North Korea’s COVID-19 restrictions are likely the largest factor exacerbating the country’s dismal humanitarian situation, according to an upcoming U.N. report, as aid organizations voice increasing pessimism about future prospects of working in the DPRK.

The assessment comes from an advanced draft of the U.N. Panel of Experts’ report on North Korea seen by NK News, which includes a section that attempts to evaluate how U.N. sanctions have hurt average North Koreans.