A Japanese report claimed that over 100 soldiers in North Korea have died of Chinese coronavirus in the past month, the conservative South Korean newspaper Chosun Ilbo reported on Monday.

Pyongyang claims to have documented zero cases of the Chinese coronavirus as of Tuesday, despite bordering China — the origin nation of the virus — and South Korea, one of the hardest-hit nations by the pandemic in the world. North Korea also borders Russia, which initially claimed to have its coronavirus cases under control but is now mulling a nationwide quarantine to stop the highly contagious virus from continuing to spread.

Chosun Ilbo, citing Japan’s Yomiuri Shimbun, noted that the Japanese newspaper used unnamed “intelligence sources” in various nations to come to the conclusion that the virus began spreading among North Korean soldiers stationed on the border with China, forcing North Korea to cancel military exercises.

“More than 100 North Korean stationed near the Chinese border are thought to have died of coronavirus since late February, the Yomiuri Shimbun claimed Sunday,” the South Korean newspaper relayed. “The regime claims there have no coronavirus infections and nobody has died from the epidemic.”

The report follows suggestions from American military officials that evidence points to a coronavirus outbreak within North Korea’s armed forces. The head of America’s military presence in South Korea told reporters the Pentagon is “fairly certain” coronavirus cases are spreading in the country.

“What I do know is that their armed forces has been fundamentally on lockdown for about 30 days, and only recently have they started routine training again,” U.S. Forces Korea Commander Gen. Robert Abrams told Pentagon reporters this month. “The North Korean Air Force did not fly a single aircraft for 24 days before resuming routine training sorties … [The North] is a closed-off nation so we can’t say emphatically that they have cases, but we’re fairly certain that they do.”

Regional media have also speculated on North Korea identifying people infected with the coronavirus. One particularly insidious rumor claimed that North Korean police shot a man dead after he tested positive for the virus, though no news source has been able to prove it. More likely reports suggested that a man who traveled to China brought the virus back to North Korea in February. JoongAng Ilbo, a South Korean newspaper, cited unnamed sources confirming that the first confirmed case in the country occurred that month. The newspaper identified the patient as a woman from Pyongyang, suggesting she was somewhat well-connected with Kim Jong-un’s totalitarian regime, as those with a family history of anti-communism are banned from visiting, much less living in, the capital.

While North Korea’s communist regime denies the existence of any coronavirus patients within its borders, Kim has taken extraordinary measures suggesting the need to respond to large numbers of infected patients. North Korea first reacted to the outbreak by shutting out all tourists — a major economic blow to the country — and canceling the annual birthday celebration for Kim’s father, late dictator Kim Jong-il. Kim also apparently ordered the use of photo editing software to crudely add medical masks to the faces of people featured in official propaganda, apparently to make his regime appear as if it were taking the pandemic more seriously.

Kim also announced the construction of a new hospital and lamented the poor state of health care in the capital — a bizarre move for a country allegedly not seeing any increased pressure on its healthcare system.

“Our Party analyzed and assessed the present state of public health service, medical service, in the country,” Kim said in a speech this month, “and, feeling miserably self-critical of the fact that there is no perfect and modern medical service establishment even in the capital city, discussed and decided on building in this year of the 75th anniversary of its founding a modern general hospital first in Pyongyang for the promotion of people’s health.”

Kim’s speech was called “Let Us Build the Pyongyang General Hospital in an Excellent Way, Greeting the 75th Founding Anniversary of the Workers’ Party of Korea.” It reportedly did not mention the pandemic.

Kim has also accepted international humanitarian and medical aid. Doctors Without Borders (MSF) announced Monday that, along with the United Nations Children’s Fund (UNICEF), it had begun shipping large amounts of medical aid to North Korea, intended to help with coronavirus response.

“The full cargo of medical supplies donated by MSF — including masks, gloves, goggles, hand hygiene products, and antibiotics — have now arrived in DPRK,” an MSF spokesperson told the North Korea interest publication NK News. UNICEF also confirmed the shipment, but not reports that North Korea had reached out directly for help containing the coronavirus outbreak.

North Korea also, in a rare move, graciously thanked President Donald Trump for offering coronavirus aid last week. In a public letter, Kim Yo-Jong, the dictator’s sister, said that Trump had “expressed his intent to render cooperation in the anti-epidemic work, saying that he was impressed by the efforts made by the Chairman [Kim Jong-un] to defend his people from the serious threat of the epidemic.”

Kim Yo-Jong called Trump’s letter “a good example showing the special and firm personal relations” between Trump and her brother.

North Korea’s state media continues to deny the existence of any cases within its borders. On Monday, however, the state newspaper Rodong Sinmun published an impassioned plea for North Koreans to “spruce up our dwellings and worksites in a hygienic and cultured way, keep ourselves neat and trim and develop our culinary culture to boost the flavor of national character.” Hygiene, particularly regular hand washing and ensuring not to sneeze or cough directly into one’s palms, is a pivotal part of containing the spread of the Chinese virus.

The Rodong Sinmun article otherwise continued in a familiar tone for North Korean propaganda.

“The imperialists are keen on anti-DPRK maneuvers to lay barriers to its advance, on ideological and cultural poisoning in particular,” the editorial read. “It is high time for all the people to work and live in a more militant way with revolutionary ideological consciousness and high cultural and intellectual knowledge, aware of themselves as masters responsible for building the powerful country.”

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