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Controlling Covid in China: Observations in Guangzhou

There is no doubt we need to pay more attention to the principles of competence, efficiency and accountability in managing the pandemic

Administering Covid tests in the sports stadium of Sun Yat-sen University - TAN CB

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I arrived in Guangzhou, China, on 16 April 2021 at 8pm.

After the various careful checks and a PCR test, I was finally ushered out of the arrival hall at around 10.30pm. Together with some of the passengers from the same flight and accompanied by a police officer, we were driven in a minibus to the allocated hotel to be quarantined.

Everyone was asked to scan a QR code to register personal information for hotel check-in and quarantine management. All our luggage was disinfected. Then we lined up to check in, which was done smoothly and quickly as the hotel already had our information and so it was just a matter of confirming our details for us to sign in and pay a deposit.

The room was fairly spacious, simple and neat. The air conditioner was not on, but the windows were slightly open, so the room was not stuffy.

In the morning, I was surprised to see not only many vehicles on the street below but also people walking, most with masks on, though many did not seem to observe physical distancing. I had arrived at a city where life seemed normal, whereas in Malaysia there was a partial lockdown when I left.

The purpose of this article is to relate my experiences and observations from April to July regarding Covid management in China. We can learn a lot from the way China manages the Covid threat. The information here will also highlight some core values instrumental to China’s modernisation.

The quarantine lasted 14 days. (Fortunately, this had been reduced from the 21 days that was imposed in February around the time of the Chinese New Year.) During the quarantine period, the only contact I had was with the medical staff who came daily to take my temperature.

My food was delivered and left on a stool by the room door, and a knock signified its arrival. The Cantonese food was simple and fairly good.

During the quarantine, I was administered nucleic acid tests three times and together with the one taken at the airport, all four tests were negative.

On 1 May, I was allowed to go back to my apartment on campus. Soon after reaching the apartment, a medical staff, arranged by the sub-district office (jiedaobanshichu) in charge of the area, arrived to take my sample for a nucleic acid test. I had expected another seven days’ home quarantine, but was informed it was not necessary. Nevertheless, I was advised to stay indoors as much as possible as there would be another PCR test in six days’ time. 

After slightly more than a year in Malaysia, I returned to Sun Yat-sen University to finalise my contract work there. Coming from Kuala Lumpur, I was surprised to see people leading a normal life, with shops open, and not everyone wore masks. Students in class also did not wear masks.

In April 2021, Guangzhou had recovered from the initial Covid wave, and there were no new local cases. Guangdong province had only a few new cases which were imported and were well controlled.

My colleagues invited me to dinner at restaurants, and I was amazed to see the lively atmosphere of Guangzhou in the evening. But the euphoria of a Covid-free normal life was short-lived as, by the end of May, we were warned of a few new local cases.

The local government took swift action and this allowed me to witness how the Chinese government and the people cooperated to prevent the spread of the pandemic.

New Covid case in Guangzhou

The latest Covid infection in Guangzhou was traced to 21 May 2021 – the Delta variant. Soon the infection spread to the nearby cities of Foshan and Maoming.

By 31 May, there were 34 confirmed and eight asymptomatic cases in Guangzhou as well as six cases in Foshan (about 27km west of Guangzhou) and one case in Maoming (about 400km southwest of Guangzhou) – a total of 49 cases.

On that day, the whole province of Guangdong had 62 new cases with the additional cases from Shenzhen. The airports and seaports in Guangzhou and Shenzhen are important points of international arrival, and the authorities had been wary of imported cases.

Attention soon focused on how the virus spread from one Madam Guo, a 75-year-old woman living in the Liwan district (Liwanqu) of Guangzhou. On 21 May, she was the first identified case of this new Covid infection. The authorities traced her movements and contacts. She had no record of travelling overseas and so how she got infected was unknown. Two days later, her husband was confirmed asymptomatic.

On 25 May, Ms Yao was confirmed positive. This was traced back to 19 May when she had served Madam Guo dim sum breakfast. She was from Maoming, which is around 4.5 hours by bus or 2.5 hours by speed train from Guangzhou. Having breakfast in the same restaurant then were Ms Song, her husband, her daughter-in-law, her niece, an eleven-year-old grandson and a friend. On 26 May, all six were confirmed positive.

