North Korea reinstates mask mandate amid fears of winter twindemic

Elderly North Koreans are seen wearing masks during an event held on Oct. 1 to commemorate the International Day for Older Persons in footage from the Korean Central News Agency, North Korea's state media agency. Yonhap

Korean-American neurosurgeon calls for systematic multi-year healthcare support for North Korea

By Kang Hyun-kyung

While South Korea recently has begun to phase-out its mask mandate, the North has gone the opposite. The reclusive state lifted its mask mandate two months ago, and reinstated it from this month, as a preemptive measure against a possible "twindemic" of seasonal influenza and COVID-19 on the coming fall and winter.

The Korean Central News Agency, North Korea's state media agency, aired footage of elderly North Koreans wearing masks while attending an event held on Saturday to commemorate the International Day for Older Persons. Korean Central TV, another state media outlet, also released footage of younger North Koreans wearing masks while at an event for the 76th anniversary of the establishment of Kim Il-sung University.

North Korea's reinstatement of its mask mandate came sooner than what leader Kim Jong-un had been quoted saying earlier. In his speech to the Supreme People's Assembly meeting held on Sept. 8, Kim had said that all North Koreans would be recommended to wear face masks from November.

The swift resumption of the mask mandate is seen as North Korea's version of a preemptive action to prepare for a possible twindemic of a COVID-19 resurgence and the flu spreading simultaneously during this year's flu season.

It also reflects the fact that North Korea has learned a lot amid the COVID-19 pandemic, as the nation has been grappling with several different infectious diseases since earlier this year.

Kee B. Park, a lecturer at Harvard Medical School, said that like other countries, North Korea has begun to rethink their pandemic prevention and response strategies since the COVID-19 outbreak there.

"In the North Korea context, health and humanitarian aid have historically been relatively scant, fragmented and politicized," he said in a recent email interview with The Korea Times.

Park is one of the few outsiders who has an insider's view of the health situation in North Korea, as he has visited the reclusive country more than 20 times since first journeying there in September 2007.

As the director of the Korea Health Policy Project at Harvard Medical School, he has led the research team to understand all of the factors that influence the health of ordinary North Koreans better.

"The geopolitics are complicated and our research is designed to help policymakers by providing options they may not have considered and ways to protect the most vulnerable," he said.

Park's latest visit to the North was in November 2019, years before North Korea reported its first COVID-19 infection in May of this year.

Kee B. Park, a neurosurgeon and lecturer at Harvard Medical School

Park said that no one knows the actual number of COVID-19 infections in the North.

"I don't think they know for sure since they were not able to test at a scale to confirm the COVID-19 cases. There is no way for anyone outside to verify the numbers, including the number of deaths," he said. "What we do know is that the government began to relax some of the restrictions fairly quickly and this suggests that the nationwide outbreak did not result in catastrophic numbers of deaths, which had been expected. There were clearly deaths but not to the level they were bracing for. We also know that they imported large amounts of medical supplies such as medicines and ventilators worth millions of dollars from China this summer as they were claiming victory."

According to South Korea's National Intelligence Service (NIS), the North Korean authorities have launched a massive vaccination campaign on residents living near North Korea-China border areas. The North has flexibly imposed COVID-19 lockdowns followed by then lifting the restrictions, depending on the situation, the spy agency was quoted as saying during a closed-door meeting with the members of the National Assembly Intelligence Committee on Sept. 28.

In May, days after North Korea confirmed its first COVID-19 case, ambiguously referring to it as a case of "fever," President Yoon Suk-yeol proposed humanitarian assistance to the North in an attempt to help it better respond to the spread of infections. Yoon made it clear that the humanitarian assistance has no strings attached.

But the North has not responded to the proposal.

Park speculated that North Korea may have turned a deaf ear to the call from the South Korean president because of the political implications as well as the availability of assistance from its allies, China and Russia.

"What we really need to do is to move toward de-linking critical health and medical aid from political objectives," he said.

As in other countries, Park said that the nationwide COVID-19 outbreak had overwhelmed the North, and retired healthcare workers and the military had been mobilized to help flatten the COVID-19 curve.

He called for international support for multi-year healthcare aid to help improve the situation in the North.

"The package should include COVID-19-related aid, support for health system strengthening, and even technical support for vaccine development and manufacturing and should be protected from political ups and downs by all sides," he said.