Emergency due to "first" cases of covid-19 in North Korea 2:16
Editor's note:
Dr. Kee B. Park (@keepark) is director of the Korea Health Policy Project at Harvard Medical School.
He has worked alongside North Korean doctors on more than 20 visits to North Korea and is a member of the National Committee on North Korea, which facilitates principled engagement between the US and North Korea.
The opinions expressed in this comment belong to the author.
Read more opinions on CNNEE.
(CNN) --
If there's one thing I've learned after performing countless operations alongside surgeons in Pyongyang over the past 15 years, it's that North Koreans waste nothing.
I have used dull scalpel by reuse to make incisions.
I once saw an anesthesiologist use his hands to squeeze a bag every three to four seconds to ventilate a patient for several hours during an operation.
It was business as usual in a place where medical equipment like mechanical ventilators are in short supply.
And I've always admired his ability to work with limited resources.
But now I fear for the safety of doctors and nurses, as well as their ability to deal with the surge of COVID-19 patients in hospitals.
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Last week, North Korea announced the first confirmed case of covid-19 within the country.
Since then, we have learned of at least 1.72 million "fever cases", with about half in quarantine and dozens of deaths so far.
The BA.2 omicron variant was found in at least one of the deaths.
With symptomatic cases accounting for about 7% of the population of 25 million, the Covid-19 outbreak is a disaster for North Korea.
We need to help North Korea immediately.
Since the entire population has yet to be vaccinated, the death toll could be unprecedented.
North Korea, like China, has adopted a zero covid strategy to manage the virus.
To its credit, this strategy of prioritizing preventing the virus from entering its borders seemed highly effective, apparently with no confirmed cases for more than two years.
But the highly transmissible omicron variants changed everything.
China had successfully thwarted the virus until recently, succumbing to drastic lockdowns in several cities, including Shanghai.
Kim Jong Un mobilizes the North Korean army in response to the covid-19 outbreak
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The health situation in North Korea
Now, the virus has penetrated North Korea's defenses.
And the country's relatively weak capacity to respond to the massive outbreak is alarming.
First, they lack medical measures.
The capacity to treat large numbers of patients with severe respiratory disease is limited.
They need oxygen, IV fluids, ventilators, personal protective equipment (especially for healthcare workers), and antibiotics.
But the most valuable items right now are the newly developed antivirals against covid-19.
Paxlovid appears to be effective against the BA.2 omicron variant, can be taken orally, and does not require any special methods of storage and transportation.
We should send these medical countermeasures as soon as possible.
People are dying now, and we can and must help.
Second, their ability to take tests is woefully inadequate.
According to situation reports from the WHO South-East Asia Region office, North Korea has been testing about 1,500 people for Covid-19 every week.
If this is its maximum capacity, it would be impossible to assess the current number of symptomatic patients, which so far is 1.72 million and counting, let alone their contacts.
They also need covid-19 tests to confirm the diagnosis before starting Paxlovid.
We should ship diagnostics in sufficient numbers now;
they are flying blind.
Third, the country suffers from food insecurity.
Lockdowns are hard on people, especially the poorest.
Even stricter isolation measures are expected now that the virus has entered the country.
Immediate food aid is needed to alleviate the hunger of those who lack supplies to get through the closures.
North Korea has not vaccinated its population.
They have turned down vaccine offers, presumably believing they could ride out the pandemic in isolation until it subsides.
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A possible vaccination plan for North Korea
The risk of the virus entering via cargo or infected foreigners bringing it in was not worth it to them despite the benefit that the vaccines would bring.
North Korea was overconfident in its ability to keep the virus away and thus unprepared for the outbreak.
The gap and the subsequent outbreak require a new strategy that can increase the protection of the population against new outbreaks.
mRNA vaccines are effective against the BA.2 omicron variant.
Sufficient quantities of vaccines and deployment supplies must be quickly offered to North Korea.
Our research has shown that North Korea can deploy mRNA vaccines using the existing network of refrigerators.
The first group of people to be vaccinated must be the frontline health personnel, as they face an avalanche of covid-19 patients every day.
In providing assistance to North Korea, the "who" and the "how" are just as important as the "what."
A national crisis requires all actors to work together.
The United Nations is in the best position to coordinate the different agencies, such as the World Health Organization, UNICEF, the World Food Program and non-governmental organizations;
manage complex regulations and logistics;
and to help implement them together with the North Korean government.
Monitoring and evaluation requirements should not be a sticking point right now: people's lives are at stake.
We should also take a caring approach and not demand that North Korea ask for help first.
Our hands must come out first;
your need is clear.
North Korea also needs to become more flexible.
They should not try to manage the crisis by putting together isolated aid packages from individual organizations.
We need a clear focal point of communication to coordinate with the international community.
The obvious counterpart to the United Nations is the DPRK Mission in New York.
To be sure, aid to North Korea is controversial.
On the same day the outbreak was announced, North Korea fired three short-range ballistic missiles.
Maybe we can have a moratorium on any military activity on the Korean peninsula until the outbreak is contained.
Such activity diverts valuable resources and attention from people's urgent needs.
All parties must have their eyes on containing the pandemic.
It is in everyone's interest to help North Korea contain this outbreak and prevent future ones.
North Korea coronavirus
