field.
“As far as we know, not many people in Pyongyang have been vaccinated and medical and epidemic prevention facilities are in short supply,” reporter Zang Qing said in a Weibo post.
“Since the capital is in lockdown, the food I have at home is only enough for a week. We are still waiting for what policy the government will announce next time.”
In a meeting on Saturday, Kim inspected the country’s emergency health measures and medical supplies. She also urged North Korean officials to learn from “China’s advanced and rich quarantine achievements and experience they have already achieved in their fight against the harmful infectious disease,” according to KCNA.
What about his vaccination coverage?
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 aren’t vaccinated, an outbreak in the country – which has limited testing capabilities, inadequate medical infrastructure, and has isolated itself from the outside world – could quickly become deadly.
Calls to the country’s leadership to provide access to vaccines are increasing.
“There is no evidence that North Korea has access to enough vaccines to protect its population from Covid-19. However, it has rejected millions of doses of AstraZeneca and Sinovac vaccines offered by the WHO-led Covax program. “Amnesty International East Asian researcher Boram Jang said in a statement.
“With the first official news of a Covid-19 outbreak in the country, continuing on this path could cost many lives and would be an inconceivable abandonment of defending the right to health”.
In February, Covax reportedly reduced the number of doses assigned to North Korea because the country did not organize any shipments, according to Reuters.
A spokesperson for Gavi, the Vaccine Alliance, said Covax has switched to “needs-based vaccine allocations” and “has not committed any volumes at this time” for North Korea.
“Should the country decide 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 achieve international immunization targets,” he said. the spokesperson.
Joshua Berlinger and CNN’s Yoonjung Seo contributed to this report.