North Korea reported 21 more 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, likely due to extremely testing capacity. country limited.
But given the opaque nature of the regime and the country’s isolation from the world – a trend that has only exacerbated 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 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 outbreak come about?
North Korean authorities have not announced the cause of the outbreak.
It is still unclear how the virus made its way through the country’s tightly closed borders.
When KCNA reported on the country’s first identification of Covid-19 on Thursday, it didn’t even specify how many infections were defected. He simply said that samples taken from a group of people with a fever on May 8 tested positive for the highly contagious Omicron variant.
As of Friday, KCNA was reporting that 18,000 new “fever cases” and six deaths had been reported on Thursday, including one that tested positive for Omicron’s BA.2 subvariant.
“A fever whose cause could not be identified has spread explosively across the country since late April,” the paper said. “So far, up to 187,800 people are being isolated.”
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 handle a large-scale outbreak?
An outbreak of Covid-19 could be disastrous for North Korea. The country’s crumbling healthcare infrastructure and lack of testing equipment are 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 pose a challenge.
North Korea has never formally acknowledged how many died during a devastating famine in the 1990s, which experts suggest killed up to 2 million. Those who fled the country at the time shared gruesome stories of death and survival, and a country in chaos.
“North Korea has such a limited supply of basic medicines that public health officials need to focus on preventive 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 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 medicine to basic health supplies.
Choi Jung-hun, a former North Korean doctor who fled the country in 2011, said that when he was helping to fight a measles outbreak in 2006 to 2007, North Korea did not have the resources to operate a 24-hour quarantine and isolation. day. installations.
He recalled that after identifying suspected cases, manuals for doctors said 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 for people in hospitals and quarantine facilities, people would escape to look for food,” Choi said during an interview with CNN in 2020.
How is North Korea responding so far?
North Korean state media declared the situation a “major national emergency” as it admitted the first officially reported Covid infection.
On Thursday, Kim put all cities on lockdown and ordered “people with fever or abnormal symptoms” to be quarantined; he also directed the distribution of medical supplies that the government would have stockpiled in the event of a Covid emergency, according to KCNA.
Kim later presided over 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 examinations to find and isolate people with “fever and abnormal symptoms”, KCNA reported on Friday.
“Practical steps are being taken to keep production high in the main sectors of the national economy and to stabilize people’s lives as much as possible,” KCNA said.
According to KCNA, the Politburo criticized the country’s anti-epidemic sector for “carelessness, laxity, irresponsibility and incompetence”, saying it “did not respond sensitively” to the increase in 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, 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 in short supply,” reporter Zang Qing said in a Weibo post.
“As 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.”
At a meeting on Saturday, Kim inspected the country’s emergency measures and medical supplies. He also urged North Korean officials to learn from China’s “advanced and rich quarantine results and the experience they have already gained in fighting the malicious infectious disease”, according to KCNA.
What about North Korea’s vaccination coverage?
North Korea is known not to have imported any coronavirus vaccines – despite being eligible for the global Covid-19 vaccine-sharing program, Covax.
Assuming most North Koreans are not vaccinated, an outbreak in the country – which has limited testing capacity, inadequate medical infrastructure and has cut itself off from the outside world – could quickly turn deadly.
Calls on the country’s leadership to provide access to vaccines are increasing.
“There is no evidence to show 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 programme,” Amnesty said. International. East Asian 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 inconceivable disregard for the defense of the right to health.”
In February, Covax reportedly reduced the number of doses allocated to North Korea because the country was unable to arrange any shipments, according to Reuters.
A spokesperson for Gavi, the Vaccine Alliance, said Covax has switched to “needs-based vaccine allocations” and “has not currently committed any volumes” to North Korea.
“Should the country decide to initiate a Covid-19 immunization program, vaccines may be made available based on Covax objective criteria and technical considerations to enable the country to achieve international immunization targets,” the spokesperson said.
Joshua Berlinger and Yoonjung Seo of CNN contributed to this report.