Seoul, South Korea
Choi Jung-hun smiled as I read the latest official Covid-19 figures from North Korean state media: less than 5 million cases of “fever” and just 73 fatalities – a fraction of the death toll of any other country in the world.
“North Koreans call them rubber band statistics,” he said, nodding to Pyongyang’s flexibility with the truth. “It’s difficult even for North Korea to know its own numbers.”
He speaks with some authority. Choi was a doctor in North Korea specializing in infectious diseases for more than 10 years before fleeing his home country in 2011.
He recalls the SARS outbreak of 2002-2004, when he says hundreds of people in the northeastern city of Chongjin, where he worked, died after reporting “cold or flu-like symptoms.”
Doctors like Choi could only suspect SARS was the culprit. North Korea couldn’t test for the disease, so it didn’t officially register any infections. Neighboring China reported more than 5,000 cases and hundreds of deaths.
Choi also recalls dealing with a nationwide outbreak of measles in 2006, armed only with a thermometer; and a 2009 flu pandemic in which even “more people died than during SARS” — a situation exacerbated by an acute shortage of drugs.
During past epidemics, Choi explains, there was never any incentive for local officials to travel from house to house to accurately count cases — they had no masks or gloves, and they thought statistics would be massaged by the regime to meet its needs. meet needs.
He assumes that little has changed since his departure and that history, while not exactly repeating itself, is at least rhyming.
As with past disease outbreaks in North Korea, one of the biggest concerns surrounding the country’s Covid outbreak is that Pyongyang’s penchant for secrecy makes it difficult to accurately gauge its severity.
International NGOs and most foreign embassies have long since left the country, and tightly closed borders make access impossible, making the accounts of defectors like Choi all the more important.
Many were surprised by Pyongyang’s decision in May to admit it was related to an outbreak, though the accuracy of its statements has since been met with skepticism. Early on, leader Kim Jong Un had described the outbreak as the “biggest turmoil” to ever hit the country. Two months and millions of suspected cases later, he claimed “shining success” in stopping the disease.
The incredibly low official death toll the country has reported inevitably raises suspicions that Pyongyang is trying to hide a bigger problem.
“I have some questions,” South Korean Unification Minister Kwon Young-se said sharply last week, noting that the story being circulated by the state media of the north is in stark contrast to the experience of the rest of the world.
The biggest fear initially was that an outbreak in an unvaccinated, malnourished population with primitive health care would be catastrophic.
Tomas Ojea Quintana, UN special rapporteur on human rights in North Korea, said it is currently impossible to know the extent of the outbreak, although he had heard unconfirmed reports of deaths among the elderly and malnourished children.
“In my position, I certainly cannot contrast the fear we had in early 2020 about the catastrophic impact of Covid in (North Korea) and the current situation.”
There are also fears that new, potentially more virulent variants could emerge from uncontrolled transmission through North Korea’s roughly 25 million residents.
dr. Kee B. Park, an American neurosurgeon who: until the pandemic started visited North Korea twice a year to work with North Korean colleagues, train them and conduct operations, saying the country seemed unwilling to share information and that this “wasn’t good for them (and) not good for the rest of the world.”
“We need to share information about any kind of new changes in the characteristics of the virus, for example, mutations, anyway,” he said.
“We need to be aware that high replication can lead to new variants. The only way to discover that is by sharing information with each other.”
In June, North Korea said it was experiencing an outbreak of an unidentified intestinal disease in South Hwanghae province, about 120 kilometers south of the capital Pyongyang.
At the very least, the announcement showed the country’s vulnerability to disease outbreaks and lack of medicines.
Park thinks North Korea may be dealing with an outbreak of typhoid fever or cholera.
“Somewhere like North Korea you can expect high rates of infectious diseases. For children under the age of 5, diarrheal diseases are even the number one cause of death.”
A ray of hope for Park was the country’s ability to vaccinate its population quickly — demonstrated during the nationwide 2006 measles immunization program.
“The first cycle they averaged one million injections per day, and by the second cycle, later in 2007, they averaged over 3 million injections per day,” Park said.
“If all conditions are right, based on those numbers, they can vaccinate the entire population at least for the first shot in eight days.”
But any optimism is dampened by the reluctance of a country sometimes referred to as “the hermit nation” to accept outside help.
“They’re socialized for scarcity,” Park said. “They struggled to provide hospitals with some of the things we take for granted,” he recalls of his time in the country. He said surgeons would reuse equipment like scalpels until they were blunt and useless.
Aid offers from the United Nations, the United States, South Korea and others have all been ignored.
However, some aid has entered the country from China. Customs records show that from January to April, North Korea imported more than 10 million masks, 1,000 ventilators and more than 2,000 kilograms of unspecified vaccines.
Global vaccine alliance Gavi said last month it understood North Korea had accepted Covid vaccines from China and had begun dosing.
A Gavi spokesperson told DailyExpertNews that North Korea has “still not made a formal request to COVAX for vaccine support, but we remain ready to assist if they do.”
The isolation of Covid patients in the country has been highlighted by the recent attempts by an activist group of defectors to send drugs across the demilitarized zone — the de facto border between North and South Korea.
The Fighters to Free North Korea said it sent large balloons with medical supplies like Tylenol and vitamin C across the border in June, as well as some with anti-regime leaflets in late April.
These balloon flights violate South Korean law and are discouraged. Unification Minister Kwon told reporters he “understands the feelings of such organizations, but I think they should abstain.”
Meanwhile, illness — be it Covid or something else — may not be the biggest problem North Koreans face.
A defector, 44, who lives in South Korea, said her family in the north contacted her shortly after the outbreak was reported. Conversely, when it came to Covid, they were most concerned about her – a reflection of Pyongyang’s considerable propaganda power.
“They said [North Korean television had] reported that many people in South Korea were dying from Covid, so they were concerned about me,” she said. “They weren’t very concerned about the virus.”
What her family was very concerned about, however, was the lack of food.
“They told me the food situation was worse than it was during the heavy march in the 1990s…I’m very concerned to know how difficult things were (then).”
The heavy march refers to a period of devastating famine when North Korea’s economy was hit by the collapse of the Soviet Union, which ended the flow of aid to the country.
Hundreds of thousands of people, or as much as 10% of the country’s population, are estimated to have starved to death. According to some estimates, the death toll is even higher.
The defector has not asked her family if anyone is dying of starvation, as she never discusses anything political during these rare contacts with her family. The chance that authorities are listening in is too great. She asked DailyExpertNews not to be identified in case her family faced retaliation.
But Quintana, the UN special rapporteur, said the danger was very real and he urged the Kim regime and others involved with North Korea to “understand in principle that there is a serious risk of starvation in North Korea.”
Whether Kim will listen is another matter.
State-run television has reported on the North Korean leader touring pharmacies, ordering his military to stabilize medical facilities and even donating some of his private medical supplies last month to fight the unidentified gut outbreak.
For Choi, the doctor who fled North Korea in 2011, such images are to be expected if the truth is treated like a rubber band. It’s a show and nothing more, he said.
“North Korean authorities have a hard time, North Korean citizens have a hard time… if you survive that’s great, but there’s nothing we can do if you die.”