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 Covid-related, 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 been exacerbated since the pandemic, it is extremely difficult to assess the real situation on the ground.

But North Korean state media reporting has been vague and many important questions remain unanswered, including the country’s vaccine coverage and the impact of the lockdown on the livelihood of its 25 million people.

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

How did the outbreak start?

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

North Korea’s borders have been hermetically sealed since January 2020 to keep the virus at bay, making the so-called “hermit nation” even more isolated from the world. He has even turned down invitations to send teams to compete in the Tokyo and Beijing Olympics, citing the threat of Covid-19.
And as new variants began to emerge, he stepped up those efforts, cutting almost all trade with China, the country’s biggest trading partner and the economic lifeblood of the Kim regime, with imports from Beijing falling 99% from September to October. of 2020. .
North Korea declares 'major national emergency' identified as first Covid-19 case, state media report

It is not clear how the virus slipped through the country’s hermetically sealed borders.

When 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 a fever on May 8 had tested positive for the highly contagious Omicron variant.

For Friday, KCNA reported that 18,000 new “fever cases” and six deaths were recorded Thursday, including one who tested positive for Omicron’s BA.2 subvariant.

“A fever whose cause could not be identified has spread explosively nationwide since the end of April,” the newspaper said. “As of now, up to 187,800 people are being isolated.”

On Saturday, KCNA said a total of 524,440 people 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 cope with a large-scale outbreak?

An outbreak of Covid-19 could prove 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 unwillingness 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 say killed up to 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 medicines that public health officials must focus on preventive medicine. They would be ill-equipped to deal with any kind of epidemic,” said Jean Lee, director of the Hyundai Motor Foundation Center. -Korea for Korean History at the Washington-based Woodrow Wilson Center, he told CNN at the start of the pandemic.

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

Doctors who have defected in recent years often speak of poor working conditions and shortages of everything from medicines to basic health care 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 and 2007, North Korea did not have the resources to operate 24 hours a day in quarantine and isolation. facilities.

He recalled that after identifying suspected cases, the manuals for doctors said that patients should be transferred to a hospital or quarantine center for follow-up.

“The problem in North Korea is that the manuals are not followed. When not enough food was provided for people in hospitals and quarantine facilities, people ran away to find 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 closed all cities and ordered the quarantine of “people with fever or abnormal symptoms”; he also directed the distribution of medical supplies that the government had reportedly stockpiled in case of a Covid emergency, according to KCNA.

Later, Kim 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 check-ups 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 major sectors of the national economy and to stabilize people’s lives as much as possible,” KCNA said.

North Korea announces first Covid deaths amid 'explosive' outbreak

According to KCNA, the politburo criticized the country’s anti-epidemic sector for “carelessness, laxity, irresponsibility and incompetence,” saying it “failed to respond sensitively” to the rise in COVID-19 cases around the world, including in neighboring regions.

A reporter from Chinese state media CGTN posted a rare video from Pyongyang on Friday, recounting his experience on the ground.

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

“Because 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 epidemic measures and medical supplies. He also urged North Korean officials to learn from the “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 vaccine coverage?

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

Assuming most North Koreans are not vaccinated, an outbreak in the country, which has limited testing capabilities, inadequate medical infrastructure and has been cut off from the outside world, could quickly turn deadly.

Calls are mounting for the country’s leaders to provide access to vaccines.

“There is no evidence to show that North Korea has access to enough vaccines to protect its population from COVID-19. However, he has refused millions of doses of AstraZeneca and Sinovac vaccines offered by the WHO-led Covax programme,” Amnesty International said. East Asian researcher Boram Jang, 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 inconceivable negligence in defending the right to health.”

In February, Covax reportedly reduced the number of doses allocated to North Korea because the country failed to arrange any shipments, according to Reuters.

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

“Should the country decide to start an immunization program against covid-19, vaccines could be made available based on Covax target criteria and technical considerations to enable the country to meet international immunization targets,” he said. the spokesman

Joshua Berlinger and Yoonjung Seo of CNN contributed to this report.

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