Authors: Bingqin Li and Bei Lu, UNSW
Fighting against the spread of COVID-19 requires people to maintain social distancing and isolate from sources of infection, as advised by the World Health Organization. China’s approach was a ‘draconian’ lockdown. Not only were municipalities closed, but also communities, housing estates, and sometimes individual buildings.
There are debates over whether China should have taken such strict measures. But regardless of whether lockdowns should happen, communities need to be well prepared when they do. The fight against the pandemic is not only a challenge for health professionals, but also a stress test for broader society.
The severity of China’s lockdown varied from one area to the next. In most cities, each household was allowed to send one person to do the shopping every two or three days. In severely infected areas, people were completely housebound. The key considerations behind the lockdown were policymakers’ estimates of the risks posed by the virus and how difficult it would be to maintain social distancing. The anticipated travel of around three billion Chinese citizens and frequent social gatherings during the Lunar New Year drove the decision.
The structure of Chinese cities facilitated the strict lockdown. Chinese cities have many communities with gated high-rises that can be readily closed. An equally severe lockdown in spread out communities would have been considerably more difficult to implement.
Many of the lockdown tasks were the responsibility of individual communities, including enforcing social distancing and the travel ban. Most entrances to communities were shut down, leaving only one entrance open. Residents could only come in or out with valid IDs and while wearing masks.
Mobile phone apps were introduced to automatically check whether a person had used up their travel quota, while ID readers were installed to verify this at building entrances. In more tech-savvy cities — such as those in Zhejiang Province — digital gadgets were introduced to carry out monitoring and surveillance with minimal human contact.
Systematic monitoring of the health status of the population was also carried out through temperature checks at home and at all entrances to public buildings and gated communities. This was complemented by digitally enabled detection and prevention.
The Chinese government enforced the close monitoring of suspected cases so they could be quarantined or treated. People with light symptoms were sent to designated quarantine facilities such as hospitals or designated hotels, while those with severe symptoms were transferred to ICUs. There was also a focus on minimising hospital visits. In cities with functioning community-based healthcare facilities, the prescriptions for over-the-counter drugs were extended, and drugs were sent to community-based GPs for collection or home delivery.
Much importance was placed on ensuring the supply of food to housebound residents. When leaving home was not allowed, food was delivered to homes or to a designated area in a community for collection.
This is by no means a complete list of the actions taken at the community level to implement the central government’s approach to combating the pandemic. Enforcing these measures required a large work force that came from several sources.
This included government staff working for multiple layers of the bureaucracy. For example, there are 12,000 grid workers in Wuhan. These workers correspond to a section of their community, each of which collaborates with a resident committee. Committees have five to nine staff members and are in charge of 100 to 700 households.
For example, the Baibuting community in Wuhan has nine resident committees. Those on the committees continued to work during the lockdown and were in charge of responding to residents’ requests. Each person answered around 200–300 phone call requests every day while doing their own work.
Paid and unpaid building and unit masters were the key link between the residents and the outside world. These are usually retired people or local CCP members who volunteer to represent community members and carry out responsibilities for resident committees. Property management companies are usually responsible for the maintenance of buildings, facilities and public spaces. During the lockdown, they became the coordinators of anti-COVID-19 activities in gated communities.
A temporary workforce was recruited from CCP members, civil servants, the army, NGO social workers and volunteers. Residents also organised themselves on a daily basis to help each other via social media. Private businesses such as supermarkets and convenience stores also stayed open. People relied more on online shopping and some restaurants offered pre-packaged take away food.
Despite all of these arrangements, general confusion and mistakes increased social tension at the beginning of the lockdown. These mistakes happened when community-based staff were overwhelmed and overworked. It was a steep learning curve, especially for those not professionally trained.
The experience and lessons from China show that communities provide the most important support structure to medical professionals in the battle against COVID-19. While one cannot generalise everything about the Chinese case, action needs to be taken at the community level in every country to minimise the human cost imposed by the virus on wider society.
Bingqin Li is Associate Professor and Director of the Chinese Social Policy Program at the Social Policy Research Centre, The University of New South Wales (UNSW).
Bei Lu is a Research Fellow at the ARC Centre of Excellence in Population Ageing Research (CEPAR) at UNSW.
This article is part of an EAF special feature series on the novel coronavirus crisis and its impact.