A man watches a television screen showing news footage of North Korean leader Kim Jong Un attending the 8th congress of the ruling Workers' Party held in Pyongyang, at a railway station in Seoul on January 6, 2021. Photo: AFP / Jung Yeon-je

Around the world, many nations are examining the overall impact of the Covid-19 pandemic. North Korea, however, maintains that although it has tested people – 42,095 of them, as of October 11 – zero cases have been confirmed within its borders.

According to a Ministry of Foreign Affairs statement early in the pandemic, North Korea’s ability to maintain zero cases within its borders was 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.”

Kim Jung Un has continued to boast of a special North Korea sauce. Last month he called for an epidemic prevention campaign in “our style.”

To many outsiders, meanwhile, rather than a normal country’s systematic effort to ensure good quality of life for all its people, the Pyongyang regime’s actions look more like an ad hoc, desperate scheme to do something, anything, to spare a vulnerable health care system from catastrophic shocks.

American football has a term for such a last-ditch response: “Hail Mary pass.” (Translation: Throw the ball high and pray that your team’s receiver will be in the right place to catch it.)

When an Amnesty International report came out 11 years ago, North Korea already was stuck with healthcare facilities that the report said were “decades old,” and that suffered from “a lack of upkeep and maintenance.”

Reports since then indicate further deterioration. Hospitals, for example, lack electricity, heat and running water while doctors, many of whom are underqualified, are forced to work without pay. Due to a lack of supplies, they 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 North Korean Worker’s Party enjoy privileged access to formal healthcare while non-elite citizens face strong barriers when attempting to access healthcare.

North Korean medical students wearing face masks disinfect their hands and undergo a temperature check as they arrive for a lecture on preventive measures against Covid-19 at the Pyongyang University of Medicine in the capital. Photo: AFP / Kim Won Jin

A rising middle class in North Korea is making it harder for ordinary people living in poorer areas of the country – areas in which Covid-19 could easily spread – to access adequate healthcare. It’s not only the strength of your political connections but also how much money you have that will determine whether you live or die.

A healthcare system with grave vulnerabilities presented the Kim regime with a critical policy conundrum: The regime needed to prevent a large Covid-19 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, as the Coronavirus started to spread in China, North Korea closed its border to international tourists and travel. This move benefited the regime in multiple ways. Apart from public health, it minimized the possibility of leaks of restricted information – which in North Korea is most information – by international tourists to their home countries. Meanwhile, it protected the North Korean medical system by preventing the virus from being brought into the country unknowingly.

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 yearly – and made it difficult for the regime to access much-needed technology and know-how to bolster its healthcare system against an outbreak.

Second, in the months following the international ban, 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, and worked to prevent “any vehicles or persons from transiting the border region to the interior of the country and the other way around.”

In this photo taken on October 29, 2020, a public security officer uses a red flag to stop a taxi for disinfection as part of preventative measures against the coronavirus, on a road at the entrance to Wonsan, Kangwon Province. Photo: AFP / Kim Won Jin

Such policies, although ostensibly designed to stop the potential spread of Covid in North Korea, also ensured that highly privileged citizens – those living in the capital, Pyongyang, in particular – did not face higher competition when trying to access healthcare services. In short, Kim Jong 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 to deal with plausible – if formally unacknowledged – Covid-19 cases within North Korea. Following the complete lockdown of Kaesong in response to a suspected case, Minju Choson, a government-run newspaper, made public a new “Emergency Quarantine Law” that outlined three levels of quarantine and lockdown procedures based on the severity of an infectious disease outbreak in a region.

Since implementing these regulations, authorities have focused on effectively enforcing them. Violators of the new restrictions reportedly 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 Jong Un was able to effectively stave off a run on the vulnerable healthcare system in North Korea while continuing to provide privileged access to the elite.

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 this writing, only 36 have entered in 2021.

Regardless of the political victory, North Korea’s Covid prevention measures are impacting the country negatively. In a June meeting of the Politburo, Kim chastised senior officials over a “grave incident” regarding Covid-19. It is also possible that Covid cases in the countryside go unreported due to lack of infrastructure and the widespread inability of the medical system to accurately diagnose and track the virus in North Korea.

While swift action may have insulated the elite from the pandemic, these measures have also impacted regular North Korean citizens in a variety of ways. Foremost among them, draconian trade restrictions intended to keep the virus from crossing borders into the country have stunted the economy.

In 2020, GDP shrank by an estimated 4.5%. While many factors are behind such a decrease, the implementation of strict Covid protocols greatly contributed to the worst economic slump of the Kim Jong Un era.

Unless the regime clearly addresses such issues, North Korea’s economic maladies may well worsen before they improve. It’s probably premature to congratulate Kim for scoring via that Hail Mary pass since the game’s not over yet.

Texas-based Benjamin Zimmer is the creator and author of a blog, 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 Security Challenges, NKNews, Asia Times, Charged Affairs, and The Peninsula Report, among others. He can be found on Twitter at @bzimmer8.

Benjamin Zimmer

Benjamin Zimmer is a program assistant at the Bush School of Government and Public Service at Texas A&M University, where his research centers on East Asian security with a focus on the Korean Peninsula. His writings have appeared in various publications, including Security Challenges, Charged Affairs, and the Houston Chronicle.