On 28 May, four other confirmed cases in Guangzhou were found to have contacts with the named family members of Ms Song, and the first asymptomatic case in Foshan had contact with Ms Song’s daughter-in-law. In the following days, more fresh cases were reported, some of whom also had contacts with Ms Song’s family. (While I had followed TV reports, for better accuracy in the narration of events, the description here is based on local news reports such as those by Du Wei and Li Mingzi published in ZhongguoXinwenZhoukan or China News Weekly, 1 June 2021, and Jiang-Xu Qiulin published in NanfangZhoumo or Southern Weekly, 3 June 2021.)

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The local government quickly identified Hainan Cun (Hainan village) of Liwan district in Guangzhou as the centre of the new surge in Covid infections. Under the leadership of the local Communist Party, various local organisations were quickly mobilised to see to its lockdown from the evening of 27 May to 20 June. Entries to and exits from the district were blocked. Four hundred volunteers were recruited to help in various tasks, including the delivery of food to 40,000 residents.

After the 24-day lockdown, all movements were still strictly monitored as residents had to show their identity cards and entry and exit permits (for a report, see Guangzhou Ribao or Guangzhou Daily, 22 June 2021).

Earlier on 22 May, Liwan district was classified from low risk to medium risk, which made it difficult for its residents to travel outside Guangzhou.

However, people in other provinces still tended to treat the whole city as medium or even high risk. A former student from Zhengzhou (Henan province) had bought an air ticket to visit me, but she had to cancel her trip, as at the last minute, her university department withdrew her leave, citing Guangzhou city as risky even though at that time only Liwan District was listed as medium risk.

Elsewhere in the city, quarantine was imposed at the blocks or areas where there were one or two infections. Haizhu district, where Ms Song’s niece lived, was the earliest area outside Liwan to be closely monitored. By 30 May all the residents there were instructed to take the nucleic acid test within the next few days, just like it was done in Liwan district on 26 May.

Meanwhile, all those who wanted to leave Guangzhou whether by road or by air had to show negative PCR results within 48 hours. Within a few days, everyone in Guangzhou City had to go for Covid tests, which allowed the authorities to trace and prevent the spread of infections.

I stayed in an apartment within the Sun Yat-sen old campus in Haizhu district. Monitoring of staff and students had begun right from the beginning of the latest Covid outbreak. Information regarding the situation in Guangzhou and the whole country was regularly disseminated, together with the requirements to observe certain new regulations. All entries into the campus were strictly monitored. Staff and students had to show the health codeon their mobile phones. Only those with a green code could enter.

In June, all residents in Guangzhou city (18 million) were required to take Covid tests thrice. I took the tests on 4 June, 10 June and 27 June, apart from the test taken on 31 May which was required of all Haizhu residents.

Each sub-district office was to ensure that each resident in its area took the tests. The university faculty offices also informed their staff and students to do the tests within two or three days, from the afternoon until 10 pm. Each person had to choose a time slot before-hand, as well as scan a QR code to fill up a form giving personal details. A screenshot was taken for reference. All this was done on mobile phones.

At the selected time slot, teachers (as well as non-academic staff and students) went to the sports stadium where the tests were conducted. They were asked to show their health code before lining up just outside the entrance of the stadium.

They were then ushered into the stadium in batches. While going to the waiting area, assistants checked their  screenshots to make sure they had filled in the personal information form. The few who had not done so or who had trouble downloading the form were asked to step aside and given assistance.

After a quick wait, each batch was guided to a desk to take the test. First, a small group of five persons went to the first desk where the screenshots in their phones were scanned. Within a few minutes, each was given a tube with his or her name and identity card number or passport number labelled.

They were then guided to a second desk to pass the tube to a medical staff, who took a sample from the person’s mouth and placed it into the tube. The process was orderly and quick. A day or two later, the test result was given over the phone.

