At least one Covid-19 patient in North Korea has died as a “fever” spread “explosively” with hundreds of thousands showing symptoms, state media said on Friday.
The country imposed a nationwide lockdown on Thursday. It had previously reported no confirmed cases since the pandemic began.
It could lead to thousands of deaths in one of only two countries in the world without a Covid vaccination campaign.
Experts said that given North Korea's limited testing capabilities, the numbers released so far probably represent a small fraction of the infections, Reuters reported.
About 187,800 people are being treated in isolation after a fever of unidentified origin “explosively spread nationwide” since late April, the official KCNA news agency reported.
About 350,000 people have shown signs of that fever, including 18,000 who newly reported symptoms on Thursday, KCNA said. About 162,200 have been treated, but the agency did not specify how many had tested positive for Covid-19.
At least six people who showed fever symptoms have died, with one of those confirmed to have contracted the Omicron variant of the virus, KCNA said.
Harvard Medical School's Kee Park, who has worked on health care projects in North Korea, said the country has been testing about 1,400 people each week, which is not nearly enough to survey 350,000 people with symptoms.
“What is more worrisome is the sheer number of symptomatic people,” he said. “Using a conservative case fatality rate of 1 per cent and assuming the surge is due to an Omicron variant of Covid-19, North Korea can expect 3,500 deaths from this outbreak.”
Kim declares 'gravest emergency'
North Korean leader Kim Jong-un visited the anti-virus command centre on Thursday to check the situation and responses after declaring a “gravest state of emergency” and ordering a national lockdown, state media reported.
North Korea has said the outbreak began in the capital, Pyongyang, in April. State media did not elaborate on the cause, but the city hosted several huge public events on April 15 and 25, including a military parade and large gatherings where most people did not wear masks.
Mr Kim, who attended several of those events, said “the simultaneous spread of fever with the capital area as a centre shows that there is a vulnerable point in the epidemic prevention system we have already established,” KCNA said.
He said isolating and treating people with a fever was a top priority.
The rapid spread of the virus highlights the potential for a major crisis in a country that lacks medical resources, has refused international help with vaccinations and has kept its borders shut.