‘Fever’ cases spread in North Korea, but hard to say if it’s COVID

A possible second wave of virus could delay reopening of vital trade with China.
By Jieun Kim and Jamin Anderson for RFA Korean
‘Fever’ cases spread in North Korea, but hard to say if it’s COVID Military construction workers known as “stormtroopers” work at a site in central Pyongyang, North Korea in 2015.

A mysterious “fever” has broken out among North Korean “stormtroopers,” or soldiers engaged in construction work, and at least one of them has died from the disease, residents in the country told Radio Free Asia.

The soldiers are apparently coming down with pneumonia and the flu, residents said. Experts cautioned that it was impossible to determine if the outbreak was a second wave of COVID-19 given the lack of transparency about health issues in North Korea.

The fever seems to be spreading mostly among “stormtroopers,” who work and live together in dormitories near construction sites and therefore can easily spread diseases, said a resident of the northern province of Ryanggang province on condition of anonymity for security reasons. 

“Yesterday morning, near Hyesan Station, a 35-year-old stormtrooper was found dead,” he said. “The young man had been mobilized for road construction in Samjiyon county. He had pneumonia and was hospitalized, but they drove him from the hospital when his symptoms did not improve. He died on the road near Hyesan Station on his way home.”

If it is an outbreak of COVID, that would likely delay the full opening of the border with China, a vital trading partner, and lengthen North Korea’s economic hardship. So far, it had been opened to sea, rail, and limited truck freight.

A South Korean expert on health in North Korea said identifying the disease was impossible now, but COVID-19 could not be ruled out.

I think the flu could be more likely,” said Ahn Kyungsoo, head of dprkhealth.org, a website that monitors health issues in North Korea. From the perspective of the North Korean authorities, even if it is COVID-19, it is difficult to distinguish it from a cold with body aches.”

And North Korea is not known to have easy access to many testing kits.

A recent resurgence of COVID-19 in China could easily spread to North Korea, said Greg Scarlatoiu, executive director at the Washington-based Committee for Human Rights in North Korea.

“Most of North Korea’s border is with China,” said Scarlotoiu. “Exchanges are at a level lower than before COVID, but the danger of contamination is there and is a possibility, a probability that Covid may resurge in North Korea as well.”

The World Health Organization did not respond to inquiries from RFA, and UNICEF told RFA that it has not received any report of an increase in fever or COVID-19 cases in the country. The organization said it does not maintain a presence in North Korea but would be willing to return should Pyongyang request it.

Past denials

For many months after the pandemic’s global outbreak in late 2019 and 2020, North Korea denied it had any COVID-19 cases. It closed its border with China in January 2020 and suspended all trade to prevent the virus from entering North Korea. 

For the next two years, Pyongyang outwardly claimed that its preventative measures had kept the country 100% virus free. 

In May 2022, Pyongyang finally admitted that a major outbreak of the disease began when troops from various parts of the country gathered in the capital for a military parade and transmitted it to others when they returned to their units. 

Authorities then began taking official tallies of “fever cases,” which observer organizations speculated was due to a lack of reliable COVID-19 testing. 

For the duration of last year’s emergency, government data showed that 4.7 million people, or 18.5% of the population, experienced fever symptoms and 74 people died. But the accuracy of those figures is questionable because the government never explained how it classified cases or collected the data, the Washington-based Stimson Center’s 38 North project said.

Adding to the opaqueness, those who had died of coronavirus-related symptoms in North Korean hospitals were quickly cremated, and their cause of death was said to be anything but COVID-19, usually pneumonia or other respiratory disease.

Pyongyang fever

Fever cases have re-emerged in the capital, too, a resident of the northwestern province of North Pyongan said.

“My acquaintance’s son is serving [as a stormtrooper] in Pyongyang, and he told his parents on the phone that a fever was circulating there,” he said. 

Another resident of the province said that the disease is coming to the capital as soldiers transfer in from the provinces to work on Kim Jong Un’s ambitious residential housing project meant to build 10,000 new homes per year and 50,000 in total by 2025. 

“Recently the stormtroopers who are mobilized to build houses in Pyongyang have been in need of medicines and medical expenses,” he said. 

“Many fever patients came from the assault brigade of stormtroopers in North Pyongan Province, which was mobilized to build 4,200 new apartment units here,” he said. “A temporary hospital ward was set up and a police force was organized to control quarantined patients from getting out.” 

North Korean soldiers walk to a construction site along the Yalu River near the town of Sinuiju in 2006. Credit: Reuters

The second resident said that authorities are setting up isolation wards there and in other provinces.

“The state is supposed to take responsibility for soldiers at construction sites by providing medicines and injections, but the stormtroopers are given only temporary first aid, like antipyretics and cold medicines,” he said. 

“There is a stormtrooper in the South Pyongan brigade who I am close to and he is building an apartment next door. He also has a fever and is isolated in a temporary ward.”

Military police in the capital are enforcing quarantine rules on soldiers and ordinary police, as well as citizens, requiring everyone to wear masks while out in public, the second North Pyongan resident said.

“At the same time, drugs used for COVID-19 symptoms … are sold at high prices at pharmacies and markets in downtown Sinuiju,” he said, referring to the northeastern North Korean city that serves as the gateway to China. “This is clear evidence that the fever continues to spread among the general population of Sinuiju.”

“I can’t understand the behavior of the authorities who are forcing collective labor at a time when the fever is spreading so fast,” he said.

Soldiers are given priority in medical centers when they come down with symptoms, but residents must spend sizable amounts of money to buy medicine, injections or masks needed for self care. Health authorities are at least engaging with the community, holding lectures on handwashing and social distancing, and the proper way to use masks.

“They are saying prevention is more important than treatment to eradicate the fever,” he said. “This month, the seriousness of this round of fever is becoming a reality …  It is difficult to purchase medicines for fever, even in pharmacies and marketplaces because the price has risen significantly,” he said.

Prices for antibiotics, cough suppressants, general cold medicines, and paracetamol – all used to treat COVID-19 symptoms – have risen by 20-50% this month, he said.

China resurgence

A COVID-19 resurgence in China will likely slow the reopening of trade with China, said Troy Stangarone, the Senior Director and Fellow at the Washington-based Korea Economic Institute. 

“Given that [the resurgence] is only expected to infect 65 million people, it is unlikely to bring trade to a halt,” said Stangarone. “However, because new infections could spread from China, North Korea will need to invest more in medicines and healthcare.”

Regarding the likelihood of a major outbreak in North Korea, Scarlatoiu said North Korea is particularly vulnerable. 

“Their overall human security status is very precarious. In particular, food security, economic security and health security,” he said. “You’re talking about a population that’s already suffering from micronutrient deficiencies. A population where ⅓ of children are malnourished.”

Stangarone pointed out that people who have already had the disease can contract a new strain.

“Given North Korea’s vulnerable healthcare system and that its population has only gone through one declared wave, the circumstances for a second wave in North Korea are potentially in place as trade resumes with China,” he said.

Translated by Leejin J. Chung and Claire Shinyoung Oh Lee. Written in English by Eugene Whong. Edited by Malcolm Foster.


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