South Korean news outlets say the novel coronavirus has spread to North Korea.
Though the country has further isolated itself from the rest of the world, its lack of medical supplies and "crumbling" healthcare system leave it ill-equipped to handle an outbreak, experts say.
Kim Jong Un recently canceled an annual parade that celebrates the founding of the military's armed forces. He did not give an explanation, fueling suspicions about the virus.
"They cannot produce the medicine they need because of the sanctions," a former World Health Organization official told Insider. "Nothing new has come to the country to updates their medicine or technology."
As the rapidly spreading novel coronavirus infects tens of thousands in China and hundreds of others around the world, one country has remained silent about the progress of the virus within its borders: North Korea.
Though North Korean leaders have yet to report any coronavirus cases, several South Korean outlets with sources inside the country report that the virus has arrived. Experts are worried that the poor, isolated country could be devastated by the illness, now officially known as COVID-19.
"There's not enough medicine for the country. I'm really concerned about them facing an outbreak," Nagi Shafik, a former project manager and consultant at the World Health Organization and UNICEF offices in the North Korean capital, Pyongyang, told Insider. "It will be dangerous for them — it could go everywhere."
North Korea has isolated itself even more amid the outbreak
North Korea was one of the first countries to block foreign tourists from entering its borders in response to the coronavirus outbreak. It has since sank deeper into isolation by limiting trade with China — the source of the outbreak — and curbing diplomatic travel into the country in the hopes of keeping COVID-19 from spreading within its borders, The Wall Street Journal reported.
North Korean leader Kim Jong Un's cancellation of an annual parade — often a huge military spectacle reported on by state-run media — without explanation has only flared suspicions that there are coronavirus infections in the country. Experts, however, say it might also be a preventive measure.
"North Korea is on lockdown. The country is on lockdown. And that's saying something," Michael Madden, a nonresident fellow at the Stimson Center who is an expert on the country, told Insider.
Madden said bolstering public health had been a priority for Kim, but it may not be enough to combat the coronavirus.
At least two South Korean media outlets claiming to have sources inside North Korea have reported on possible coronavirus cases in the country.
Chosun Ilbo, one of South Korea's largest newspapers, reported that there were at least two suspected cases of the illness in the city of Sinuiju, which borders China. The South Korea-based Daily North Korea reported that as many as five people had died of the novel coronavirus in the same city. Additionally, coronavirus cases have been confirmed in Japan and South Korea.
Many suspect the coronavirus could have crossed the 880-mile border between China and North Korea, a "porous" border where smugglers often help North Korean defectors escape and exchange goods, according to Chosun Ilbo. A Chinese region near the North Korean border reported its first coronavirus case on January 30, according to the news agency UPI.
North Korean leaders have yet to report any cases of the coronavirus, however. A representative from the World Health Organization told Insider there were no reports of a coronavirus case in the country yet.
The country's isolation measures may not be enough
If the coronavirus were to spread within the borders of North Korea, experts say, its healthcare system would most likely not be equipped to fight it.
Though the North Korean government has asserted that "everyone" in the country "receives medical service of all categories equally, practically and free of charge," a 2010 Amnesty International report called the country's healthcare system "crumbling." The organization found chronic shortages of medicines and medical supplies and decreased access to medical facilities in rural areas.
Shafik, who worked on behalf of the WHO in Pyongyang until 2009, said the country had many trained nurses and doctors, some of whom are sent to other countries to be trained. According to Shafik, while the country has the healthcare infrastructure to handle a health crisis, it most likely lacks the medical supplies to prevent, diagnose, and treat the coronavirus.
He says the country probably doesn't have enough masks and protective clothing to protect its citizens and wouldn't have the laboratory equipment, including chemicals and reagents, to test for the virus.
Wong Maye-E (Associated Press)
While Shafik says North Korea should focus on getting protective gear first, he said the country would also need antibiotics to treat the fatal symptoms of the virus.
"People died from the secondary complication of pneumonia," Shafik added. "You have to have antibiotics. I doubt that they have antibiotics to treat such cases." Though North Korea has the factories to produce the necessary medicine and vaccines to treat the country, Shafik says, international sanctions have stifled medical progress in the country.
"They cannot produce the medicine they need because of the sanctions," Shafik told Insider. "Nothing new has come to the country to updates their medicine or technology. What even is the best doctor without equipment?"
Shafik noted, however, that he believed North Korean leaders would call for help if the situation became dire, as they did with the SARS outbreak, which was also caused by a coronavirus.
Madden echoed that issues with combatting the coronavirus would come down to resources in the country. Madden noted that the treatment would most likely be concentrated on people of better standing in the country.
"There's a massive disparity of its medical treatments in hospitals," Madden told Insider. "They have a caste system. People of a higher caste can receive better medical treatment than people in the lower caste."
Madden, however, believes North Korea is doing what it can to mitigate the spread of the coronavirus. Beyond the measures the country has taken to keep foreigners outside its borders, it has also restricted the movement of goods like rice and sounded alarms about the infection.
"North Korea is taking steps to mitigate coronavirus," Madden told Insider. "They're broadcasting internationally and internally that the government and regime is taking all necessary precautions."
Additionally, the power the country does have at its disposal is the ability to move and quarantine people. China has carried out similar measures, quarantining entire cities and millions of people to prevent the spread of the virus.
But beyond the dangers the virus could pose to the country's population, an outbreak could deal a bigger blow to Kim's delicate authority over the country and its people.
"This is something they can't control," Madden said. "They can control information, population movement, but things like epidemics — that's the kind of stuff that the regime can control — nobody can control it. It could create the image that the regime is not the great powerful Oz. it will cause some fissures that Kim Jong Un would have to deal with personally."
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