Massive regional die-off
The Lake Nyos disaster is one of the creepiest natural disasters I've ever heard of. The disaster was a limnic eruption:
A limnic eruption, also known as a lake overturn, is a very rare type of natural disaster in which dissolved carbon dioxide (CO2) suddenly erupts from deep lake waters, forming a gas cloud capable of asphyxiating wildlife, livestock, and humans.
This will be kind of like that.
In your case, the source of carbon dioxide is the 444 million victims who appear every two days and then draw breath for 4 minutes before dying. As a point of comparison, 444 million is ~1/3 larger than the entire population of the United States, and ~15 times larger than the population of North Korea. These victims appear beneath NorKo, transform breathable atmosphere into CO2 for several minutes, then die.
How much CO2 is that?
A relaxed, healthy adult male exhales 250 milliliters of CO2 per minute, according to Dr. John G. Mohler, medical director of the pulmonary physiology laboratory at the University of Southern California School of Medicine (quoted in the New York Times). Four minutes would be 1 liter, making for 444 million liters of CO2 exhaled per wave of victims. My dimensional analysis is pretty rusty these days, but I believe this is a lot less than Lake Nyos (300,000 tons), but neither is it the proverbial fart in the wind.
It would be a gargantuan task to build a ventilation system robust enough to service a subterranean space that can hold 444 million people. I doubt it could be done. Probably the first wave of victims would begin to suffocate before their 4 minutes was up, and the atmosphere down there would just grow more depleted as successive waves materialize and gasp their way to death faster than the cavern can exchange air with the surface.
Pretend they solve that problem: now all that CO2 is being pumped out of the cavern, to the surface of NorKo, while it sucks fresh atmosphere down, away from the surface and human residents of NorKo.
CO2 is heavier than regular atmosphere, so this cloud of deadly, drained air will spread along the ground, suffocating animals and people near the exhaust points, spreadingexpanding outward as it mixes with nearby atmosphere. Yes, atmospheric turbulence will help to replenish the oxygen, but it's not a magically efficient system, and we're talking about a lot of CO2. And that CO2 doesn't vanish, it moves to nearby areas.
Each wave of victims will trigger something like a (weak?) limnic eruption. Each eruption will drain more of the surrounding atmosphere. Two days is plenty of time to replenish, but then it hits again with the same force with the next wave.
I have a hunch this will result in the suffocation of most people and animals in North Korea, plus whatever regions are consistently down-wind while this is going on.
I do expect the rest of the world to notice when people and animals in that part of the world start dying, especially since it would extend beyond the borders of North Korea.