“It is easy to see how an outbreak of covid-19 could easily overrun the limited capacity to treat those patients,” said Kee Park, a scholar at Harvard Medical School who has studied North Korea.
Pyongyang has insisted it has no cases of coronavirus, and the World Health Organization said it has seen no indications to contradict that.
But three news outlets with extensive contacts inside the country, NK News, Daily NK and AsiaPress, have reported cases in the border cities of Sinuiju or Rason and said that some people may already have died. The reports could not be independently verified.
North Korea has moved swiftly to close its limited contacts outside its borders.
It began by banning tourists on Jan. 22, and then shut down all flights and trains in and out of the country. Visitors from abroad were quarantined, and foreign diplomats were placed under virtual house arrest in Pyongyang.
Anyone showing possible symptoms faces a month-long quarantine, as do customs inspectors and trade officers who deal with China. On Tuesday, South Korea’s spy agency told lawmakers in Seoul that the North has put at least 7,000 people under quarantine.
Trade across the border with China — a critical economic lifeline for Kim’s regime — has collapsed. A major crackdown on cross-border smuggling also has been imposed, news reports say.
Kim warned last week of serious consequences for the country if the virus enters. His propaganda machine has cranked into overdrive.
Rodong Sinmun, the ruling-party newspaper, called the battle against coronavirus one of “national survival” and last week urged citizens not to gather in restaurants.
“Talking while eating would become a major route of infection,” it warned.
The media coverage has been “highly unusual, in terms of volume, level and duration,” said Rachel Minyoung Lee, an analyst at NK News.
She described it as “a strong indicator of how seriously concerned North Korea is about the virus.”
“The virus situation, should it spiral out of control, could pose a major setback to the Kim regime’s domestic and perhaps even foreign policy goals,” she added.
The restrictions are also considerably tougher than those imposed during the severe acute respiratory syndrome epidemic in 2002-2003. They are already having a noticeable effect on the economy.
Tourism from China was a major source of foreign currency, while consumer goods from China are disappearing from markets, news reports say. This especially stings because so many North Koreans depend on income from private trading to supplement meager official incomes.
The self-imposed shutdown has ironically served to close loopholes in international sanctions, noted Bruce Klingner, a former CIA analyst and Northeast Asia specialist at the Heritage Foundation.
Market information compiled by Daily NK shows prices of rice, corn, diesel and gas all rising, some to their highest levels in a year or two. The regime has responded by trying to impose price controls and ordering sugar and soybean distributors to release stocks.
Kim’s attempt to develop his country’s economy was already foundering under sanctions. And his attempt to come in from the cold diplomatically suffered a major setback with the breakdown of a summit with President Trump in Hanoi a year ago.
Kim has already adjusted course, warning North Koreans in late December they would have to further tighten their belts as the regime tries to be more self-reliant.
Andrei Lankov, a professor at Kookmin University in Seoul, said the virus is not good news for Kim but that “the news was bad anyway. This doesn’t change much.”
And however bad it gets, it is not about to bring down the regime in a country where the control of the security services remains pervasive, he said.
“Kim Jong Un may worry about regime stability, but there were no protests or uprisings in the 1990s when 1 million North Koreans died from starvation and related diseases,” Klingner said.
Harvard’s Park said the international community is looking for ways to help.
Doctors Without Borders was granted an exemption from U.N. sanctions to send in protective equipment and diagnostic tests. But foreign medical experts and humanitarian groups remain excluded from the country by Kim.
While the world frets about the coronavirus, North Korea’s nuclear weapons program has moved way down the global agenda. That could work in Kim’s favor, said Jean Lee at the Wilson Center.
“The isolation buys him time to focus on his nuclear strategy as he watches political developments in the United States,” she said, before voicing a more hopeful thought.
“I’d like to see Kim accept goodwill offers of humanitarian assistance for the sake of his people,” she said. “That might also open up a window of diplomatic opportunity.”