The emergency quarantine column appeared at the parade held to commemorate the 90th anniversary of the founding of the Korean People’s Revolutionary Army on April 25. ⓒ Chosun Central TV screen North Korea first made the news of the outbreak of a COVID-19 fever (confirmed person) official on May 12. It’s not May 12, 2020. It is May 12, 2022. According to the Korean Central News Agency, the number of new fever cases per day peaked at 399,920 on May 15, from 18,000 on May 12. Since then, the spread has subsided, and on May 24, the number of fever cases reached 115,970. The number of deaths, which once climbed to 21 a day, gradually decreased, and counted as ‘0’ for two days from May 23. If we look only at the announcement from the North Korean side, North Korea has now passed the hurdle of Corona 19. On May 24, the Korean Central News Agency reported, “In just a few days after the maximum emergency quarantine system was put into operation under the insomnia guidance of the Party Central Committee, the nationwide incidence and mortality rates have significantly decreased, and the number of recovered patients has increased, effectively suppressing the spread of infectious diseases. · It has been managed and a clear stabilization has been maintained.” Vaccination against COVID-19 has not yet been administered in North Korea. How should we understand North Korea’s COVID-19 quarantine, which has externally recorded ‘0 confirmed cases’ and ‘0% vaccination rate’ for the past two years? Did you really pass this (officially) first wave safely? What will be the next wave? Is North Korea-style COVID-19 quarantine sustainable in the future? Why is North Korea’s ‘with corona’ important to South Korea, and how can South Korea help it? Most of the information related to the COVID-19 situation in North Korea is in the fog, but one thing is certain. North Korea was very afraid of COVID-19. A series of measures taken by North Korea since early 2020 support that fact. On January 21, the day after the outbreak of the first confirmed case of a Chinese tourist in South Korea, North Korea notified a travel agency specializing in North Korea in China to ban Chinese entry. From January 22, all borders have been closed. All passageways in contact with the outside, such as roads, railroads, sea roads, and sky roads, were blocked. Since the UN sanctions against North Korea were implemented in 2014, it has also completely stopped people and goods exchanges with China, its only trading partner. A new law was also created. In North Korea, the epidemic prevention method adopted in 1997 already existed. It is a law that specifically specifies the principle of quarantine and blocking of infectious diseases, and how to respond in case of an epidemic. In April 2020, North Korea amended the law. In August 2020, four months later, a new corporation, the ‘Emergency Prevention Act’, was created separately. It stipulated the authority of the National Emergency Quarantine Command, which oversees and directs all projects and activities related to quarantine, mobilizes the military and police to manage infectious diseases in an emergency. It describes in detail the obligations and penalties for violations. Kim Su-yeon, a senior researcher at Seoul National University’s Institute of Health and Environment, who studied North Korea’s emergency quarantine method, said. “In the process of revising the existing infectious disease prevention method, it is presumed that the emergency prevention method was created because it was not enough. It is proof that a pandemic epidemic such as COVID-19 was recognized as a serious national disaster.” North Korea’s strategy was a thorough ‘contain-ment’. The Rodong Sinmun, dated August 2, 2020, said in an editorial: “Strictly blocking and strictly managing all passages and spaces through which the new coronavirus can enter, including borders and seas, is one of the key issues in the emergency quarantine project. (Omitted) If there is even a hole the size of a needle in the project to thoroughly block the flow of infectious diseases, the consequences will be fatal, beyond imagining or recovering.” On May 19, North Korean groups held a press conference calling for the resumption of humanitarian cooperation between the two Koreas to overcome COVID-19. ⓒYonhap News Why North Korea Rejected Vaccine Assistance ‘Mitigation’ was not included in North Korea’s option. Most countries in the world weighed ‘blockade’ and ‘mitigation’ strategies appropriately in consideration of the epidemic situation and social and economic damage at that time. When the epidemic grows, it restricts overseas entry and raises the level of social distancing, but when it calms down, some restrictions are loosened, and when it rises again, it is tightened repeatedly. North Korea has been in a ‘blockade’ for over two years. Why? Because ‘mitigation’ strategies require resources. The basic premise of a mitigation strategy is to accept that a certain number of infected patients will occur. However, it must be managed so that the scale does not grow too explosively, and several health care resources are essential. Consider, for example, Korea’s ‘3T’. Once a test system for diagnosing infection has been established, it should be possible to determine the overall scale of the spread (Test). An administrative system is also needed to conduct epidemiological investigations, quarantine, and support for infected and suspected cases (Trace). Hospitals, doctors, nurses, medicines, and medical devices that can accommodate