North Korea reported 21 more deaths and 174,440 new “fever” cases Friday, according to state media KCNA, though it did not specify how many of the deaths and cases were linked to Covid, likely due to the country’s extremely limited testing capacity.
However, 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 been vague, and many important questions remain unanswered, including the country’s vaccine coverage and the impact of the shutdown on the livelihoods of its 25 million people.
Here’s what we know and what we do not know about the outbreak:
How did the outbreak occur?
The North Korean authorities have not disclosed the cause of the outbreak.
It is still unclear how the virus slipped through the country’s tightly closed borders.
When the KCNA reported the first identification of Covid-19 in the country on Thursday, it did not even specify how many infections had been defected. It simply said that samples collected from a group of people who experienced fever on May 8 were tested positive for the highly contagious Omicron variant.
On Friday, the KCNA reported that 18,000 new “fever cases” and six deaths were recorded Thursday, including one that tested positive for the BA.2 subvariant of Omicron.
“A fever whose cause could not be identified explosively spread across the country since late April,” the newspaper said. “At present, up to 187,800 people are being isolated.”
On Saturday, the 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 quarantined while the rest had recovered.
Can North Korea cope with a large-scale outbreak?
An outbreak of Covid-19 could prove disastrous for North Korea. The country’s dilapidated health infrastructure and lack of test equipment will hardly cope with the task of treating a large number of patients with a highly contagious disease.
North Korea’s lack of transparency and unwillingness to share information also poses a challenge.
North Korea has never formally acknowledged how many died during 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 stories of death and survival and a country in chaos.
“North Korea has such a limited supply of basic medicine that public health officials have to focus on preventative medicine. They would be ill-equipped to deal with any kind of epidemic,” said Jean Lee, director of the Hyundai Motor-Korea Foundation Center for Korean story at the Washington-based Woodrow Wilson Center, CNN reported at the beginning of the pandemic.
Doctors who have dropped out in recent years often talk about poor working conditions and lack 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 helped fight a measles outbreak in 2006 to 2007, North Korea did not have the resources to conduct 24-hour quarantine and isolation. facilities.
He recalled that after identifying suspicious cases, manuals told doctors that patients should be transferred to a hospital or a quarantine facility for monitoring.
“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 fled to look for food,” Choi said in an interview with CNN in 2020.
How is North Korea reacting so far?
North Korean state media declared the situation a “major national emergency” as they admitted the first officially reported Covid infection.
On Thursday, Kim closed all cities and ordered “people with fever or abnormal symptoms” in quarantine; he also led the distribution of medical supplies that the government allegedly had in stock in the event of a Covid emergency, according to the KCNA.
Kim later chaired a meeting of the country’s powerful politburo, which agreed to implement “maximum” emergency measures against the epidemic. The measures include isolating work units and proactively performing medical checks to find and isolate people with “fever and abnormal symptoms,” the KCNA reported Friday.
“Practical measures are being taken to keep production going at a high pace in the key sectors of the national economy and to stabilize the life of the population to the maximum,” the KCNA said.
According to the KCNA, the Politburo criticized the country’s anti-epidemic sector for “carelessness, laxity, irresponsibility and incompetence,” saying it “failed to respond sensitively” to rising Covid-19 cases worldwide, including in neighboring regions.
A reporter for the Chinese state media CGTN on Friday released a rare video from Pyongyang that tells about his experience on earth.
“As far as we know, not many people in Pyongyang have been vaccinated and the medical and epidemic prevention facilities are in short supply,” said journalist Zang Qing 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 time.”
At a meeting 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 gained in their fight against the malignant infectious disease,” according to the KCNA.
What about North Korea’s vaccine coverage?
North Korea is not known to have imported any coronavirus vaccines – despite being eligible for the global Covid-19 vaccine sharing program, Covax.
Provided that most North Koreans are unvaccinated, an outbreak in the country – which has limited testing opportunities, inadequate medical infrastructure and which has isolated itself from the outside world – can quickly become fatal.
Calls are rising for the country’s leadership 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 has rejected millions of doses of AstraZeneca and Sinovac vaccines offered by WHO-led Covax. program, “Amnesty International said in a statement. East Asia researcher Boram Jang, 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 unscrupulous neglect of upholding the right to health.”
In February, Covax reportedly scaled down the number of doses assigned to North Korea because the country failed to arrange any shipments, according to Reuters.
A spokesman for Gavi, the Vaccine Alliance, said Covax had switched to “needs-based vaccine allocations” and “has not currently committed to any volume” for North Korea.
“If the country decides to launch a Covid-19 immunization program, vaccines may be made available based on Covax target criteria and technical considerations to enable the country to meet international immunization targets,” the spokesman said.
CNN’s Joshua Berlinger and Yoonjung Seo contributed to this report.