The world has long been focusing on the threat to international peace and security posed by North Korea’s missile and weapons of mass destruction programs, in particular its development of nuclear weapons. The threat posed by Pyongyang’s increasing reliance on cybercrime and blockchain exploitation has also rightly drawn global attention and concern.

The COVID-19 epidemic, however, presents a new and invidious threat that has the potential to emanate from North Korea and threaten global security. Given its proximity to countries with major outbreaks of the new coronavirus, its virtually nonexistent medical infrastructure outside Pyongyang, and its political culture of secrecy and deception, North Korea represents a human petri dish that could prove a source for major international infections.

Ironically, repeated missile tests by North Korea have seemingly desensitized world opinion, despite multiple violations of United Nations Security Council resolutions. Recent photos of Kim Jong Un published in the official newspaper of the North’s ruling Workers Party, showing him viewing a missile launch, have drawn attention primarily because the senior military officials accompanying him were wearing black face masks. This image, strangely evocative of Hollywood Western movie portrayals of villains, demonstrated strikingly how North Korea is taking extreme precautions to contend with the COVID-19 infections.

Despite North Korea’s official statements that there have been zero cases of COVID-19 infections within its borders, such assurances fly in the face of reality, given the dramatic and tragic coronavirus outbreaks in neighboring countries, particularly China — Ground Zero for the epidemic. North Korea shares a long and, in segments, highly porous border with China, which it depends on for 90 percent of its trade and, until recently, a flood of Chinese tourists — estimated conservatively at over 350,000 in 2019.

Moreover, numerous North Korean indentured workers in China — estimated at around 50,000 — were obliged by U.N. sanctions to return to North Korea at the end of 2019. It is highly dubious that all complied, given lax Chinese enforcement. That said, China has asserted that it is in full compliance with U.N. sanctions, and any workers returning to North Korea represent another potential source of contagion. Moreover, North Korean workers in China are reportedly not required to get a work permit if they stay under 90 days, compounding the potential contagion problem through frequent turnover.

An additional reason for skepticism about North Korea’s claims about zero COVID-19 cases is the pattern of Pyongyang’s public deception as to other outbreaks in the past. During the 2009 swine flu (H1N1) outbreak, Pyongyang initially denied that there were any cases within its borders, despite reports from international relief officials to the contrary.

Now, various South Korean media sources have reported numerous coronavirus cases in North Korea, with estimates running as high as hundreds dead and thousands more in quarantine, despite Pyongyang’s insistent denial.

Irrespective of how far COVID-19 has advanced in North Korea up to this point, there is very real concern that an outbreak could not be contained. North Korea has little or no medical infrastructure or medical supplies anywhere in the country, particularly beyond Pyongyang. Some hospitals reportedly even lack water and electricity.

In fact, according to Johns Hopkins University’s 2019 Global Health Security Index, North Korea was rated 193rd out of 195 countries globally — almost dead last — in preparedness for managing outbreak of a disease. North Korea basically pulled zeroes in terms of biosecurity, biosafety, emergency preparedness and response planning, exercising response plans, emergency response operations, risk communication, medical countermeasures and personnel deployment, infection control practices and availability of equipment.

In practice, this means North Korea largely lacks the health infrastructure even to test those potentially infected, let alone treat them. A new coronavirus outbreak in North Korea would quickly spread. Moreover, the generally weakened health and malnourishment of most of the North Korean people would render most susceptible to COVID-19 contagion, with dire consequences.

It is clear that Pyongyang is at least aware of the new coronavirus contagion risks it faces given both its dependency on China and its appalling medical infrastructure, prompting a draconian response by the North Korean leadership. Pyongyang declared a national emergency and closed its 1,400 km border with China (and its 17 km border with Russia). North Korean official media stated that roughly 3,000 people in North Pyongan province, which borders China, are being monitoring in case they display possible coronavirus symptoms.

According to the North’s Korean Central News Agency, North Korean officials are also educating North Korean residents along the Chinese border in the west about COVID-19 preventive measures and sending medicine and disinfectants to the region.

Pyongyang meanwhile shut down flights and railway transport from China and Russia, curtailed foreign tourism, and canceled both the annual parade in honor of North Korea’s military as well as the annual Pyongyang Marathon, with its many international participants. North Korea is quarantining for 30 days all foreigners entering the country — more than twice the new coronavirus incubation period — and strengthening customs measures, including by isolating all foreign goods being imported for 10 days. The North has imposed restrictions even on international aid workers and health agencies that are there to help, and has quarantined nearly 400 international workers, including diplomats.

The net result has effectively been de facto self-sanctioning by the North Korean regime. Severing physical and economic ties with China, on which North Korea is so economically dependent, is no doubt dealing a severe blow to the official North Korean economy. The impact can only be similarly grave for North Korea’s “gray economy” in the form of cross-border traders and outright smugglers, and the private markets that Pyongyang has allowed to blossom under Kim’s regime.

Not only that, North Korea’s plans to step up its hard currency earnings from Chinese tourists — not subject to international sanctions — appear to be in the deep freeze. For example, the mountain spa and ski resort in Samjiyon and the beach resort being developed at Wonsan, which have been aimed at attracting Chinese tourists, have apparently been slammed by Pyongyang’s stringent anti-coronavirus measures.

From the perspective of the international community, North Korea’s COVID-19 containment effort has had the effect of tightening sanctions vis-a-vis China more effectively than could otherwise have been imagined. The effective stranglehold North Korea is placing on its own lifeline to China cannot help but put severe strain on the North Korean economy.

At first blush, this should strengthen the hand of the United States and its allies, as international sanctions relief should be even more vital to the North. However, the leverage afforded may be less than meets the eye. Even if North Korea were to decide today to dismantle its nuclear program and meet all conditions necessary for lifting the sanctions, the effectiveness of sanctions relief would be circumscribed by what are, after all, Pyongyang’s self-imposed restrictive measures. And it is unclear whether South Korea or Japan, grappling with their own COVID-19 problems, would be focused on providing assistance to North Korea at this juncture.

At the same time, while the hermit kingdom understandably appears to be turning inward, it may also feel compelled to lash out internationally — both to project an image of strength and to provide a useful domestic distraction from its coronavirus crackdown. North Korea may be down, but it is not out, and the international community should continue to observe it with caution.

Despite the challenges involved, the international community, led by the U.S., should also be alert for any opening to provide North Korea with assistance in contending with the COVID-19 outbreak. This could help keep channels of communication open with Pyongyang and mitigate the possibility that an unchecked North Korean coronavirus outbreak could spill over and pose a further threat to global health.

Thomas Cynkin is a former U.S. charge d’affaires to the Conference on Disarmament in Geneva. He is vice president of the Daniel Morgan Graduate School of National Security.

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