North Koreans have been warned that “not even a tiny crack or mistake is allowed when it comes to emergency quarantining”, as the country persists with the extreme isolation policy that it imposed at the beginning of the coronavirus pandemic.
“Stay vigilant and strictly abide by quarantine regulations,” said a report this week in state newspaper Rodong Sinmun, reminding citizens to wear face masks and ventilate indoor areas.
“Even if the mistake was as negligible as the tip of a needle, it could deal a critical blow to the country’s quarantine bases. Emergency quarantining is currently the foremost priority in our country,” it added.
While in China, panicked local authorities have imposed lockdowns in response to Omicron outbreaks in several cities, Pyongyang maintains it has kept its population Covid-free by sealing the country's borders.
Information from inside North Korea is scarce, but the government is not believed to have confined citizens across the country to their homes. North Korea and Eritrea are the only two countries that have not initiated a Covid-19 vaccination programme.
Pyongyang’s claims that it has not recorded a single case have been widely ridiculed. But experts have argued that while it was highly unlikely that the country had no infections at all, no evidence had emerged of any large-scale outbreaks.
Kee Park, a lecturer at Harvard Medical School who has worked inside North Korea, said the country had proved successful in keeping the virus out but that its approach would ultimately prove unsustainable.
“A prolonged lockdown will lead to increased excess deaths – caused by poor nutrition, food shortages, increasing poverty, degradation of health systems and the loss of humanitarian aid – that will eventually exceed the number of deaths caused by the virus itself,” said Park.
“China shows you can’t have even a limited opening without the virus spreading,” Park added. “North Korea is going to have to open and I think they’re going to be able to manage it, but they will need an aggressive vaccination programme.”
North Korea's leader Kim Jong-un reacted decisively to the emergence of coronavirus in early 2020, sealing borders with China and Russia, tightening restrictions on internal movement and ejecting foreign diplomats and aid workers.
Since then, the country has allowed only very limited transport of freight from China, which must pass through specially-constructed disinfection centres.
Kim’s measures intensified the fallout from international sanctions imposed on North Korea in response to illicit nuclear and ballistic missile tests in 2017, as well as the effects of a series of droughts and floods.
The North Korean regime has acknowledged the existence of a “food crisis”, even last year extolling the virtues of the meat of black swans reared in state-run duck farms.
The country's economy contracted 4.5 per cent in 2020, according to estimates from the Bank of Korea in Seoul, its sharpest decline since a famine killed millions of people in the 1990s.
Vaccines refused
Andrei Lankov, a North Korea expert and professor of history at Kookmin University in Seoul, said the regime's approach to the pandemic reflected a rational appraisal of the limitations of its own health system.
“North Korea is perhaps the best-placed country worldwide to do a quarantine-based policy because they have controlled the domestic movement of the population for decades,” said Lankov.
“They can close their borders completely without the need to worry about domestic political discontent and they are doing it because they assume that if there is an outbreak then many people [will] die because their health system will be unable to cope.”
More than two years after imposing the border lockout, Kim has not initiated a Covid-19 vaccination programme and has refused deliveries of Russian and Chinese vaccines offered through the World Health Organisation’s Covax programme.
Park said North Korea’s rejection of vaccines did not reflect hostility to inoculations but rather its scepticism over the efficacy and safety of the jabs offered through Covax.
"They're not turning down all vaccines, they're turning down the vaccines they feel are inferior," said Park, noting that North Korea had also expressed concerns over the safety of AstraZeneca jabs.
Before the pandemic struck, between 95 and 97 per cent of North Korea’s 25 million people were routinely immunised against diseases, including measles and polio, he added.
"I can say categorically that they do want vaccines," he said. "If they're provided with mRNA vaccines like Pfizer or Moderna and in a sufficient amount to vaccinate their population, including the booster dose, I think the reply will be different."
North Korea had the potential to develop its own vaccines, although it would struggle to test them on a Covid-free population, Park added.
South Korean intelligence officials have accused North Korean hackers of attempting to steal information on coronavirus vaccines and treatments from companies such as Pfizer, Johnson & Johnson and Novavax.
Even if it somehow acquired tens of millions of mRNA vaccines, North Korea probably did not have the “cold-chain” infrastructure for them to be stored and distributed around the country, said a western diplomat.
A recent report by the Center for Strategic and International Studies think-tank in Washington outlined several factors that could encourage Pyongyang to change course. These included the easing of restrictions in China and South Korea, a worsening food crisis and the emergence of a new coronavirus variant.
“Rather than ending the lockdown, the regime may manage ongoing health and food crises through small and sporadic openings ... with the release of some shipments of humanitarian aid and a limited resumption of trade with China,” said the report.
Eric Feigl-Ding, an epidemiologist at the New England Complex Systems Institute, warned that however Pyongyang chose to proceed, it could not keep the virus out forever.
“China’s experience shows that what used to work against a less contagious strain may not work any more,” he said. “The North Koreans could get lucky for another few months but their luck will eventually run out.” – Copyright The Financial Times Limited 2022