I find people cooperated willingly, although the system also enjoined them to do so. Those who had not taken the test would find their health code change from green to yellow, requiring them to take a test to show negative results to get back the green health code, which allowed them to visit many public places. Staff from the sub-district office would also follow up with those who did not take the tests.

Lockdown in a residential area

To give a clearer picture of how the quarantine in a residential area is conducted, let me give the experience of a friend who lives in Haizhu district.

She lives in a housing area which comprises three blocks, two of which are linked. A person from her block, who went to Liwan district for dim sum, tested positive for Covid. Immediately, her block and the adjoining one were placed under quarantine. The swift action caught everyone by surprise.

My friend wrote (in a WeChat message): “Our residential quarters (xiaoqu) were locked down on the evening of 2ndJune. During the lockdown, all residents, including babies, had to undergo Covid-19           tests seven times. The lockdown was lifted on 18th June. After that, for a week, only residents could leave and enter the xiaoqu, outsiders including home assistants and couriers were not allowed entry. Only after 26th June were outsiders allowed access, and life returned to normal.”

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During the lockdown, no one was allowed to step outside their apartment. An electronic device was installed at each apartment to record each time the door was opened. Residents were only allowed to open the door to collect things or throw away garbage bags. If the authorities were suspicious of the records, police manning the area would phone up to enquire.

During the lockdown, social workers and volunteers helped to deliver food and other items to the residents. A few rows of shelves were set up in the common area to place items. Courier items and food deliveries ordered by the residents were left at the gate for volunteers to deliver to the apartments concerned. The delivery time was between 11am to 4pm.

Ordering online is very common in China. Residents could also leave messages on the WeChat group link to request for help to get certain items. It helps when one block in the xiaoqu was not locked down (but closely monitored) and residents there could help buy food or take photos of the delivery centre for their friends quarantined in the other blocks.

The Dumpling Festival (Duanwujie) fell on 14 June, and on that day the government sent gifts of dumplings, noodles, herbal tea and various snacks.

Nanjing Airport loopholes

The monitoring of Covid cases in Guangzhou showed that each infection spread rapidly in time and space, and immediate movement control was essential to reduce the chance of its spread to other cities.

A new infection in Nanjing illustrated this and provided a contrast to the control in Guangzhou. On the morning of 20 July, news from Nanjing of nine confirmed Covid cases at the Lukou International Airport alarmed people in the country. Eight of them were airport cleaners and one was a passenger cabin cleaner. On 27July, in a matter of seven days, Nanjing reported a surge of 106 confirmed cases and six asymptomatic cases.

Because of the failure to immediately control exit from the city by air and by land, the outbreak soon spread to other cities. On that day, the new infection had spread to nine cities in five provinces, namely in Suzhou (where Nanjing is the capital), Liaoning, Anhui, Sichuan and Guangdong (in Zhongshan and Zhuhai). Then there were only 20 Nanjing-related cases outside Nanjing, but this increased quickly. By the ninth day, the infection had spread to 27 cities in 15 provinces.

I was still in Guangzhou, and received messages from the university, the local authorities and telecom companies about the new outbreak. People became vigilant, although the economic life in Guangzhou remained normal.

The source of the Nanjing infection involved cleaners cleaning the cabin of a flight from Russia. Due to negligence in the health control of the cleaners (apparently arising from the poor coordination between the airport authorities and the cleaners’ company), the virus spread from them.

The swift spread of infections could be seen in the case of 64-year-old Madam Mao. On the evening of 21 July, just before the Jiangning bus station in Nanjing was closed on the following day, she boarded the bus to go to stay with her elder sister in Yangzhou, about 100km away. In the next few days, she visited a mahjong parlour.

On 27 July, she was sent to the hospital and found to be Covid-positive, later confirmed to be the Delta variant. She had not only spread the virus to her sister but also to the many who had played mahjong with her.

On 3 August 2021, a Jiangsu health official reported that there were 94 cases in Yangzhou, 64% of whom had connections to the mahjong parlour. Madam Mao has since been detained to be prosecuted for violating travel restrictions and for not reporting her residence after arrival in Yangzhou. (There are many reports about the Nanjing-related infection, see for instance, ZhongguoXinwenZhoukan, 28 July and 7 August, and PengpaiXinwen, 30 July.)