more than a certain number of patients and treat them appropriately should be sufficient (Treat). Currently, in North Korea, these resources do not exist, are insufficient, or do not function properly. Theoretically, North Korea’s health care system is good for preventing and responding to infectious diseases. Article 48 of North Korea’s ‘Socialist Constitution’ declared preventive medicine as a constitutional value, and Article 3 of the ‘People’s Health Act’ declared that “the basis of socialist medicine is preventive medicine.” Article 1 of North Korea’s ‘Infectious Disease Prevention Act’ states that “We contribute to the elimination of infectious diseases and the protection and promotion of people’s lives and health by strictly establishing the system and order in the detection and isolation of infectious agents, blocking the transmission route, and vaccination against infectious diseases.” Based on the free medical system, a ‘doctor in charge’ with the concept of a primary care physician takes charge of 100 to 150 households and takes care of the health of local residents. But this is a system that works well when the state has money. In North Korea, which has suffered from economic difficulties for a long time, this system is not operating well. There is a shortage of basic medicines such as antibiotics and antipyretics, let alone free medical care, so you have to buy them privately at the market. Even before COVID-19, many North Koreans died from infectious diseases. According to the ‘2019 World Health Estimates’ report by the World Health Organization (WHO), tuberculosis (67.9 per 100,000 population) is the fourth leading cause of death among North Koreans. The WHO’s ‘2021 World Tuberculosis Report’ estimated that there were 135,000 tuberculosis patients in North Korea as of last year. North Korea is also a major source of malaria and parasite infections. Don’t you know the importance of vaccination as much as you have suffered from infectious diseases? But why did North Korea not vaccinate against COVID-19? It is known that North Korea has so far rejected all proposals from the international community to provide COVID-19 vaccines. Is it because of doubts about the effectiveness or safety of the vaccine? On the surface, yes. The Rodong Sinmun published on May 4 last year said, “Vaccines are by no means a universal solution. “Some vaccines can cause side effects, leading to death.” In June, it was reported that the effect of the vaccine may not be sufficient due to the emergence of a mutated virus. Then the position changed slightly. In mid-May of this year, when the COVID-19 outbreak spread on a large scale. The Rodong Sinmun published an article on the treatment of COVID-19 on May 17 that said, “Vaccin (vaccination) should be carried out”, and on May 18, “Vaccination of vaccine is vital” and “Wak-chin is critical to treating seriously ill patients.” It is very effective.” After May 20, when the official number of fevers decreased, the vaccine was again devalued. “Pharmaceutical companies are developing vaccines that can respond to various mutated viruses (viruses), and therapeutic drugs have been developed, but it is questionable whether they can be used on a global scale (<Rodong Sinmun, May 24).” North Korea's unpredictable attitude toward the COVID-19 vaccine should be read by North Korean experts, taking into account the complexity of North Korea's internal affairs and inter-state dynamics. Hong Sang-young, secretary-general of the Korean People's Help Movement, said, "Since the failure of the North Korea-US summit in Hanoi in 2019, North Korea has implemented a policy of living independently without external support, called a 'head-on breakout'. He said, "It would not have been easy to openly accept external support such as vaccines while publicly advertising to the people that the policy was successful, despite having endured it for two years and three months as a containment method even under the Corona 19 situation." There is also an analysis that North Korea does not want to receive a vaccine. However, there were many practical obstacles. A major stumbling block is the amount of vaccines. North Korea's population is about 25 million. A total of 50 million doses are needed to vaccinate all residents twice or more. Last year, the number of vaccines Covax proposed to North Korea was in the range of hundreds of thousands or millions of doses. Kim Shin-gon, president of the Association for Unification Health and Medical Services (professor at Korea University Medical University), said, “It may have been a horribly smaller amount than North Korea had expected.” There is also a story that North Korea wanted mRNA vaccines from Pfizer and Moderna instead of AstraZeneca, Synovec, and Novavax, which were offered assistance. These are vaccines that the 'cold chain' must operate together. Refrigeration and vehicle facilities for this purpose are currently prohibited items from being brought into North Korea under UN sanctions. North Korea also applied to supply a COVID-19 vaccine directly to Kovax early last year. However, it was blocked by the conditions and administrative procedures that followed. Chairman Kim Shin-gon believes that if the international community's 'unconditional' 'large-scale' vaccine support is provided, North Korea will have sufficient will to vaccinate and have sufficient capacity to implement it. Such was the case during the 2006 measles epidemic in North Korea. “The North Korean authorities have vaccinated 3.3 million people a