A lack of testing equipment has made determining concrete numbers difficult.

Last week, North Korea made the rare public divulgence that several citizens had been confirmed to be sickened with COVID-19. A lockdown effort was immediately launched in an effort to contain the spread of the virus, but it seems these measures were insufficient, as the disease as swiftly spread through the isolated country.

According to a state-run North Korean news report picked up by South Korean analysts, at least 2.24 million citizens have become visibly ill with fevers. The report doesn’t outright identify the sickness as COVID, though the analysts suspect this is due to North Korea’s lack of COVID testing equipment. Without testing kits, North Korean medical services can’t actually confirm whether these illnesses are the result of COVID or not.

“There is no evidence that North Korea is using PCR test kits to determine COVID-19 patients, so no one outside can say for sure if it’s just fever or COVID-19 symptoms,” Philo Kim, associate professor at Seoul National University’s Institute for Peace and Unification Studies, told ABC News.

As the country likely does not have access to any vaccines due to its isolationist nature and insufficient medical services, cases are expected to increase and worsen until the country can achieve herd immunity naturally, though this would take a long time and likely result in many deaths.

“It will take time to reach herd immunity either through vaccinations or by having COVID,” Dr. Jiho Cha, professor at Korea Advanced Institute of Science and Technology’s Moon Soul Graduate School of Future Strategy in Daejeon, told ABC News, noting that “a conservative figure would be at least 200,000 deaths.”

South Korean President Yoon Suk-Yeol has offered to deploy vaccines and medical equipment to North Korea if they want it, but at the time of writing, Pyongyang has not responded to the offer.