Given the seriousness of the Covid resurgence in Nanjing, the provincial discipline committee was quick to announce disciplinary action against the officials involved. By 7 August, the whole country learned of the names of the individuals disciplined.

The Chinese system of disciplinary action varies from a warnings, a serious reprimand, a demerit record, suspension or dismissal from job or party position, and prosecution.

Obviously, most officials sanctioned were from the airport authorities and from Jiangning district, where the airport was located. For example, the Lukou sub-district head in Jiangning District was removed from his position. Even the deputy mayor of Nanjing was given demerit discipline (jiguochufen). (See for example ZhongguoXinwen, 7 August 2021, and PengpaiXinwen, 7 August 2021.)

Taking disciplinary actions against party and administrative officials is a common practice in communist China. This is called the wenzeor accountability system. When something negative happens, officials in charge of an area or a department are identified and held responsible, often even when they may not be directly responsible.

Back in Guangzhou, while the quick action to control the new outbreak there was impressive, leading cadres were disciplined, mainly from the municipal health committee, the centre for disease control and prevention and the sub-district offices (especially in Liwan district) where there were outbreaks of new Covid cases. Two deputy mayors were reprimanded and given demerit points respectively (ZhongguoXinwenwang, 12 August 2021).

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Final thought

While it is debatable whether a country can bring Covid infections down to zero, there is no doubt that China has been successful in keeping the cases low. This allows businesses to operate and people to travel freely within the country. On 30 April 2021, for instance, China had only 16 new Covid infections, all imported, whereas a small country like Malaysia had 3,788 new cases on that day. Malaysia was beginning to experience a new surge.

Western media were quick to highlight the rise of new Nanjing-related cases in China without providing the background of China’s relative successful control compared to other countries. For example, on 5 August,China had 124 new cases, of which 44 were imported cases and 80 were local infections (61 of which were in Suzhou, where Nanjing is located). This was the time of the reported new Covid crisis in China. On the same day, Malaysia had 20,596 new cases while the US had 267,677 new infections between 2 August and 4 August!

The imported cases in China showed it was difficult to control the outbreak of new infections. International airports like those in Shanghai and Guangzhou continued to have imported cases. With so many of its citizens overseas as well as so many international businesses in the country, China cannot close off its borders.

China also has extensive land borders with mainland Southeast Asia. As the Covid situation in Myanmar deteriorated, many at the northern border tried to cross into China, which they had been able to do so easily before the Covid crisis.

The statistics of 44 new imported cases on 5 August were instructive: of these, 13 were in Guangdong, 10 in Yunnan, eight in Shanghai, eight in Shandong, two in Sichuan, two in Shaanxi and one in Tianjin. Those in Guangdong and Shanghai arrived by air, while those in Yunnan were from border crossings.

Following the increases in the number of imported cases in the border city of Ruili in Yunnan, the authorities built a 500km border wall and barbed wires equipped with high-definition cameras and vibration sensors over forested and mountainous areas along the border with Myanmar, literally overnight, in early July. Still, effective control of illegal crossings from Myanmar involved round-the-clock patrols and mobilisation of citizens to report ‘illegal’ migrants, for which a cash reward is provided.

While very few countries can emulate China’s effort to control Covid to such a low figure (the only other notable example is New Zealand), we can still learn from China’s relative success.

First, the attitude and will of the government is crucial. The media and politicians in the West like to highlight the authoritarian aspects of communist rule. However, taking care of the masses is not just a slogan in China, it is an important aspect of its communist governance, as it provides important legitimacy for its rule. This care for the welfare of the people comes to light most vividly in the effort to control Covid.

Second, competency and effective organisation are well illustrated in China’s control of Covid cases. Of course, the communist system of having a party secretary at every level of administration and the presence of jiedaobanshichu (sub-district offices) help to ensure that policies are implemented at the grassroots. This system can be an instrument of authoritarian control, but at a time of a pandemic crisis, it is most expedient and had the support of the masses.

