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Preventing an Outbreak? The Impact of COVID-19 on North Korea

Many nations, as they work to return to a post-pandemic normalcy, are taking a holistic look at the impact of COVID-19 within their borders. North Korea, however, maintains that, despite testing 31,794 people, zero cases have been confirmed within its borders. According to a statement from its Ministry of Foreign Affairs, North Korea’s ability to maintain zero cases within its borders is due to “the measures of isolation and quarantine” taken early enough “by the Party and the government of the DPRK” and the “concerted action and mobilization of the whole society and entire people.” North Korea’s actions, however, were designed to spare a vulnerable health care system from a catastrophic shock rather than ensure quality of life for regular North Koreans.

Roman Harak, CC BY-SA 2.0 , via Wikimedia Commons

North Korea’s healthcare system remains rife with facilities that, according to a 2010 Amnesty International Report, “are decades old and suffer from a lack of upkeep and maintenance.” Hospitals, for example, lack electricity, heat, and running water, while doctors, many of whom are underqualified, are forced to work without pay and, due to a lack of supplies, must rely on patients to bring everything needed for treatment. Another critical issue within North Korea’s health system is a disparity of access. Members of the elite or the North Korean Worker’s Party enjoy privileged access to formal healthcare while others face substantial barriers when attempting to access healthcare in North Korea. In fact, a rising middle class in North Korea is making it harder for poorer areas of the country—areas in which COVID could easily spread—to access adequate healthcare. In short, how much money you have or the strength of your political connections determines whether you live or die.

A healthcare system ripe with vulnerabilities presented the Kim regime with a critical policy conundrum: the regime needed to prevent a large COVID outbreak in North Korea while also ensuring access to the healthcare system for the elite. By taking three critical steps, the Kim regime sought to address this problem.

First, North Korea closed its border to international tourists and travelers. This move benefited the regime in multiple ways. It minimized the possibility of an information leak from international tourists to their home countries and protected the North Korean medical system by preventing COVID-positive foreign travelers from spreading the virus to North Korea. While closing the border may have prevented an early outbreak of COVID-19, it eliminated a critical economic lifeline—international tourists typically bring in about $40 million annually—and made it difficult for the regime to access much-needed technology and know-how to bolster its healthcare system against an outbreak.

Second, North Korea enacted draconian domestic travel restrictions to prevent the spread of the virus. In February 2020, North Korean authorities banned all travel between provinces, prohibited teachers from traveling at all, and erected checkpoints to prevent “any vehicles or persons from transiting the border region to the interior of the country and the other way around.” Though ostensibly designed to stop the potential spread of COVID in North Korea, such policies also ensured that highly privileged citizens—those living in Pyongyang, for example—did not face higher competition when trying to access healthcare services. In short, Kim Jung-un’s travel restrictions limited the ability of regular citizens to travel and access healthcare facilities while ensuring access to those close to the regime.

Finally, the regime enacted strict quarantine regulations for plausible COVID-19 cases within North Korea. Following the complete lockdown of Kaesong in response to a suspected case of COVID, Minjo Choson, a state-media outlet, made public a new “Emergency Quarantine Law,” which outlined three levels of quarantine and lockdown procedures based on the severity of an infectious disease outbreak in the region. Since implementing these regulations, authorities have focused on effectively enforcing them. Violators of the new restrictions are sent to a newly constructed prison, charged with violating party policies, and treated as political prisoners.

Acting in such a manner provided the Kim regime a much-needed political victory; Kim Jung-un was able to effectively stave off a run on the vulnerable healthcare system in North Korea, providing privileged access to the elite. Despite the political victory, North Korea’s COVID prevention measures contributed to a strong retraction of the economy and significant reduction of North Koreans traveling across the border. In a June meeting of the Politburo, Kim Jung-un chastised senior officials over a “grave incident” regarding COVID-19. COVID cases in the countryside may go unreported due to the lack of infrastructure and the inability to accurately diagnose and track COVID in North Korea.

These measures have also impacted regular North Korean citizens in a variety of tertiary ways. Draconian regulations have stunted North Korea’s economic growth and increased the volatility of North Korea’s black-markets. In 2020, the North Korean GDP shrunk by 4.5%. While many factors contributed to such a decrease, the implementation of strict COVID protocols greatly contributed to the worst economic slump under Kim Jung-un. Increased security and travel restrictions are also contributing to a record low number of defections. Since 2019, the number of defectors entering South Korea has decreased 80% per year; only 229 defectors entered South Korea in 2020 and, as of writing, only 36 entered in 2021.

While swift action may have insulated the elite, growing economic concerns have forced the regime to take action. In November, North Korean authorities urged embassies to place import orders, a sign of growing interests in reestablishing connections closed due to the pandemic. While such signs are promising, they will not go far enough to allivate North Korea’s economic malidaies brought on by the regime’s draconian response to COVID.


Benjamin Zimmer

Benjamin is a Master of International Affairs student at The Bush School of Government at Texas A&M University where he focuses on East Asia and intelligence. He is the creator of The Korea Page: News and Analysis from the Korean Peninsula. His research interests include North Korean politics, the North Korea-United States relationship, and nuclear proliferation. His writings have appeared in The Peninsula Report, Foreign Policy Press, and The Sphere. He can be found on twitter at @bzimmer8.

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