COVID-19 pandemic in North Korea

North Korea is an impoverished country with a weak healthcare system and is subject to sanctions, rendering it vulnerable in the event of an outbreak.[4][5] There is concern that widespread malnutrition could exacerbate the spread of COVID-19.[2] North Korean public health official Pak Myong-su said that if the disease spread in North Korea, "a serious disaster could not be avoided".[6]

Diplomatically and economically isolated,[2] the country borders China, the starting point of the pandemic, which is North Korea's closest ally, most important trading partner, and a source of tourists.[5][7]

North Korea's government is secretive and the media are tightly controlled, making it hard for outside observers to determine what is really going on in the country.[2]

Historically, North Korea has restricted travel in the face of epidemics abroad, for instance during the 2014 Ebola epidemic.[5] Moreover, the country has had success in disease eradication in the past; it reportedly eliminated measles in 2018.[8][2] North Korea's government is highly totalitarian and maintains strict control over the country and its society, which experts anticipated could help in enforcing disease control measures such as social distancing.[2][9] North Korea also has many doctors for its per capita GDP, though they are less skilled and equipped than their counterparts in the Western World and in South Korea, and a high level of public hygiene.[9]

Some South Korean sources say the pandemic is steadily affecting the country. The virus is more likely to have come into North Korea from China, where the virus originated, than from South Korea. The Chinese-North Korean border restrictions are more relaxed than the heavily militarized border between North and South Korea. However, suspected COVID-19 cases in the two Chinese provinces (Liaoning and Jilin) bordering North Korea have been low.[2]

North Korea prevented the entry of SARS in 2003, and it restricted international travel in 2014 in response to the Western African Ebola virus epidemic.[10]

Masikryong Ski Resort, a popular ski resort in North Korea. Due to the outbreak of the virus, ski resorts and spas in North Korea have been closed.

North Korea was one of the first countries to close borders due to COVID-19.[10] The government has implemented widespread travel restrictions,[11] including closing the border to foreign tourists in late January 2020[5] and then suspending flights and banning travel in and out of the country.[10] Though many parts of the border were closed, the bridge between Dandong and Sinuiju remained open and allowed supplies to be delivered.[12] In late February, the North Korean government said that it would keep the border closed until a cure was found.[13]

The possibility of a COVID-19 outbreak in North Korea is a concern to international organizations and observers due to the country's poverty and low-quality healthcare infrastructure. Outside organizations have provided aid to help the country fight the virus: the Russian government provided test kits,[12] the World Health Organization announced plans to send supplies despite the lack of confirmed cases, and the International Federation of Red Cross and Red Crescent Societies, U.S. State Department, and South Korean government all indicated willingness to help.[2] The U.S. government worked with the United Nations to make exceptions to sanctions, though they were also criticized for slowing down the process for providing aid.[11] Doctors Without Borders said in late March that supplies of diagnostic equipment and personal protective equipment were stranded on the Chinese border.[14]

In early February, the North Korean government took severe measures to block the spread of the coronavirus. Rodong Sinmun, the Workers' Party of Korea newspaper, reported that the customs officials at Nampho port were performing disinfection activities, including placing imported goods in quarantine.[15] All international flights and railway services were suspended in early February, and connections by sea and road were largely closed over the following weeks.[13]

In February, wearing face masks was obligatory and visiting public places such as restaurants was forbidden. Ski resorts and spas were closed and military parades, marathons, and other public events were cancelled.[13]

Schools were closed throughout the country; university students in Pyongyang from elsewhere in the country were confined to their dormitories.[16][17]

North Korean citizens returning from other countries were subjected to a 40-day isolation period to which was added a 30-day "medical observation" period. According to North Korean media, nearly 7,000 North Koreans were subjected to these rules on 1 March.[13]

According to the North Korean government, 10,000 people had been quarantined by the end of March.[7] From 12 February, the 14-day quarantine on all foreigners (including their local staff) was extended to 30 days.[13] Diplomats and other foreigners were evacuated to Vladivostok in March.[11][12] By 27 March, according to North Korean media, there were only two foreigners in quarantine and 2,280 North Koreans were under "medical observation" in areas such as South Phyongan province and North Phyongan province, Ryanggang province, and the city of Rason.[14]

The North Korean military fired five missiles on two occasions in early March 2020, which may be "an effort to ensure the country remains on the agenda for other nations amid the virus outbreak".[2] More missile tests followed in late March, along with an announcement that the Supreme People's Assembly would meet in early April. Foreign observers said the government was trying to show confidence in their handling of the virus.[18] The South Korean military called the provocation "extremely inappropriate" in light of the pandemic.[19]

On 18 March 2020, North Korean leader Kim Jong-un ordered the construction of new hospitals.[20]

Kim Jong-un sent a letter to South Korean president Moon Jae-in as a show of support amidst the outbreak in South Korea.[21] US President Donald Trump wrote a letter to Kim Jong-un to express his willingness to work with him on dealing with COVID-19.[22] North Korean state media has reported on the severity of the outbreak in other countries.[7]

On 31 March 2020, the Asia Times reported that North Korea's measures against the pandemic seemed largely successful.[23] Edwin Salvador, WHO's representative in North Korea, reported that as of 2 April, 709 people had been tested, with no confirmed cases, and 509 people were in quarantine.[24]

On 11 April, Kim Jong-un presided over a meeting of the Politburo of the Workers' Party of Korea. The meeting adopted a joint resolution by the Central Committee, State Affairs Commission and the Cabinet, "On more thoroughly taking national measures for protecting the life and safety of our people from the worldwide epidemic disease". The resolution called to take strict national countermeasures to thoroughly check the inroads of the virus due to the steady spread of the epidemic.[25]

On 23 April, US analyst website 38 North reported that North Korea's early and extensive response appeared to be successful in containing the virus.[3]

In June, North Korea announced its schools were reopening.[26]

Although South Korean media shared news hinting at the spread of the COVID-19 epidemic to North Korea, the WHO denied the veracity of such claims. On 18 February, Rodong Sinmun quoted a public health official reiterating the country had had "no confirmed case of the new coronavirus so far". The WHO prioritised aid for North Korea, including the shipment of protective equipment and supplies.[27]

• Health in North Korea

• Media related to COVID-19 pandemic in North Korea at Wikimedia Commons