day with the measles vaccine supported by the WHO and UNICEF. If a lot of the COVID-19 vaccine is put in properly, we will probably be able to finish the vaccination within a month.” Currently, the vaccination rate in North Korea is 0%. Under this circumstance, there was a massive outbreak of COVID-19. North Korea propagates that the spread of the virus has stopped at the end of May, but whether you believe it or not, experts predict that the damage to North Koreans will be huge in the future. Shin Young-jeon, a professor of preventive medicine at Hanyang University College of Medicine, said, “Even if the actual graph is broken, it only buys time and cannot reduce the number of final infections and deaths.” “The fatality rate of Omicron is low, but it is different for unvaccinated people. In Korea, the fatality rate of COVID-19 among the unvaccinated population is 0.6%, which is much higher than that of those who have been vaccinated. As in any country, COVID-19 will eventually spread until more than 70% of the population gains immunity through vaccination or natural infection. Compared to the North Korean population, the number of infected is 17.5 million, multiplied by the fatality rate of 0.6%, the number of deaths is over 100,000.” Chairman Shin-Gon Kim also said, "The number of infected people has accumulated to 3 million so far (May 25), but in reality, it is estimated that it has spread on a much larger scale." In his view, North Korea is not without its advantages in terms of prevention and control of COVID-19. Although it does not work well, a health care system exists and the ability and dedication of health care personnel is high. But there are also many disadvantages. Compared to other low-income countries, the proportion of the elderly population is high (10%). Due to the nature of COVID-19, which is particularly deadly for the elderly, many human casualties are expected. In addition, more than 40% of the residents, including infants, are undernourished (United Nations Food and Agriculture Organization and World Health Organization '2021 World Food Security and Nutritional Level report'). Regional disparities are also significant. “It is said that North Korea consists of two republics, Pyongyang and outside Pyongyang. Although Pyongyang has the potential to control the spread and damage to some extent, I am concerned that the vulnerable people living outside Pyongyang will be helplessly damaged.” North Korea's propaganda related to Corona 19 reported by the Korean Central News Agency on May 23. ⓒPyongyang Chosun Central News Agency There is no disagreement that North Korea should be helped under the pretext of 'contributing to the international community's response to the pandemic'. In the 'People's Opinion Poll for Peaceful Reunification' conducted by the Advisory Council for Democratic and Peaceful Reunification in March last year, 74.1% of the people answered that 'they are in favor of providing a COVID-19 vaccine to North Korea after the Korean people have been sufficiently vaccinated.' President Yun Seok-yeol announced on May 13 that he would provide vaccines and other medicines to North Koreans. The joint statement issued by the leaders of the Republic of Korea and the United States on May 21 also contained the policy of North Korea's support for responding to COVID-19. On May 22, Japanese Foreign Minister Yoshimasa Hayashi said, "We do not have diplomatic relations with that country, but we must not leave it alone." But, as always, North Korea refuses to stand in the position of a beneficiary. There has been no response yet to the proposals for aid from South Korea and the international community. As a neighbor who experienced the COVID-19 crisis first, and as a compatriot who longs for peace and reunification on the Korean Peninsula, what attitude should South Korea have toward North Korea? Should we wait for North Korea to reach out on its own and ask for help? Secretary-General Hong Sang-young said, “It should never be condescending or giving any help.” “The government should clearly articulate the route to approach COVID-19 quarantine support separately from military issues. Priorities such as UN sanctions should be resolved in advance so that they can be implemented immediately upon request, and private channels should be actively used.” Chairman Kim Shin-gon said that it is necessary to find creative ways to achieve the common goal of quarantine and denuclearization, while extinguishing the fire in the short term and protecting North Korea's cause and pride in the mid- to long-term. “For example, right now, rapid support of a treatment such as Paxrovid can be of more effective help than a vaccine that takes time to build up immunity. Also, even if it's not a big deal, you can envision a 'small to medium deal' as a long-term roadmap. For example, it is a plan to make the Kaesong Industrial Complex a 'COVID-19 free zone'. The workers there will be first vaccinated, and the Kaesong Industrial Complex will be converted into a production base for quarantine materials to prepare for a new pandemic. If you give North Korea the justification that it can contribute to responding to global pandemic crises in the future, the burden of receiving external support right now will be reduced even in North Korea's situation. If this happens, the mutual trust that has been built through this may bring North Korea back to the international community and lead to a roadmap for denuclearization.”
ssn-general
How South Korea Helps North Korea’s ‘With Corona’
