North Korea says its COVID outbreak is now under control. But is it?

SEOUL — Before May 12, many experts doubted North Korea's claims not to have a single case of COVID-19.

But the country changed its story on that day, admitting its first outbreak although not specifying the number of cases. The following day it reported that 350,000 people had developed fever symptoms with 18,000 cases on May 12 alone.

Two weeks later, the North has reported a total of 3.27 million "fever patients" and 69 deaths. It also claims that 90% of the patients have fully recovered. And on Thursday, the North reported no fatalities for the third day in a row.

Experts are doubting Pyongyang's claim that the numbers – and the government's assertion that the outbreak is now under control.

In fact, North Korea is unable to confirm if the "fever patients," as they call them, have COVID-19 due to its limited testing ability. Only able to conduct a few hundred tests a day out of a population of more than 25 million, "they're flying blind, basically," says Kee Park, a Harvard lecturer and neurosurgeon who has worked in North Korea.

Nevertheless, an editorial in the official Rodong Sinmun newspaper boasted over the weekend that North Korea had set a record for the longest stretch without a single case of COVID-19 in the middle of a global pandemic.

"We stably suppressed and controlled the spread of the virus in a short period in the sudden situation," the editorial claimed, "clearly proving a thousand times that our Party's epidemic policy is right."

That policy included sealing the borders from the start of the pandemic until the resumption of some border trade with China this spring and giving border guards shoot-to-kill orders (one South Korean fisheries official who apparently tried to cross into North Korea by sea was shot to death and his body incinerated at sea). Then following the outbreak announced in May, there was a national lockdown and mobilization of the military to distribute medicine.

But experts argue that Pyongyang is probably understating the outbreak's extent. It's far from over, they say, cautioning that its impact will likely be felt for months to come at least — and that things are likely to get worse if Pyongyang continues to reject foreign donors' offers of vaccines.

Will lockdowns work without vaccines?

But without a supply of vaccines, will the lockdown imposed on May 12 really be effective?

It may slow the virus's spread but not stop it, says Shin Young-jeon, a professor of preventive medicine at Hanyang University in Seoul, who has visited North Korea and advised aid groups on medical exchanges with the North.

COVID-19 cases won't peak until 70-80% of the population has gotten it, he says.

Shin adds that assuming a minimum fatality rate of 0.6% for the omicron strain of the virus — which is the death rate that South Koreans who are not fully vaccinated have experienced — the North can expect over 100,000 deaths from the outbreak.

Others are more optimistic about the impact of a lockdown.

Jeong Eun Mee, an expert on North Korean society at the Korean Institute of National Unification (KINU), a government think-tank in Seoul, notes that North Koreans have long adapted to strict social controls imposed by the government.

"By closing down and isolating residential or work units very fast, I think they could contain the spread relatively fast in the early phase" of the lockdown, Jeong says.

But as in some cities in neighboring China, such as Shanghai, the lockdown has caused considerable hardships for residents.

Residents endure lockdown hardships

Jeong is hearing accounts of distress from defectors whose relatives in North Korea are saying that "they can't go out to a market and buy things when they need them."

Food distribution outside Pyongyang is generally inadequate, and the pandemic has made matters worse and pushed up prices.

"Essentials are in short supply," Jeong adds, "and even if they find a way to obtain basic items, prices have soared more than five times than their typical price," especially outside Pyongyang, as the regime tries to keep elites well-supplied in the capital.

What's more, the lockdown could have an impact on food supplies in the months ahead. Jeong notes that every May, North Korean authorities mobilize urbanites to head to the countryside to plant rice.

That will be difficult under the current lockdown, and a shortfall in agricultural production could last into next year and worsen the malnutrition already affecting some 40% of North Korea's population.

All of these hardships could trigger a groundswell of grousing among the North Korean populace. But Jeong notes that North Korea's leaders are adept at shifting the blame to their own underlings.

"Chastiing officials for failing to act responsibly or engaging in corruption is a typical leadership management tactic North Korea has used in times of crisis," Jeong notes.

Kim Jong Un has already been reported by state media as chewing out health authorities for bungling the government's response to the COVID cases. This month, for example, he criticized cabinet and health officials "for their irresponsible work attitude and organizing and executing ability" in tackling the outbreak.

Why North Korea keeps saying 'no' to vaccines

In recent days, state media have also cast doubts on foreign-made vaccines.

A Rodong Sinmun article opined this week that, while foreign pharmaceutical companies try to produce new jabs to beat new COVID-19 variants, "it is becoming doubtful they will be useful on a global scale."

Such reports may suggest that Pyongyang's resistance to accepting donated foreign shots may be stiffening. North Korea may not want to be seen as relying on outside help — or may be trying to justify their decision not to take donations by casting doubts on the vaccines' effectiveness.

Before the outbreak, North Korea rejected millions of vaccines offered by COVAX, and since the outbreak, South Korea and China have offered vaccines and aid, but not received a response.

But there is the possibility that North Korea is willing to accept aid secretly from China. South Korea's Yonhap News Agency reports that two trains with 30 cars each passed over the border from China into North Korea Thursday night, filled with medical supplies. Reuters now reports that North Korea imported millions of face masks, 1,000 ventilators and possibly vaccines ahead of the current outbreak, according to Chinese customs data.

Hanyang University's Shin Young-jeon argues that both North Korea and donors need to put aside their concerns. Donors are often concerned about donations being diverted to the military, while North Korea resents efforts to monitor the distribution of the donations inside their country.

"I think North Korea has the primary responsibility to accept offers of vaccines," he says, "but now is the time for the donating side to not attach any conditions."

Another part of the problem may be one of poor cultural communication. Shin says that donors must not expect or wait for pleas for assistance that North Koreans are too proud to make.

Then again, there is the possibility that North Korea is willing to accept aid secretly from China. South Korea's Yonhap News Agency reports that two trains with 30 cars each passed over the border from China into North Korea Thursday night, filled with medical supplies. Reuters now reports that North Korea imported millions of face masks, 1,000 ventilators and possibly vaccines ahead of the current outbreak, according to Chinese customs data.

"They've never told me, 'we lack such and such, so please help,'" Shin says. "We need to understand the different language they use."

Shin offers an example of this language, from a North Korean contact.

"A longtime acquaintance once told me: 'Nothing is in short supply. But we need everything.' "

NPR's Se Eun Gong contributed to this report in Seoul. [Copyright 2022 NPR]