North Korea and Eritrea are the only sovereign UN-member countries not to have rolled out vaccines, but Tedros said neither country has responded to WHO’s offers of vaccines, medicines, tests and technical support.

“WHO is deeply concerned at the risk of further spread in [North Korea],” Tedros said, also noting the country has worrying numbers of people with underlying conditions that make them more likely to get severe Covid-19.

Unvaccinated North Korea reluctant to accept medical aid, Seoul says

A failure to control the outbreak could have dire consequences in North Korea, considering its broken healthcare system and its rejection of internationally offered vaccines that has left a population of 26 million unimmunized.

The outbreak is almost certainly greater than the fever tally, considering the lack of tests and resources to monitor the sick, and there’s also suspicion that North Korea is under-reporting deaths to soften the blow for Kim, who already was navigating the toughest moment of his decade in power. The pandemic has further damaged an economy already broken by mismanagement and US-led sanctions over Kim’s nuclear weapons and missiles development.

The North’s official Korean Central News Agency said Kim during a ruling party Politburo meeting on Tuesday criticised officials over their early pandemic response, which he said underscored “immaturity in the state capacity for coping with the crisis” and blamed the vulnerability on their “non-positive attitude, slackness and non-activity.”

Seoul plans to provide vaccines to North as Covid situation ‘appears serious’

He urged officials to strengthen virus controls at workplaces and make “redoubled efforts” to improve the supply of daily necessities and stabilise living conditions, the KCNA said on Wednesday.

Kim’s comments came days after he ripped officials over how they were handling the distribution of medicine released from state reserves and mobilised his army to help transport the supplies to pharmacies in capital Pyongyang, which were made open 24 hours to deal with the crisis.

Before acknowledging Covid-19 infections last Thursday, North Korea had insisted of a perfect record in keeping out the virus that has reached nearly ever corner of the world, a claim that was widely doubted. But its extremely strict border closure, large-scale quarantines and propaganda that stressed antivirus controls as a matter of “national existence” may have staved off a huge outbreak until now.

It’s unclear whether the North’s admission of a Covid-19 outbreak communicates a willingness to accept outside help. Kim’s government had shunned millions of vaccine shots offered by the UN-backed Covax distribution programme, likely because of international monitoring requirements attached to them.

It has so far ignored rival South Korea’s offer to provide vaccines, medicine and health personnel, but experts say the North may be more willing to accept help from its main ally China. South Korea’s government said it could not confirm media reports that North Korea flew multiple planes to bring back emergency supplies from China on Tuesday.

How will Kim Jong-un handle North Korea’s ‘explosive’ Covid-19 spread?

North Korean officials during Tuesday’s meeting continued to express confidence that the country could overcome the crisis on its own, with the Politburo members discussing ways for “continuously maintaining the good chance in the overall epidemic prevention front,” KCNA said.

While Kim was seen wearing masks for the first time following North Korea’s admission of Covid-19 infections last week, state media photos of Tuesday’s meeting showed Kim and Politburo members engaging in discussions barefaced, in a possible expression of confidence.

Additional reporting by Reuters