How China Slowed Coronavirus: Lockdowns, Surveillance, Enforcers

Authorities ignored global norms for responding to epidemics; now other countries are taking a look at Beijing’s strategies

By Liza Lin
March 10, 2020 3:22 pm ET

When China’s Communist Party locked down an entire city to fight the outbreak of a new coronavirus there, some global public-health officials warned that the iron-fisted approach ignored world-wide norms for responding to epidemics and could make things worse.

Now, with the number of new cases across China dwindling—and rising outside its borders—the nation’s hard-line response to the pathogen is challenging decades of conventional wisdom about how best to handle infectious diseases.

This week, Italy sealed itself off from the rest of the world, placing the entire nation under quarantine. South Korea has restricted travel inside the country and increased surveillance on its citizens.

On Tuesday, Chinese President Xi Jinping visited Wuhan, the city at the center of the pandemic, for the first time since the outbreak began, a signal that the Communist Party sees itself as winning its battle against the pathogen.

Chinese leaders were seemingly caught off-guard when the virus began to spread widely early this year. Authorities at first muzzled frontline doctors attempting to warn their peers and the public of the deadly new virus. Officials denied it could be transmitted between humans. The delays allowed infections to multiply.

Since then, Beijing has attacked it aggressively. The campaign, described by Mr. Xi as a “people’s war,” melds technology with tactics from the party’s Maoist past.

Authorities sealed off Wuhan, a city of 11 million, on Jan. 23. At least a dozen more lockdowns followed. The party dispatched armies of low-level enforcers to guard the gates of residential compounds and restrict the movements of people living inside.

The government tapped data from state-run mobile carriers to track down individuals who slipped lockdowns, recruited volunteers to go door-to-door in apartment buildings to record body temperatures, and enlisted the help of tech companies to develop apps to separate healthy people from those at high-risk.

China’s government had, at various points in January and February, confined more than 500 million mostly healthy people—more than the combined populations of the U.S. and Mexico—to their homes, according to a conservative Wall Street Journal estimate based on state media reports. At its height, the quarantine encompassed at least 20 provinces and regions.

World Health Organization guidelines for epidemics recommend isolation only for individuals who show symptoms, and two-week quarantines for people exposed to a Covid-19 patient. Public-health experts in the West say that is because broad, indiscriminate quarantines are hard to enforce, encourage people to lie about their health and can disrupt access to critical supplies.

Some scientists say it is too early to know for certain whether the Communist Party’s reaction to the threat is the right approach. Nevertheless, signs that the contagion is dwindling outside the epicenter have caused epidemiologists and other public-health experts to rethink their assumptions about what is possible in battling epidemics.

Arthur Reingold, an infectious-disease expert at the University of California, Berkeley’s School of Public Health who was initially skeptical of China’s approach, said, “China has proven that maybe if you are draconian enough, if you put enough resources into it, you can actually retard transmissions.”

Other nations would likely face big obstacles employing the same tactics. Unlike in many other countries, China’s government has a tolerance for economic pain and willingness to run roughshod over individual rights.

“Nothing like this has been tried before in modern history,” said Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health. “Most countries couldn’t even logistically attempt it.”

The rapid imposition of quarantines, digital surveillance of potential virus carriers and mass testing have made it possible for China’s government to trap most of the outbreak in Wuhan and its surrounding province of Hubei.

On March 9, 17 new cases of Covid-19 were diagnosed in Hubei, with two new cases in the rest of the country. Hubei has accounted for 96% of the 3,136 deaths from the virus in the country so far. The fatality rate for the disease stood at between 2% and 4% in Wuhan, where medical resources were stretched, and 0.7% elsewhere in China, the WHO said in a media briefing in late February.

With Covid-19 cases multiplying in other countries, the WHO said in a report published last week that China’s strategy “provides vital lessons for the global response.”

Giovanni Rezza, the chief epidemiologist at Italy’s National Health Institute, was doubtful at first that China’s measures could be implemented in Europe. He changed his mind over the weekend as the number of Italian cases climbed.

