Russian diplomats fleeing North Korea have described acute shortages of medicines and other basic goods in the country, indicating a crisis fuelled by one of the world’s strictest quarantine regimes amid the coronavirus pandemic. In a letter posted online on Thursday, employees of the Russian embassy in Pyongyang described a “collective exit” of foreign diplomatic staff that they predicted would “unfortunately not be the last” due to unbearable conditions in the North Korean capital. “It is possible to understand those leaving the [North] Korean capital. Hardly everyone can stand the unprecedented total restrictions [on individuals], the sharp deficit of essential goods, including medicines, the lack of any possibility to resolve health problems,” members of staff at the Russian embassy wrote. Russia has one of the largest foreign diplomatic footprints in North Korea, but staff have begun leaving due to shortages and problems obtaining key medicines. There were “hardly any diplomats left” in Pyongyang, the embassy letter said, tallying the total international presence in North Korea at 290 people. All but three foreign aid workers had evacuated the country as of last December, according to reports, and last week the United Nations said it had no international staff members left in the country. In February, Russian diplomats and their family members were forced to ride a hand-pushed rail trolley across the border after spending more than 30 hours onboard a train from Pyongyang to the frontier. North Korea’s borders have in effect been closed since last January in what is probably the world’s most severe Covid-19 quarantine. Analysts say the measures have allowed the government to increase its control over daily life to levels similar to the famine years of the 1990s. While little information has leaked out of the country, there have been hints of food shortages and a deepening crisis. Six North Korean border guards defected to China last week after describing “hunger and fatigue”. While defections occur regularly, it is unusual for such a large group to cross the border at once. In a report last month, a senior researcher on North Korea for Human Rights Watch said she had been told last year of shortages of food, soap, toothpaste and batteries. North Korean trade with China has fallen by about 80%, with imports of food and medicine falling close to zero last year as the government claimed that the trade, along with “yellow dust” blowing over the border from China, could lead to the spread of coronavirus. Severe floods have also undermined agricultural production, exacerbating food shortages in the country, Lina Yoon, the researcher, wrote. She compared the new “extreme measures” to “ultra-strict controls in past decades, when the government controlled all information and the distribution of food and materials, while prohibiting ‘free market’ activities. These conditions led to mass famine in the 1990s after the Soviet Union collapsed, and food supplies failed.” Officially, North Korea has reported no cases of coronavirus in the country, crediting strict travel restrictions and quarantine facilities. But analysts believe there may have been outbreaks in the army and in border cities later quarantined by the government. North Korea will receive 1.7m million doses of the Oxford/AstraZeneca vaccine as part of the World Health Organization’s Covax programme, which delivers vaccines to middle- and low-income countries. Yoon had called on the Biden administration and other foreign governments to give priority to aid efforts to North Korea, rather than focusing mainly on negotiations over its nuclear weapons programme. Last month the country resumed testing of cruise missiles and short-range ballistic missiles. “It is vitally important for the world to remember the people of North Korea, not just its nuclear weapons,” she wrote.