Early in 2020 — before the coronavirus spread around the world — North Korea took severe steps to keep out the virus and described them as a matter of “national existence”. It quarantined people with symptoms resembling COVID-19, all but halted cross-border traffic and trade for two years and is even believed to have ordered troops to shoot on sight any trespassers.

The extreme border closures further shocked an economy already damaged by decades of mismanagement and US-led sanctions over its nuclear weapons and missile program, pushing Kim to perhaps the toughest moment of his rule since he took power in 2011.

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North Korea had been one of the last places in the world without an acknowledged COVID-19 case. Turkmenistan, a similarly secretive and authoritarian nation in Central Asia, has reported no cases to the World Health Organisation, though its claim also is widely doubted by outside experts.

In recent months, some Pacific island nations that kept the virus out by their geographic isolation have recorded outbreaks. Only tiny Tuvalu, with a population around 12,000, has escaped the virus so far, while a few other nations – Nauru, Micronesia and Marshall Islands – have stopped cases at their borders and avoided community outbreaks.