Not so the DPRK, which decided to gamble with its people’s lives and country’s future. Until now, the cost was significant—lost trade, empty foreign embassies, suspension of aid programs—but appeared manageable. Indeed, Pyongyang found an additional benefit of hermetically sealing the border: shrinking foreign contact. Fewer North Koreans can flee their nation or gain access to South Korean movies, music, and television.

However, if the pandemic is fully loosed upon the North, disaster beckons. Few North Koreans, other than some number who are members of the ruling elite or have traveled abroad, are vaccinated. The DPRK’s health care system is primitive and has lost outside support from foreign NGOs, which maintained programs for the most vulnerable. Most North Koreans have been weakened physically from years of malnutrition and poor medical care. The ruling political ideology insists upon communal activities through which COVID could quickly spread: much more than in China, individual and family isolation is perceived as a threat to ideological control. A widespread infection could have catastrophic consequences.