North Korea- a Quarantine Within Quarantine

North Korea- a Quarantine Within Quarantine
The debilitating effect of the pandemic may force Pyongyang to rethink its isolationist policies and seek access to much-needed medical and economic aid

As countries across the world adapt to the ‘new normal’ – compulsory masks, social distancing, international travel bubbles, and strict government guidelines – North Koreans can be considered a step ahead. After all, North Korea had already been in self-imposed quarantine due to its economic, social, and diplomatic isolation. While this isolation may have assisted its COVID 19 efforts (although there is little coming out of the country), they have also exacerbated its economic and public health crises. Weighed down by sanctions from several countries and international institutions due to its nuclear programme, North Korea might have to consider meeting the world halfway to recover from the toll of the pandemic.


North Korea claims that it was one of the few countries that took immediate action during the initial stages of the pandemic. As cases in Wuhan peaked, North Korea closed its borders to foreigners in January itself. It declared a national emergency and imposed a 30-day quarantine period on suspected carriers. In addition, it regulated imports by isolating goods for ten days and conducted public health campaigns encouraging everyone to wear masks. North Korea has not officially reported a single COVID-19 case, while its immediate neighbours China, Russia, and South Korea have reported over 85,000, 1 million, and 20,000 cases respectively. Even the one time there was a suspected case, it was attributed to a defector from South Korea, who had ‘inconclusive’ test results.  

North Korea’s existing medical infrastructure was created in the 1970s under Kim Il-sung.  He also invested in training a large number of doctors, whose numbers remain high although there is a shortage of nurses. While the medical infrastructure was designed for preventive medicine, it cannot handle a full-blown pandemic.  Since 1979, the cash-starved regime has been placing more emphasis on traditional Korean medicine based on herbs and acupuncture.

In the 1990s, the health care system deteriorated rapidly due to natural disasters, economic deprivation and food shortages.  In the 2000s, hospitals were bereft of essential medicines and equipment, including electricity and water, as the sanctions were showing their effects.  A 2010 WHO report on N Korea’s health care system, (once called "the envy of the developing world by the WHO") highlighted the poor infrastructure, lack of equipment, malnutrition and shortage of medicines in hospitals. In fact, Amnesty International reported them as "barely functioning hospitals."  

Although Pyongyang offers free universal healthcare to its citizens, this system has been marred by accusations of favouring the elite. The country prioritises military development over public well-being, which has led much of its population to live in impoverished conditions and with chronic illnesses. Moreover, North Korea has been grappling with the aftermath of floods and torrential rains during its rainy season.

This raises questions about the country’s COVID testing and treatment capabilities, as a number of cases – especially in rural areas – could remain undetected and untreated. With the government suppressing and monitoring information, the actual number of cases is difficult to discern, although local sources report cases in at least three North Korean provinces. Some sources also suspect over 100 deaths amongst North Korean troops at the China border, due to COVID-related symptoms.


Over recent months, North Korea has enforced stricter preventive measures, possibly due to rising cases within the country. Barring the entry of a few essential supplies, the country has completely blocked its air, land, and maritime borders. The goods that are granted entry are quarantined and disinfected before domestic distribution. The country has also shut down public spaces, and passed orders to cremate (rather than bury) its dead. But these steps come at a high economic cost.

Due to sanctions from the United States and Japan, North Korea relies on China for 95 per cent of its trade. Prior to the outbreak, leader Kim Jong-un had pledged to circumvent the sanctions and boost the economy by locating legal and illegal new sources of income. However, with the borders closed now, North Korean exports and imports to China have decreased by 96 per cent and 85 per cent, respectively, from last year. This has severely impacted the economy and increased smuggling. As a result, shoot-to-kill orders have been issued, further restricting entry from neighbouring countries.

Reports from North Korean defectors in South Korea highlight the struggles faced by the country’s population. Shortage of medical supplies, food, and other essential goods is necessitating the need for international intervention. North Korea has reportedly reached out to WHO, UNICEF, Doctors without Borders, and NGOs in neighbouring countries for testing kits and medical equipment. Additionally, NGOs from the U.S. and Switzerland have also been stepping up to provide otherwise sanctioned goods. Even President Donald Trump, despite North Korea’s standstill on sanction-relief talks with the U.S., has extended his support to help North Korea.

These details suggest that North Korea’s pre-existing isolationist policies and distance from the international community are not necessarily mitigating the costs of the pandemic.  Although countries across the globe have closed their borders, they continue relying on each other for medical equipment and breakthroughs in the search for a vaccination. North Korea has been attempting to mask this reliance by outwardly rejecting international aid and militarising its borders to prevent COVID cases into the country. Thus, while North Korea largely remains in economic and physical quarantine from the rest of the world, it may have to ease its diplomatic quarantine to fight the pandemic. 


  • While the pandemic has physically distanced countries by closing borders and restricting travel, it has also underlined the need for international cooperation.  For its own survival, North Korea might have to revisit its pre-existing quarantine and seek international medical and economic assistance.
  • This is difficult to achieve due to North Korea’s unwavering stance on nuclear weapons. Moreover, any dictatorial regime abhors losing face before its own people, even at the cost of their lives. However, Kim Jong-un has been surreptitiously reaching out to China, Russia, and even South Korea for aid and circumventing sanctions for emergency supplies. It has also received assistance from various international non-profit organisations.

Till North Korea comes up with a long-term solution to protect its citizens, it would benefit from China and South Korea’s interests in maintaining relations with the country to ensure stability in the region. North Korea may also gain some diplomatic points by being able to delay denuclearisation talks with the U.S. on the grounds of its public health crisis.