North Korean authorities suggested in January that they were moving to “advanced, people-friendly” quarantine protocols, but they are still taking intensive measures regarding disease control. An expert says North Korea could face a pandemic crisis even as the world moves into the endemic stage.

Jung Jae-hun, a professor in the Department of Preventive Medicine of Gachon University’s College of Medicine, recently told Daily NK that a large-scale outbreak in North Korea is inevitable given its low vaccination rate and low levels of immunity.

This suggests that even after the border is reopened after the COVID-19 pandemic ends, stopping the virus from entering the country and infecting people will prove difficult.

In particular, Jung said because North Korea’s medical environment is antiquated, an outbreak of COVID-19 could lead to serious harm.

In a recent report on North Korea’s COVID-19 lockdown, US-based Center for Strategic and International Studies (CSIS) also said a mass outbreak of COVID-19 in North Korea would have no short-term solution because North Koreans have no immunity to infection and few vaccinations were carried out.

The report said North Korea apparently had no choice but to enact tough lockdown quarantine measures because it lacks a medical system that can deal with COVID-19.

Some people even say dramatic lockdowns were the best quarantine policy the North Korean authorities could adopt.

In a telephone conversation with Daily NK, Choe Jeong-hun, a senior researcher at Korea University’s Public Policy Research Institute, said the border closure and travel bans have caused major economic damage, while city lockdowns and coercive quarantines have caused deaths. However, he said considering North Korea’s dire internal situation, shutdowns might have been North Korea’s best available option. 

Prior to the development of the vaccines, all nations found that minimizing infections though isolation and movement bans was the most effective quarantine policy. In the end, it was effective for North Korea, too, given how difficult containing the damage would be if the coronavirus entered the country.

Despite this, experts say “zero COVID” policies like those pushed by North Korea and China cannot keep infections at zero forever, even if they do delay an outbreak.

This is because even after a virus acclimatizes and herd immunity emerges, the virus does not completely disappear.

On social media on Mar. 1, Jung said you can control an outbreak through policy in temporary circumstances, but you cannot do so over the long haul. He said the only long-term alternative is to build up immunity through vaccinations and infections.

The problem is North Korean authorities are refusing vaccine assistance, and they are using the border closure and movement bans as means of internal control.

The international vaccine distribution initiative COVAX Facility earmarked 8.11 million doses of AstraZeneca for North Korea last year. However, Pyongyang refused to accept them, taking issue with both the kind and amount of the vaccine offered.

This year, US drug maker Novavax allotted 252,000 doses of its vaccine for North Korea, but North Korea has yet to indicate it will accept them.

CSIS said in its recent report that North Korea apparently worries that if it accepts the vaccines, it may have to accept monitoring demands, or that introduction of the vaccines could be tied to other matters such as denuclearization talks.

The report also mentioned a possible solution, namely, monitoring that highlights “technical support” or the deployment to North Korea of at least one “humanitarian activist” to head monitoring activities.

Voice of America reported on Mar. 16 that the UN Security Council Sanctions Committee on North Korea accepted UNICEF’s application for a sanctions exemption to ship vaccine storage equipment to North Korea.

North Korea’s attitude regarding shipments of vaccine-related equipment bears watching. Only two nations have yet to begin mass vaccinations: North Korea and Eritrea.

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