IE 11 is not supported. For an optimal experience visit our site on another browser.

Covid outbreak in North Korea: What we know, and what we don't know

The outbreak comes as President Joe Biden is set to arrive in Seoul on Friday for a visit to South Korea and Japan, his first trip to Asia since taking office.

For more than two years, North Korea claimed that Covid-19 had not penetrated its borders. That changed last week, when leader Kim Jong Un acknowledged an outbreak of the omicron variant that is spreading “explosively” through the population of 26 million.

As of Wednesday, the country has reported 62 deaths and more than 1.7 million fever cases since the outbreak began in late April, according to The Associated Press. Of those, more than a million people have recovered and almost 700,000 are in quarantine.

The outbreak comes as President Joe Biden is set to arrive in Seoul on Friday for a visit to South Korea and Japan, his first trip to Asia since taking office. The international response to North Korea’s nuclear and missile programs, and now its virus outbreak, will be high on the agenda as he meets with the new leaders of those two countries.

Here’s what we know and don’t know about North Korea’s outbreak. 

How bad is the outbreak?

It’s difficult to know the true extent of the outbreak, not least because North Korea lacks the testing capacity to confirm most infections, labeling them instead as “fever cases.” The true numbers may also be higher because asymptomatic cases are going undetected or officials want to minimize the damage to Kim’s image.

Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said Tuesday that North Korea had not responded to a request for more data about its outbreak.

“WHO is deeply concerned at the risk of further spread of Covid-19 in the country, particularly because the population is unvaccinated and many have underlying conditions, putting them at risk of severe disease and death,” he said at a news conference.

Officials also note that the unchecked spread of the virus in North Korea or elsewhere could lead to the emergence of new variants.

Kim has criticized officials over their handling of the outbreak, citing their “nonpositive attitude, slackness and nonactivity,” The Associated Press said.

According to the website 38 North, the outbreak is concentrated in North Korea’s main cities, including the capital, Pyongyang. About a third of deaths have been among North Koreans 61 and older, and there have been at least eight deaths among infants and children up to 10.

Though Kim has ordered a nationwide lockdown, there are various exceptions for agriculture and other economic activities. May and June are traditionally the best months for planting rice, North Korea’s staple food, and the government doesn’t want to risk worsening food shortages, said Dominique Fraser, a Sydney-based research associate at the Asia Society Policy Institute.

“They realize that this is really serious in terms of food supply,” she said.

Greengrocers carry produce to supply to residents staying home as the state increased measures to stop the spread of illness in Pyongyang on Monday.
Greengrocers carry produce to supply to residents staying home as the state increased measures to stop the spread of illness in Pyongyang on Monday.Jon Chol Jin / AP

Did North Korea really not have an outbreak until now? 

Experts say while it’s unlikely that North Korea previously had no cases at all, it’s conceivable that this is the first major outbreak. Since the start of the pandemic, North Korea’s “zero-Covid” strategy has relied on sealing itself off from the world, with borders firmly shut and almost all trade brought to a halt. 

But the government held some large-scale events in April, including a military parade that involved about 20,000 people and marked the 90th anniversary of the army.

“It does seem like this turned into a superspreader event,” Fraser said. “Since then soldiers from all over the country that took part in that military parade have gone home and come down with this fever.”

What does this mean for Kim?

The outbreak is unlikely to threaten Kim’s rule, but it does present risks, said Christopher Green, a senior consultant on the Korean Peninsula for the International Crisis Group. The outbreak and the measures to contain it cut across economic classes, including the elite in the capital whose support Kim depends on and whose business interests have already been hurt by pandemic restrictions.

“There’s a fair amount of pent-up frustration in Pyongyang at that fact, so if those people are angry or frustrated about their situation then that is always a risk for Kim,” he said.

Though the highly transmissible omicron variant poses a major challenge to Kim’s pandemic strategy, changing course could be awkward for a leader who is portrayed as infallible.

“When a decision is made by the supreme leader, it’s a problem to say that something has stopped working,” Green said. 

Government staff disinfect the floor of Pyongyang station on Tuesday to try to curb the spread of Covid in North Korea's capital.
Government staff disinfect the floor of Pyongyang station on Tuesday to try to curb the spread of Covid in North Korea's capital.KCNA / via AP

Will North Korea receive help?

Throughout the pandemic, North Korea has refused offers of aid from international groups, as well as individual countries like China, Russia and South Korea.

Dr. Michael Ryan, head of the WHO’s emergencies program, said Tuesday that while the organization stood ready to help both North Korea and Eritrea, the only other country that has not yet started vaccinating its population, it “has no special powers to intervene in a sovereign state.”

In the current outbreak, Pyongyang has so far not responded to an offer of help from South Korea’s new conservative president, Yoon Suk-yeol. The United States says while it supports international distribution programs like Covax, it has no plans to share vaccines with North Korea directly. 

There are reports that North Korea has sent aircraft to pick up medical supplies across the border in China, whose strict pandemic response Kim has praised.

“North Korea likes to be able to say that they are self-sustaining and independent, but if external help is necessary at all then it’s so much better to rely on China, which is a military ally of North Korea,” said Tongfi Kim, a senior researcher at the KF-VUB Korea Chair in Brussels.

Kim said the outbreak was an opportunity for the U.S. and other countries to re-engage with North Korea after years of stalled denuclearization talks. But on purely humanitarian grounds, the West should be ready to offer any help that North Korea is willing to accept, even as it prepares for a possible seventh nuclear test, said Ankit Panda, a senior fellow in the nuclear policy program at the Carnegie Endowment for International Peace.

“Quite simply, if North Korea tests its seventh nuclear device at 9 a.m. on a given day and requests pandemic-related assistance at 9:30 a.m., there should be no hesitation in responding positively — even as the nuclear testing should be condemned,” he wrote in Foreign Policy this week.

What does the outbreak mean for North Korea’s weapons testing?

North Korea has been launching weapons at an unusually frequent rate this year, including its first test of an intercontinental ballistic missile since 2017. It is widely expected to test another ICBM or even a nuclear device as early as this month as it tries to force the international community to accept it as a nuclear power and obtain relief from crippling U.S.-led sanctions.

The country tends to become more aggressive when it is unstable internally, Green said, suggesting weapons tests could continue. On the same day it announced the virus outbreak, North Korea launched three short-range ballistic missiles in its 16th round of tests this year.

Employees of Songyo Knitwear Factory wearing face masks work Wednesday to produce knitted goods in Songyo district in Pyongyang.
Employees of Songyo Knitwear Factory wearing face masks work Wednesday to produce knitted goods in Songyo district in Pyongyang. Jon Chol Jin / AP

But the outbreak is a “black swan” event that could change Kim’s calculations, Green cautioned. Weapons tests involve large gatherings of people and, in the interest of slowing virus transmission, Kim may choose to delay further launches until cases have subsided. Testing an ICBM or nuclear device before or during Biden’s Asia trip would also make it much harder for the U.S. to offer assistance with the outbreak.

“We can’t be absolutely certain that past precedent about its [North Korea’s] actions will continue to guide tomorrow’s decisions,” he said.