SEOUL, SOUTH KOREA -- North Korean leader Kim Jong Un criticized officials over slow medicine deliveries and mobilized the military to respond to a surge in suspected COVID-19 infections, as his nation struggled to contain a fever that has reportedly killed dozens and sickened nearly a million others in a span of three days.
North Korean health authorities said Monday that eight more people died and an additional 392,920 were newly found to have feverish symptoms. That brings the death toll to 50 and illnesses to more than 1.2 million, respectively. It's a sharp jump from six dead and 350,000 sick reported last Friday, a day after the North said that it found that an unspecified number of people in capital Pyongyang tested positive for the Omicron variant.
Kim has acknowledged that the fast-spreading fever, highly likely driven by COVID-19, is causing "great upheaval" in the country, and outside experts say the true scale of the outbreak is likely much bigger than what's described in the state-controlled media.
Some suspect that North Korea has understated its fatalities or illnesses to shield Kim's leadership from criticism. The North likely lacks test kits and other tools to detect virus carriers with no or mild symptoms, which means that several million might already have been infected.
"When people die, North Korean authorities will say they've died of overwork or from natural deaths, not because of COVID-19," said Nam Sung-wook, a professor at Korea University in South Korea. Nam said the North is likely understating the death toll to protect "the dignity of its supreme leader."
While neighbouring South Korea and China have offered to send medical supplies and other help, experts say it's too late to inoculate the North's 26 million people, and that the only realistic outside help would be offering limited supplies of vaccines to reduce deaths among high-risk groups, including the elderly and people with preexisting conditions.
"With the country yet to initiate COVID-19 vaccination, there is risk that the virus may spread rapidly among the masses unless curtailed with immediate and appropriate measures," Dr. Poonam Khetrapal Singh, the World Health Organization's regional director for South-East Asia, said in a statement. He said WHO is ready to provide North Korea with technical support to increase testing and with essential medicines and medical supplies.
It's unclear whether and how soon Kim would accept outside offers of aid because he has previously rallied for unity at home to guard against the pandemic without resorting to foreign help.
State media didn't specify how many of the fever cases were confirmed as COVID-19. Among the 50 fatalities, North Korea officially identified only one as a COVID-19 case so far.
North Korea is believed to be mostly relying on isolating people with symptoms at shelters. Analyst Cheong Seong-Chang at South Korea's Sejong Institute said the North's limited number of test kits are likely mainly reserved for the ruling elite.
Failing to slow the virus could have dire consequences for North Korea, considering its broken health care system and that its people are believed to be unvaccinated. There's also malnourishment and chronic poverty.
North Korea imposed what it described as maximum preventive measures that restricted travel between cities and counties, and Kim ordered public health officials, teachers and others to identify people with fevers so they could be quarantined. As of Sunday, more than 564,860 people were in quarantine, North Korea's state media reported.
The explosive growth in fever cases may underscore how fast Omicron could travel across an unvaccinated population without access to proper health tools, and fatalities will surely jump in coming weeks considering time lags between infections and deaths, said Jung Jae-hun, a professor of preventive medicine at South Korea's Gachon University.
While it's clear COVID-19 is spreading at an alarming speed, there are questions about the accuracy of North Korea's fever tally. Jung said it's unlikely that North Korean health workers are able to make reliable daily updates, considering the lack of tests and other resources, and are possibly adding multiple days of cases into their single-day counts following delays.
Cho Han Bum, an analyst at Seoul's Korea Institute for National Unification, said North Korea's fever totals seemed an "outright lie."
"North Korea says about 390,000 more fell ill but only eight died in the past day, while South Korea (on Sunday) reported 25,000 new cases and 48 deaths," he said.
Yang Moo-jin, a professor at Seoul's University of North Korean Studies, said that the real number of COVID-19 infections in North Korea is likely at least three times larger than North Korea's tally of fever patients because of underreporting, the bad health care system and poorly computerized administrative networks.
Kim during a ruling party Politburo meeting on Sunday criticized government and health officials over what he portrayed as a botched pandemic response, saying medicine supplies aren't being distributed to pharmacies in time because of their "irresponsible work attitude" and lack of organization.
The Politburo had issued an emergency order to immediately release and quickly distribute state medicine reserves and for pharmacies to open for 24-hour shifts, but Kim said such steps weren't being properly implemented. Kim ordered the medical units of his military to get involved in stabilizing the supply of medicine in Pyongyang, KCNA said.
North Korea's previous claim of a perfect record in keeping out the virus for 2.5 years was widely doubted. But its extremely strict border closure, large-scale quarantines and propaganda that stressed anti-virus controls as a matter of "national existence" may have staved off a huge outbreak until now.
South Korean President Yoon Suk Yeol told the National Assembly on Monday that the South was willing to send vaccines, medicine, equipment and health personnel to the North if it's willing to accept.
South Korean officials say Pyongyang so far has made no request for Seoul's help. The North also shunned millions of vaccine doses offered by the UN-backed COVAX distribution program, likely because they carried international monitoring requirements.
Kim still stressed the country's economic goals should be met, which likely means huge groups will continue to gather at agricultural, industrial and construction sites.