Third, there is the emphasis on accountability. The wenze or responsibility system is important in holding officials responsible and accountable for their jobs. Although this can yield some unreasonable ways of handling matters as officials do not want anything bad to happen during their terms of office, it has been important in making officials feel responsible for their performance.

The principles of competence, efficiency and accountability have an played important role in China’s success in its modernisation and economic success. China’s success in modernisation and development is not due to economic factors alone, but cultural factors, like these, are important too.

These are principles which many countries, including Malaysia, need to embrace. For example, during the pandemic, the Malaysian government has often put the blame on people for not observing its standard observing procedure, but how many officials have been held responsible for the outbreak of Covid clusters, one after another? Surely there are individuals in factory management and in government administration that should be held responsible for the many outbreaks in factories.

The purpose here is not to glorify China. For all its weaknesses, I treasure living in Malaysia, where one can have free access to Google and WhatsApp and where there is, relatively, better protection of individual rights. But there is no doubt we need to pay more attention to the principles of competence, efficiency and accountability, which can guide us in judging the performance of a government.

The writer on his last day of teaching at Sun Yat-sen University

Tan CB (PhD, Cornell University) taught at the University of Singapore, the University of Malaya, the Chinese University of Hong Kong (where he is currently adjunct professor) and Sun Yat-sen University, Guangzhou. A cultural anthropologist, he has carried out research in Malaysia and China. His major publications include, as author, The Baba of Melaka (2021, new edition by SIRD) and Chinese Religion in Malaysia: Temples and Communities (Brill, 2018) and as editor, the Routledge Handbook of the Chinese Overseas (Routledge 2013)

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Tan Chee Beng (PhD, Cornell University) taught at the University of Singapore, the University of Malaya, the Chinese University of Hong Kong (where he is currently adjunct professor) and Sun Yat-sen University, Guangzhou. He is also a long-time Aliran member, who served in our executive committee in the 1980s.A cultural anthropologist, Chee Beng has carried out research in Malaysia and China. His major publications include, as author, The Baba of Melaka (2021, new edition by SIRD) and Chinese Religion in Malaysia: Temples and Communities (Brill, 2018) and as editor, the Routledge Handbook of the Chinese Overseas (Routledge 2013)
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Chan Chee Khoon
1 Sep 2021 5.55pm

hello, Chee Beng, thanks for a very informative, insightful article.
I’m also curious about those party, govt, other officials in Wuhan & Hubei who were reprimanded, transferred, or sacked, for (delays?), (incompetence?), (neglect?), (corruption?) in the early response to the first recognisably novel (atypical pneumonia cases), in late Dec 2019 and first half of Jan 2020…what were the reasons for the disciplinary actions taken against them? (western media & govts divert attention from their own incompetence by highlighting the early confusion and delays in Wuhan, in an initial encounter with a novel pathogen, and the ensuing outbreak investigation)

Chan Chee Khoon
28 Sep 2021 1.51am
Reply to  Tan Chee Beng

Many thanks for your thoughtful reply, Chee Beng (my apologies, I just saw it). Stephen Roach and Shan Weijian had pointed out that it was not Dr Li Wenliang, but Dr Zhang Jixian, head of respiratory and intensive care at Hubei Provincial Hospital of Integrated Chinese and Western Medicine who had first raised the alarm of a possible SARS-like outbreak on December 27, 2019 (Dr Zhang had diagnosed a family of three as suffering from a viral pneumonia of unknown cause, and had immediately submitted a report to her hospital, which in turn contacted the Wuhan Health Commission on December 29. The following day (December 30), the Wuhan Health Commission dispatched an urgent warning to all medical institutions under its jurisdiction about this mysterious new pneumonia. On the same day, an expert working group from the National Health Commission in Beijing was assembled to conduct on-site investigations and review contingency plans for an epidemic response. The team arrived in Wuhan early on December 31, and by 1pm that day, the Wuhan Health Commission had issued a public announcement regarding 27 pneumonia cases of unknown etiology. On… Read more »

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