What we know (and don't know) about North Korea's Covid outbreak - CNN

North Korea reported 21 more deaths and 174,440 new "fever cases" Friday, according to state media KCNA, though it did not specify how many of the deaths and cases were linked to Covid, likely due to the country's extremely limited testing capacity.

The climbing death toll and surging "fever cases" come after North Korea said Thursday it had identified its first ever case of Covid-19 -- an alarming development for a country with one of the world's most fragile public health systems and a largely unvaccinated population.

But given the opaque nature of the regime and the country's isolation from the world -- a trend that has only exacerbated since the pandemic -- it is extremely difficult to assess the real situation on the ground.

They would be ill-equipped to deal with any kind of epidemic," Jean Lee, director off the Hyundai Motor-Korea Foundation Center for Korean History at the Washington-based Woodrow Wilson Center, told CNN at the outset of the pandemic.

Doctors who have defected in recent years often speak of poor working conditions and shortages of everything from medicine to basic healthcare supplies.

Choi Jung-hun, a former physician in North Korea who fled the country in 2011, said when he was helping to combat a measles outbreak in 2006 to 2007, North Korea did not have the resources to operate round-the-clock quarantine and isolation facilities.

He recalled that after identifying suspicious cases, manuals for doctors said patients were supposed to be transferred to a hospital or a quarantine facility for monitoring.

"The problem in North Korea is that manuals are not followed.

When there wasn't enough food provided for the people at hospitals and quarantine facilities, people escaped to look for food," Choi said during an interview with CNN in 2020.

How is North Korea responding so far?

North Korean state media declared the situation a "major national emergency" upon admitting the first officially reported Covid infection.

On Thursday, Kim placed all cities into lockdown and ordered "people with fever or abnormal symptoms" into quarantine; he also directed the distribution of medical supplies the government had reportedly stocked in case of a Covid emergency, according to KCNA.