North Korea tally surpasses 1 million sick amid COVID-19 surge

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 what it's referring to as a"fever" that has reportedly killed dozens and sickened nearly a million others in a span of three days.

Last week, North Korea acknowledged a COVID-19 outbreak for the first time andimposed a nationwide lockdown. Since then,the death toll has reached 50 and more than 1.2 million are feared sick.

That's a jump from last Friday, when six deaths were reported and 350,000 said to be ill.

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."

Too late to innoculate entire population

While neighbouring South Korea and China have offered to send medical supplies and other help, experts say it's too late to innoculate the North's 26 million people.

The only realistic outside help, experts say, would be offering limited supplies of vaccines to reduce deaths among high-risk groups, including the elderly and people with pre-existing conditions.

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.

Infection numbers could be three times higher

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 Jae-hun, a professor of preventive medicine at South Korea's Gachon University, said it's unlikely that North Korean health workers are able to make reliable daily updates, considering the lack of tests and other resources.

Jung saidthey 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.