“There’s no question they were able to combat the epidemic efficiently,” he said Tuesday of China. “We weren’t able to contain our initial cluster. Our restrictions were softer than China’s. But seeing how serious is the situation in the north, we couldn’t help but be scared for the rest of Italy.”

South Korea, where the virus has infected more than 7,500 residents, has canceled public activities and raised its virus alert to red, the highest of four levels, clearing the way for authorities to cancel public activities and restrict domestic travel. The government also is conducting more aggressive surveillance on potential carriers of the virus.

The experience of Vivy Shen, a 27-year-old operations assistant at a video-streaming company in the eastern Chinese city of Hangzhou, shows how Chinese authorities moved to contain the virus.

Ms. Shen spent two weeks in Wuhan on a work trip in the early stages of the outbreak, when officials were playing down the danger. She returned to Hangzhou on Jan. 19, the same day officials in Beijing dispatched a team of medical researchers to Wuhan.

A few days later, the team revealed that the virus was passing from person to person. Officials announced the lockdown of Wuhan on Jan. 23, a day after Ms. Shen had traveled back to her hometown, the nearby coastal city of Wenzhou, to spend the Lunar New Year holiday with her family.

For a week, Ms. Shen was inundated with phone calls from local police, community officials, health workers and others asking about her recent travel history and whether she had a fever. One call came from officials in a city she had passed through on her way to Wenzhou.

“They told me I had likely passed the place and my telecom provider had given them my data,” she said.

Along with state-run rail operators and airlines, China’s big three telecom providers— China Mobile, China Telecom and China Unicom —were the government’s first line of defense against the spread of the virus. Chinese rules requiring a government-issued ID to purchase rail and plane tickets, and to buy SIM cards for phones, made it relatively easy for authorities to track and contact anyone who had traveled through regions hard hit by the outbreak.

The mobile carriers shared location data on users who had passed through Hubei with the Ministry of Industry and Information Technology, which in turn passed it on to the National Health Commission and other agencies involved in the virus response.

The data enabled virus response teams to reconstruct the movements of potential virus carriers and others who may have come into contact with them, a process known as contact tracing, with unusual precision. Some cities used this information to publish messages on social media detailing the movements of likely carriers to warn populations that might have been exposed.

Soon, though, it became clear that the contagion was outpacing the data. As the number of new infections climbed, party leaders turned to older methods of control. They ordered local officials to seal off more cities and towns, and activated residential committees—remnants of the Mao Zedong era—to conduct human surveillance on residents of neighborhoods and apartment complexes.

Home to a large community of itinerant merchants and traders, Wenzhou was one of the worst hit in the early stages of the outbreak. Officials ordered buses to stop running and closed hotels and restaurants.

The residential committee overseeing her parents’ apartment ordered Ms. Shen to self-quarantine indoors for 14 days. Her mother was allowed to leave the complex to buy groceries once every other day, applying for an exit permit each time.

Authorities mandated the imposition of “closed-style management” at apartment complexes, blocking off side entrances so that residents can come and go only at a single point manned by security guards. The system mirrors those used to control Muslim minorities in the far western region of Xinjiang, where authorities have instituted a mix of digital and human surveillance to suffocate a separatist movement they say is driven by extremism.

Some local governments in Hubei, at the epicenter of the epidemic, have required residents who don’t comply with health guidelines to undergo compulsory education.

In the Hubei city of Huanggang, people caught in public without a mask or wandering outside without authorization have to pay a 1,000 yuan ($140) fine, and a fee of 40 yuan a day for two weeks of “forced study” classes, which are conducted in a sports stadium with students seated far apart, Huanggang residents said in interviews.

As infections rose in Huanggang in early February, the Communist Party dispatched a team there with instructions to “round up everyone who needs rounding up,” according to a state broadcaster, a phrase the party also has used to describe its campaign against Muslims in Xinjiang.

In Wuhan, some younger residents have called the police on older relatives for refusing to take proper precautions against infection, according to 26-year-old Uyen Yang, one of the volunteers helping Hubei officials collate health data.

“They didn’t know what else to do and are extremely worried,” Ms. Yang said of friends who reported family members. “Their parents won’t listen to them.”

