“We assume the situation is getting worse, not better,” said Michael Ryan, emergencies chief of the World Health Organization (WHO), addressing the COVID-19 situation in North Korea on June 1.

On May 12, the state-run Korea Central News Agency (KCNA) reported the presence of the Omicron variant in Pyeongchang, marking the first public acknowledgment of COVID-19 in the notoriously secretive country. President Kim Jong-un subsequently enacted lockdown measures, but the administration eased restrictions, citing low case counts.

On May 15, KCNA reported close to 400,000 new “fever” cases, but the daily case count has since fallen to less than 10,000. In addition, KCNA has reported a total of 71 "fever deaths," but only two deaths due to COVID-19 and one death as a result of fever since the beginning of June. Public health officials have cast doubt on the miraculous public health success story that state statistics spell out. Prior to May 12, many doubted the absence of COVID-19 in North Korea given the country’s shared borders with Russia and China as well as its poor health infrastructure – especially outside of Pyeongchang, where hospitals often lack medicine and supplies. Now, health organizations like the WHO operate under the assumption that North Korea may become a breeding ground for infections and new variants because the country has no vaccination program.

Throughout the past decades, North Korea has adopted a policy of isolationism and censorship across the board; the government has criticized what it views as Western interference in matters ranging from nuclear weapons development, to extrajudicial killings and labeled humanitarian aid as an extension of underhanded diplomacy, meant to create political dependency. The government tightly controls the flow of information across its borders by limiting freedom of the press, so little confirmed information exists regarding the country’s common access to resources and quality of life. For example, the United Nations estimated that 11 million people, roughly 40 percent of the population, were malnourished in 2019. That number has likely increased due to food shortages caused by the pandemic and closed borders, but global bodies can only estimate the high hunger and poverty rates; the last census was published in 2008.

The COVID-19 situation is a prime example of how such a political approach may come at the cost of civilian lives. Here too, little information exists, but it's likely that, by and large, the North Korean populace is unprotected from the virus since there is currently no state-sponsored mass immunization program, and though there is evidence the government received a small amount of the Sinovac vaccine from China in February, the government has rejected all other offers of assistance with vaccination from international organizations and individual countries alike. North Korea is not a part of the Access to COVID-19 (ACT) Accelerator initiative sponsored by the WHO and other organizations. The initiative's COVID-19 Vaccines Global Access (COVAX) pillar covers the global distribution of vaccines scientifically proven to reduce hospitalization and mortality rates, and, in September of last year, North Korea rejected millions of Sinovac doses along with AstraZeneca vaccines paid for by COVAX. According to the chief of emergencies, the WHO has offered vaccines three times and continues to offer vaccines, treatments, and medical supplies, albeit in vain. During a visit to South Korea in May, U.S. President Joe Biden confirmed receiving a similar nonresponse, and an article published last year by the North Korean Ministry of Foreign Affairs decried U.S. humanitarian aid as part of a "sinister political scheme." Certainly, North Korea's actions and replies to international invitations have clarified the country's desire to be self-sufficient and its stance against South Korea as well as the other country's democratic allies. However, this approach is problematic as government statistics may not reflect reality. There may be many more people affected by COVID-19 than the published statistics suggest - and correspondingly, many more cases and deaths that will be swept under the carpet as government officials continue to insist that the pandemic has been resolved.

Even if government rhetoric asserting that outbreaks have been contained and that no further action is necessary rings true, the status quo leaves the majority of North Koreans without adequate protection from future variants and recovering patients without potentially life-saving resources. COVID-19 is a mutating virus; as is the case with every disease, the chance of reinfection rises with each subsequent variant more unfamiliar to the body. While the vaccines unavailable to North Koreans cannot offer complete protection from new variants, they can offer partial immunity and, again, reduce hospitalization and mortality rates to lessen the strain on healthcare systems. Continuing, the ACT initiative oversees the development and global distribution of not just vaccines but also diagnostic kits, medications, and medical supplies. Typically, the unvaccinated need more care, whether that translates to breathing machines or antiviral drugs, but North Korean hospitals may lack the resources needed to treat vulnerable patients, especially in rural areas. The net result is preventative and remedial treatments that are only available to wealthy North Koreans if they travel to other countries; North Korea will be a state wherein socioeconomic circumstances determine health outcomes.

In North Korea, the issuing of geopolitical statements takes precedence over preserving the safety and well-being of citizens. Political and social factors converge to strip agency from all but a select group with the money and resources to cross borders in a land dispute. The pandemic has thrown North Korea in sharp contrast to other countries demonstrating transparency and a willingness to participate in global programs, and the situation at hand is perhaps best seen as a harsh reminder that, ultimately, it's people trapped in unfair situations who suffer the consequences of political conflicts.

Editors: Cydney V., Blenda Y., Rachel C., Evie F.

This article was originally written in July 2022

Image Credits: Kim Won Jin—AFP/Getty Images

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