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What we know (and don’t know) about North Korea’s Covid outbreak


North Korea’s first reported Covid-19 outbreak is the “biggest turmoil” to hit the country since its founding more than 70 years ago, leader Kim Jong Un says, as the isolated and impoverished nation crumbles. struggles to curb the spread of a highly transmissible virus. virus that threatens to cause a major humanitarian crisis.

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.

The rising death toll and spike in ‘fever cases’ comes after North Korea said on Thursday it had identified its first ever case of Covid-19 – an alarming development for a country with the one of the most fragile public health systems in the world and a largely unvaccinated population.

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.

Foreign diplomats and aid workers had fled North Korea in droves in 2021 due to shortages of goods and “unprecedented” restrictions on daily life, making it all the more impossible to obtain information from the country other than by the official media.

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:

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

North Korea’s borders have been tightly closed since January 2020 to keep the virus at bay, making the so-called “hermit nation” even more isolated from the world. He even declined 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, it stepped up those efforts, cutting off nearly all trade with China — the country’s biggest trading partner and economic lifeline for the Kim regime — with imports from Beijing falling by 99% from September to October 2020.

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.

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 type of epidemic,” Jean Lee, director of the Hyundai Motor-Korea Foundation’s Korean History Center 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 in a 2020 interview with CNN.

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 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 China’s “advanced and rich quarantine results and experience they have already achieved in their fight against the malicious infectious disease”, according to KCNA.

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 to show 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,” Boram Jang, East Asia researcher at Amnesty International, said 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 Covax target criteria and technical considerations to enable the country to catch up with international vaccination targets. “said the spokesperson.

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