North Korea wrestles with worst health crisis

North Korean leader Kim Jong-un inspects a pharmacy in Pyongyang as the country grapples with the COVID-19 pandemic, in this photo released by the Korean Central News Agency (KCNA), Sunday. KCNA-Yonhap

Kim Jong-un orders military to stabilize medicine supplies

By Lee Hyo-jin

The situation in North Korea has gone from bad to worse since the reclusive country confirmed its first official case of BA.2, the "stealth" variant of Omicron, on May 12. The country added 392,920 new cases of fever on Sunday, with eight new deaths. The aggregate number of suspected cases of the coronavirus now stands at 1,213,550, with 50 deaths, according to North Korea's emergency epidemic prevention headquarters.

North Korean leader Kim Jong-un issued an order mobilizing military resources to stabilize medicine supplies, three days after declaring the implementation of a "maximum emergency prevention system." Kim reportedly criticized officials of the public health sector that the medicines procured by the state are not reaching people in a timely and accurate manner.

But the current wave has yet to reach its peak, according to medical experts here.

Oh Myoung-don, an infectious disease specialist at Seoul National University (SNU) Hospital, estimated that the ongoing wave in North Korea would kill at least 34,540 people, based on data on Omicron's fatality from the U.S. Centers for Disease Control and Prevention and the Hong Kong government.

He disclosed such data during a seminar hosted by the Institute for Peace and Unification Studies at SNU, Monday.

In addition, Oh projected that if 30 percent of the North's population is infected, 420,000 people would require hospitalization, and the number would increase to 700,000 if around 50 percent of the population gets infected.

Chon Eun-mi, a respiratory disease specialist at Ewha Woman's University Mokdong Hospital, viewed that the ongoing pandemic would have a devastating impact on North Korea, given that many of the people there are undernourished, and remain unimmunized against COVID-19.

North Korea is one of the world's only two countries not to have launched a vaccination campaign.

According to the latest data from the Food and Agriculture Organization of the United Nations, about 11 million North Koreans, or 42 percent of the population of 25 million, suffered from undernourishment between 2018 and 2020.

"Malnourished patients face a higher risk of death and hospitalization from COVID-19, just as from any other diseases," Chon told The Korea Times. "The situation in North Korea may develop similarly to that of India, where the cumulative number of deaths due to COVID-19 stands at the highest level in the world."

She added that the totalitarian state may be facing a much more serious situation, since it has yet to vaccinate its citizens.

This photo released by Korean Central Television, Monday, shows a broadcast instructing viewers to treat COVID-19 with paracetamol. Yonhap

Chon projected that the fatality rate from COVID-19 in North Korea could reach at least 1 percent, higher than that of many other countries, which stand between 0.05 to 0.1 percent, thanks to the aggressive use of antivirus pills and vaccines.

"Although it's difficult to make accurate predictions due to limited data, the death toll could reach up to 100,000," she said.

The doctor viewed that the most urgent support for the North is the swift provision of self-test kits, as early detection is the first step in containing the virus spread.

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As for the vaccines, Chon said the country should be equipped with enough doses to inoculate its elderly population and people with underlying diseases. But even if it succeeds in vaccinating the priority groups, it would take at least four weeks to see visible effects, she said.

She also commented that none of the treatment options introduced by the North Korean government, such as "interferon alpha 2-b" and other traditional Korean medicines, have been proven to be effective through clinical trials.

Pyongyang's motives behind disclosure of COVID-19 cases

An employee cleans the surface of a display cabinet as part of preventative measures against the coronavirus at the Pyongyang Children's Department Store in Pyongyang, March 18. AFP-Yonhap

There are several questions that have remained unanswered since North Korea officially confirmed its first COVID-19 victim and started disclosing its new infected cases on a daily basis.

Some of those questions are: why did the North, which had claimed it had zero COVID-19 cases, start to disclose its infection cases?; how did the figure surge so sharply within a day since it reported the first case?; is it true that the nation really had zero infection cases at this time when other countries across the world have all been struggling to flatten the curve?

Choi Jung-hoon, a North Korean defector who fled to the South after he finished medical school in the North, gave answers to some of these questions. Choi, now a senior researcher at Korea University's Public Policy Research Institute, focused more on the implications of Pyongyang's decision to disclose its virus situation ― a highly rare admission of a health crisis coming from the reclusive state.

"It seems illogical that no one was infected during the last two years and three months. I think lots of people have already been infected and many likely passed away. And infections could have surged recently after the celebration of the major holidays in April, with the mass events held in Pyongyang," he said.

"So the sudden announcement of infections seems rather intentional. For one thing, the Kim Jong-un regime wants to show the world that the country is capable of genetically sequencing Omicron cases, fighting back claims that their medical capacity is substandard," Choi said.

Choi, who used to be in charge of drawing up antivirus measures for contagious diseases at the sanitation unit in Chongjin before defecting to South Korea in 2012, presumed that the first reported case announced last week couldn't possibly be the first-ever infection.

He said it is an unusual move for Kim to allow state media to report about the current outbreak, which could be interpreted as the regime's failure to prevent the virus spread. He also viewed that the current outbreak may not be as serious as it is being described by the media, as it has not stopped North Korea from pushing forward with major state-led construction projects and missile tests.

"I would assume that the situation was more serious in the first half of 2020, especially when Kim disappeared from public view, prompting rumors that he could be seriously ill, or even dead," Choi said. "There's a high possibility that Pyongyang was going through a serious wave of infections at that time, which forced him to evacuate to a rural area," he said.

But Choi expressed concerns that the totalitarian state is poorly equipped with the tools to diagnose or treat COVID-19, explaining that it has no other option than to rely on draconian lockdowns to contain the spread of the virus.

According to Choi, when a person is suspected of being infected with the virus, he or she is told by the doctor to stay at home, without any medical support.

Will North Korea accept outside help?

South Korean President Yoon Suk-yeol said Monday that the government will offer to send vaccines and other necessary medical supplies if Pyongyang agrees to accept them.

But given that Pyongyang previously turned down offers of pandemic aid, including vaccines from relief groups and the COVAX facility, a global vaccine distribution project, and even from China and Russia, it remains to be seen whether it will welcome South Korea's assistance.

President Yoon Suk-yeol speaks during his first budget speech at the National Assembly, Seoul, Monday. Yonhap

Choi said there is a low chance that the North will respond promptly.

"They could be aware that existing vaccines are less effective against Omicron and new variants, and could be skeptical due to side effects such as heart inflammation and blood clotting," he said. "Unlike in South Korea, these problems cannot be treated in a timely manner there."

"In addition, the belated vaccination campaign could backfire, as residents could complain about why they have to rely on foreign aid, which only shows that their government has failed to develop its own vaccines and treatments," he added.

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