Covid-19 is spreading like wildfire in North Korea

JUST OVER a week after North Korea recorded its first case of covid-19, on May 8th, the official case count had risen to 168 infections and one death. That would be a creditable feat of containment were it not for the nearly 1.5m cases of “fever”, responsible for another 56 deaths, that the country has also reported. Given the speed of the spread, it is all but certain that North Korea is being ravaged by an outbreak of the highly infectious Omicron variant.

One theory for the two-tier system of reporting cases is that authorities are using “fever” as a ploy to disguise the seriousness of the crisis. But the more likely, and worrying, reason is that the regime is using temperature as a proxy because it lacks the testing infrastructure necessary to confirm diagnoses of covid.

For more than two years, North Korea has shut itself off from the world and hoped that the pandemic would simply go away. It sealed its already tight borders as early as January 2020, putting a near halt to trade with China, including of vital medical supplies. Yet instead of using that time to immunise its population or build up health-care capacity for an eventual outbreak, the regime just sat on its hands.

Worse, North Korea has consistently refused offers of jabs from abroad; not one of its people is known to be vaccinated. The shutdown of trade further immiserated an already miserable population. Hunger is rampant. Lack of testing and the regime’s history of duplicity make its numbers hard to trust, so it is difficult to model how bad the outbreak might be. But the toll it exacts is likely to be high.

On May 13th Yoon Suk-yeol, South Korea’s president, offered vaccines and other medical supplies. In a budget speech a few days later he repeated that his country “will not spare any necessary support” to help its neighbour. But the North has so far demurred. South Korea’s Ministry of Unification said it had received no response to a fax offering help. The World Health Organisation (WHO) said it has been in touch with North Korean authorities, but has yet to receive an official report regarding the outbreak.

It may be politically difficult for Kim Jong Un, North Korea’s dictator, to reverse course on accepting vaccines from the South. His claim to legitimacy is derived from the state’s foundational myth that his family is the sole protector of the North Korean people from the tyrannical yoke of America and its lackeys. To accept aid directly from the country’s enemies would give that myth the lie.

There are signs that Mr Kim may, however, be willing to accept help from China. South Korean media outlets have reported that North Korea wants to begin talks with its patron. China’s foreign ministry says the country is “ready to go all out” to help contain the virus. Kyunghyang Shinmun, a South Korean outlet, reported that North Korea dispatched three planes to retrieve medical supplies from China.

In the meantime, North Korea claims to have mobilised 1.3m people and set up “epidemic prevention posts”. The army has been deployed to stabilise the supply of medicines to Pyongyang, the capital, and enforce quarantines. Mr Kim has also been quick to find scapegoats for the spread of the virus, saying apparatchiks and health-care workers “have not rolled up their sleeves” and distributed drugs in a timely fashion.

The state is also producing guidance so that citizens can treat themselves. Rodong Sinmun, a party organ, advises a range of DIY treatments, including ibuprofen, a painkiller used to reduce fever, cheongsimhwan, a traditional Korean herbal medicine, and rinsing one’s mouth with salt water, ostensibly as a disinfectant. It also recommends a diet rich in fresh fruit and vegetables and proteins such as meat and shrimp.

Though a varied and nutritious diet is good advice in most circumstances, covid or no covid, it is less helpful in a country where many citizens are struggling to consume their daily minimum of calories. Long-running food shortages have been exacerbated by the rising cost of staples such as corn and rice and an ongoing drought threatens to prolong scarcity. This puts the regime in a bind. Though Mr Kim has ordered the country to “thoroughly lock down”, forcing people to stop work could pose a risk to the upcoming rice harvest, potentially resulting in yet more deaths from malnutrition. As of May 16th farmers could still be seen tending their rice fields from across the border with South Korea.

One effect of having avoided an outbreak so far is that North Koreans have developed no immunity to covid through prior infection. The prevalence of tuberculosis and malnutrition, both of which are associated with increased risk from covid, increases the urgency of getting shots into arms. One way to persuade Mr Kim to accept vaccines from his enemies is for South Korea and other countries to co-ordinate their efforts through the WHO, from which North Korea has previously accepted help in the fight against other diseases, such as measles and polio. That would help Mr Kim save face. More importantly, it would help save North Korean lives. ■

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