North Korea is in a state of emergency as Covid-19 spreads rapidly in the isolationist country, reports say.

According to the Korean Central News Agency (KCNA), the number of newly “feverish” people surged from 18,000 on May 12 to 174,440, 296,180, and 392,920 in the following three days before falling to 186,090 last Friday.

The cumulative number of feverish, i.e., confirmed, cases stood at 2,646,730 on Friday. Among them, 2,067,270 were recovered, and 579,390 were receiving treatment. Sixty-seven people had died. North Korean authorities stressed they managed the pandemic stably, citing the relatively low fatality rate of 0.003 percent.

However, experts noted that the real numbers of patients and death toll could be far higher than officially announced. In addition, they pointed out that the North Korean authorities use the term “feverish” instead of “confirmed” persons, probably because they have insufficient diagnostic equipment. In a situation where the impoverished country lacks facilities to treat severely ill patients, the North’s government might be concerned that a surge of new virus cases would throw North Korean residents into a panic, the experts added.

“A country that seemed to have put Covid-19 under control better than any others has become one witnessing the fastest spread of pandemic worldwide,” said Kim Shin-gon, head of the Unification Society of Health and Medical Sciences and a professor of endocrinology at Korea University Anam Hospital.

North Korea is facing a very serious situation, he added.

Kim made these and other points at “Coronavirus Fighters Live,” a Youtube show aired by The Korean Doctors Weekly, the sister paper of Korea Biomedical Review, last Friday.

The “heartfelt treatment” -- which calls for taking care of patients like family members – is the slogan of the North Korean healthcare system, which prioritizes prevention over treatment, and regional doctors manage patients. Since the aborted currency reform of the 2000s, however, unofficial markets called “jangmadang” and foreign trade have expanded, leading to the collapse of the public health and medical system. Many hospitals in Pyongyang and its vicinity have been modernized, but the lack of medical equipment and products exposed a vulnerability to Covid-19, he said.

“Only when sufficient supplies needed for quarantine exist can the merits of the North’s classical control of the pandemic become apparent. Unfortunately, however, the reclusive regime is facing a situation where its healthcare system reveals its limitations obviously, making things even more serious.” Kim said.

North Korea lacks various things and has insufficient facilities and equipment to treat severely ill patients. The endocrinology experts said that if the scale of infections increases, it can be a great scare for the residents.

“If the death toll rises to several thousand a day, it will come as an unbearable shock for the North Korean society,” Kim predicted. “The official Covid-19 death toll might be an incorrect report, but I have a hunch that the North Korean authorities manage the number of dead from the aspect of psychological quarantine.”

Kim emphasized that South Korea and the international community need to give “a justification” to the North so that the isolated regime can accept the help from them.

“North Korea attaches importance to a cause, and I think the outsiders should consider these points,” Kim said. “In seeking cooperation with North Korea, three things should be considered – humanitarianism, urgency, and practicality. All parties involved should create an environment where they give and take without conditions as all this is about saving lives.”

Kim stressed that the would-be helpers should set a justification for North Korea, proposing a mid- to long-term cooperative road map aside from cooperation to get over the Covid-19 pandemic in the short term.

“For instance, the Koreans could consider turning Gaeseong Industrial Complex into a manufacturing base of quarantine supplies and Covid-19 vaccines,” he said. “North Korea would think it more justifiable to receive aid if it is guaranteed to contribute to the world someday,” Kim said.

However, most urgently needed now is the supply of Covid-19 vaccines and treatments to North Korea.

“If vaccines arrive in the North, the vaccination speed will be very fast,” Kim said. “North Korea may be able to vaccinate all people in just days, as regional public doctors can handle everything. If South Korea can create an environment where it supplies vaccines, and the North willingly accepts them, they can be a powerful weapon (in the current North Korean situation).”

Stressing that timing is everything in all matters, Kim said. “After a month or two, the pandemic will have swept the entire country. If we cannot do anything to ease the pains of North Koreans, a sense of guilt will last long among South Koreans.”

Kim said that if the South wanted to help the North, it should do so now without showing it off.