North Korea entered a fourth day under COVID-19 lockdown Sunday, reporting 15 deaths and more than 296,000 new cases of “fever” as the impoverished country faces down the growing crisis.

The surge in cases came a day after leader Kim Jong Un said the outbreak was causing a "great upheaval," leaving the country — which has one of the world's worst health care systems — on the brink of disaster.

The state-run Korean Central News Agency reported Sunday that a total of 42 people had died since the start of the outbreak, with 820,620 cases of fever and at least 324,550 receiving treatment. The country’s media has not specified whether the new cases or those who died had tested positive for COVID-19.

A separate report by KCNA said that “all provinces, cities and counties of the country have been totally locked down and working units, production units and residential units closed from each other since the morning of May 12 and strict and intensive examination of all the people is being conducted.”

The North, which until Thursday had not officially confirmed any COVID-19 cases, has not accepted vaccines or antiviral drugs and lacks mass-testing capabilities, leading some observers to conclude that the actual number of infections could be much higher.

KCNA said that authorities had set up “epidemic prevention posts” and “urgently transported” medical supplies to hospitals and clinics. A "large proportion" of the deaths, the report added, had been due to people being "careless in taking drugs due to the lack of knowledge and understanding of (the) stealth Omicron variant."

Later Sunday, a senior South Korean official said that Seoul plans to offer working-level talks with North Korea in an apparent move to help it contain the outbreak.

People sit near a screen showing a news broadcast of North Korean leader Kim Jong Un, at the main railway station in Seoul on Thursday. | AFP-JIJI
People sit near a screen showing a news broadcast of North Korean leader Kim Jong Un, at the main railway station in Seoul on Thursday. | AFP-JIJI

"The government is actively reviewing to officially propose to North Korea holding a working-level meeting at the beginning of the week," the Yonhap news agency reported, quoting an unidentified senior South Korean official.

The official said South Korea plans to deliver its proposal to the North after holding consultations with relevant ministries. Momentum could build for the plan after new Unification Minister Kwon Young-se takes up his post around Monday, Yonhap added.

The offer, if accepted by North Korea, would be the first talks between the two Koreas since South Korean President Yoon Suk-yeol was sworn in last week. Yoon, who has voiced a tougher stance toward Pyongyang than his predecessor, promised in his inauguration speech to put forward an “audacious” plan to bolster North Korea's economy — but only in return for steps toward denuclearization.

On Friday, Yoon offered to send COVID-19 vaccines and other medical supplies to the North.

North Korea had, prior to the recent outbreak, turned down vaccine offers from its main patron, China, and the World Health Organization's COVAX project.

Kim said Saturday that his country will seek to "actively learn" from China's “COVID-zero” strategy.

Some experts, however, say the North Korean regime is unlikely to accept vaccines because it lacks both the needed technology and distribution systems and, perhaps more importantly, is unwilling to tarnish its reputation and weaken its control over society.

“The type of medical aid that the regime may find complementary to its zero covid policy is antivirals such as Remdesivir & Paxlovid,” Go Myong-hyun, a senior fellow at the Asan Institute of Policy Studies in Seoul, wrote on Twitter.

“The regime may even employ antivirals to ensure elite loyalty, by doling out antivirals only to the most loyal the way the regime rewards loyalists with imported luxury goods. Antivirals would strengthen the regime by reassuring the elites while subjecting the rest to lockdown” and maintaining an iron grip on society, he added.