As the number of new infections declines, Chinese leaders are relaxing some of the stricter controls in a bid to restart the country’s stalled economy. To guard against a resurgence in Covid-19 cases as people return to work, they have turned again to digital surveillance.

n orders from regulators, China Mobile and other telecom giants have developed services that call up a user’s travel history over the prior 14 days—the average incubation period of the virus—so that employers and managers of commercial properties can ascertain the exposure of returning workers.

The government also has worked with e-commerce behemoth Alibaba Group Holding Ltd. and social-media giant Tencent Holdings Ltd., the country’s two largest tech companies, to develop smartphone apps that assign health ratings to individuals. The system Alibaba helped develop is color coded: Symptomless users with clean travel histories are given green badges that allow them to pass through city checkpoints with the scan of a QR code, while higher risk users are assigned yellow or red badges that limit their movements. On Tuesday, Hubei announced plans to implement a similar system as it begins to lift travel restrictions.

The measures mirror Xinjiang, where authorities use a combination of data to label Muslim residents as safe, average or unsafe, notes James Millward, a professor of Chinese history at Georgetown University.

To the Communist Party, “the extremism in Xinjiang is a ‘metaphorical virus,’” Mr. Millward said. “Now we have a real virus, and some of the ways they are attempting to deal with it are the same.”

Chinese leaders have drawn fire from critics who blame the party’s top-down politics for suppressing critical information at the start of the outbreak. Frustration exploded on Chinese social media in January after the death from the virus of a doctor, Li Wenliang, whom local police had previously reprimanded for discussing the pathogen with classmates on a messaging app.

Some of those trapped in Wuhan have gone on social media to decry dire conditions in hospitals and a climate of uncertainty. Around the country, people prevented from returning to work live in fear of losing their jobs.

Still, the Chinese people interviewed by the Journal said they accepted the controls as a necessary sacrifice at a time of crisis.

Despite feeling uncomfortable at having her data shared with officials, Ms. Shen said she couldn’t complain. “Moments like this, it’s not the time to be difficult about such things,” she said.

By trapping the coronavirus in the hardest-hit areas, the Communist Party appears to be succeeding where other governments have failed.

During the West African Ebola outbreak in 2014, an attempt by Liberian authorities to lockdown townships and villages sparked violence that undermined efforts to respond to the disease. In Sierra Leone, the government prematurely lifted Ebola quarantines in the capital of Freetown after the city faced challenges delivering food and water.

Chinese leaders cleared the way for trucks to continue ferrying supplies into Hubei and other locked down areas, mobilizing volunteers and Communist Party cadres to take grocery orders and deliver food to individual apartment blocks.

In a study released March 6, researchers at Northeastern University in Boston said the Wuhan travel ban slowed the pathogen’s spread in China by three days.

In the U.S., responsibility for responding to infectious disease largely falls to state governments, each of which has its own laws governing quarantines. The Centers for Disease Control and Prevention needs a federal quarantine order for each individual it wants to sequester.

Digital surveillance also is trickier in the U.S., according to Albert Fox Cahn, executive director of the Surveillance Technology Oversight Project at New York University’s School of Law. Legal hurdles to accessing personal tracking data are lower in the case of public-health crisis, he said, but companies can be reluctant to hand it over, and authorities are required to obtain subpoenas in most cases.

Some Asian governments already have expanded surveillance efforts. South Korea is using credit-card transactions to track patients’ travel routes, and it started using a GPS-based app to monitor people under self-quarantine. Singapore’s health authorities have tapped ride-sharing data and surveillance cameras to do the same. In Taiwan, health inspectors track mobile-phone signals to make sure people don’t ignore home-isolation orders.

Officials in China and elsewhere have promised that new surveillance measures put in place to fight Covid-19 are temporary. Academics and privacy advocates, however, warn that once mass data collection has begun, governments have few incentives to roll it back.

“It’s not just Chinese. It’s common anywhere where there are systems of information gathering and control in place,” said Georgetown’s Mr. Millward. “Governments are data greedy entities.”