North Korea reported 21 more deaths and 174,440 new “fever cases” on Friday, according to state media KCNA, although it did not say how many deaths and cases were Covid-related, likely in 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 reports from North Korean state media have remained vague and many important questions remain unanswered, including the country’s vaccination coverage 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 epidemic appear?
North Korean authorities have not announced the cause of the outbreak.
It is still unclear how the virus crossed the country’s tightly closed borders.
When KCNA reported on the country’s first identification of Covid-19 on Thursday, it didn’t even say how many infections had been faulty. He simply said that samples taken from a group of people with fever on May 8 tested positive for the highly contagious variant of Omicron.
On Friday, KCNA reported that 18,000 new “fever cases” and six deaths were recorded Thursday, including one that tested positive for Omicron’s BA.2 subvariant.
“A fever whose cause could not be identified has spread explosively throughout the country since late April,” the newspaper said. “As of today, up to 187,800 people are in isolation.”
On Saturday, KCNA said a total of 524,440 people reported symptoms of “fever” 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 dilapidated healthcare infrastructure and lack of testing equipment is unlikely to be up to scratch to treat large numbers of patients with a highly contagious disease.
North Korea’s lack of transparency and reluctance to share information also pose a challenge.
North Korea has never officially acknowledged the death toll from a devastating famine in the 1990s that experts say killed up to 2 million people. Those who fled the country at the time shared horrifying stories of death and survival, and a country in chaos.
“North Korea has such a limited supply of basic drugs that public health officials need to focus on preventative medicine. They would be ill-equipped to deal with any kind of outbreak,” Jean Lee said. , director of the Hyundai Motor-Korea Foundation Center for Korean History at the Washington-based Woodrow Wilson Center, told CNN at the start of the pandemic.
Doctors who have defected in recent years often speak of poor working conditions and shortages of everything from drugs to basic healthcare supplies.
Choi Jung-hun, a former doctor from North Korea who fled the country in 2011, said when he helped fight a measles outbreak in 2006 and 2007, North Korea did not have the resources. to operate 24-hour quarantine and isolation. facilities.
He recalled that after identifying suspected cases, doctors’ manuals said patients were supposed to 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 for people in hospitals and quarantine facilities, people escaped to look for food” , Choi said during an interview with CNN in 2020.
How is North Korea reacting so far?
North Korean state media declared the situation a “major national emergency” after admitting the first officially reported Covid infection.
On Thursday, Kim placed all cities under quarantine and ordered “persons with fever or abnormal symptoms” to self-quarantine; he also led the distribution of medical supplies the government would have stockpiled in the event of a Covid emergency, according to KCNA.
Kim then chaired a meeting of the country’s powerful political bureau, which agreed to implement “maximum” emergency anti-epidemic measures. Measures include isolating work units and proactively conducting medical examinations to find and isolate people with “fever and abnormal symptoms,” the KCNA reported on Friday.
“Practical measures are being taken to keep production at a high rate in key sectors of the national economy and to stabilize people’s lives as much as possible,” KCNA said.
According to KCNA, the political bureau criticized the country’s anti-epidemic sector for “negligence, laxity, irresponsibility and incompetence”, saying it “has not responded sensitively” to the increase in cases of Covid-19 around the world, including in neighboring regions.
A reporter from Chinese state media CGTN released a rare video from Pyongyang on Friday, recounting his experience on the ground.
“As far as we know, few people in Pyongyang have been vaccinated, and medical and epidemic prevention facilities are scarce,” reporter Zang Qing said in a post on Weibo.
“Because the capital is on lockdown, the food I have at home is only enough for a week. We are still waiting for the policy that the government will announce next.”
At a meeting on Saturday, Kim inspected the country’s emergency epidemic 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 achieved in their fight against the malicious infectious disease”, according to KCNA.
What about North Korea’s vaccination coverage?
North Korea is not known to have imported coronavirus vaccines – although it is 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 isolated itself from the outside world — could quickly turn deadly.
Calls are increasing to the country’s leaders to provide access to vaccines.
“There is no evidence that North Korea has access to enough vaccines to protect its population from Covid-19. Yet it rejected millions of doses of AstraZeneca and Sinovac vaccines offered by the WHO-led Covax programme,” Amnesty International said. Boram Jang, East Asia researcher, in a statement.
“With the first official news of a Covid-19 outbreak in the country, continuing down this path could cost many lives and would be an unconscionable failure to uphold the right to health.”
In February, Covax reportedly reduced the number of doses allocated to North Korea because the country did not organize any shipments, according to Reuters.
A spokesperson for Gavi, the Vaccine Alliance, said Covax has moved to “needs-based vaccine allocations” and “has not currently committed any volumes” for North Korea.
“In the event that the country decides to launch a vaccination program against Covid-19, vaccines could be made available based on the criteria of the Covax targets and technical considerations to allow the country to catch up with the international vaccination targets” , said the spokesperson.
CNN’s Joshua Berlinger and Yoonjung Seo contributed to this report.