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Do we need a unified 'health code' system?

By Hu Yinglian | China Daily | Updated: 2022-01-26 06:59

A health code for Guangdong province's residents is seen in this photo on Jan 10, 2022. [Photo/Xinhua]

On Wednesday morning Beijing's local health code system malfunctioned for a while. Similar incidents happened previously in other cities. Some cannot help asking how to improve the health code system and whether it is necessary to implement a nationwide one.

Non-pharmaceutical interventions (NPIs) have played a critical role in COVID-19 prevention and control, with the digital certificate or "Health Code" being one such NPI tool.

Actually, people in general have got used to showing their "green pass" before entering a public place such as a shopping mall or an office building. However, frequent travelers have to install more apps on their mobile phones since the digital certificates are not compatible across major cities.

Worse, the digital certificate system in Xi'an, Shaanxi province, collapsed in the wake of a latest cluster outbreak, which raised the cost of the nucleic acid tests and epidemiological investigations carried out in the city because health officials could not readily reckon the health data of local residents. As a result, there is a growing call for establishing an integrated digital certificate system for the whole country. But before doing so, the authorities need to thoroughly weigh the pros and cons of such a system.

Why didn't we have a nation-wide digital certificate in the first place? The simple answer is: it's a bottom-up innovation process. When the COVID-19 pandemic broke out, cities such as Hangzhou, Zhejiang province, in their attempt to minimize the social cost of tracing the close contacts of infected people, used this precision infection-control method.

The digital certificate system, based on census data and migrant population data, which are quite localized and somewhat diverse in terms of standard, originated at the city or prefecture level, and then expanded to the provincial level.

In other words, fragmented data configuration among local governments is a major obstacle to building a unified digital certificate system. That's why we see different digital certificates in practice for different purposes and in different parts of China.

Later, the central government introduced a nation-wide "Tour Code", though, to facilitate rapid response to advance epidemiological probes. The new code is based on people's consent, and studies are carried out based on phone signal. Although the app is not as conducive to detailed tracing as the digital certificate, it's pretty useful for cross-province investigation.

With the advancement of technology, digital certificate apps have come to include more information. One key improvement is the embedding of nucleic acid test results and inoculation database, which can be checked on the mobile phone when needed.

However, the initial digital certificate structure does not take these functions into account due to time constraint and fiscal shortage, and this disadvantage cannot be resolved through hardware expansion. During a massive population flow, especially a regional outbreak, intensive check requests may lead to system overload. This is what might have happened in Xi'an, causing the collapse of the digital certificate system.

Many would argue that with technology upgrading, the chances of malfunctioning will reduce drastically. Still, is an integrated digital certificate system the solution to the Xi'an-like system collapse? The authorities need to do an empirical cost-benefit analysis before approving the economic legitimacy of such a policy.

Besides, digital certificate is a governance tool closely related to local socioeconomic factors such as literacy, infrastructure, housing and living conditions, so it should be flexible enough when it comes to lockdown and other containment measures. For example, in big cities such as Shanghai and Shenzhen, a large percentage of the population lives in downtown, so real time location will be necessary to ensure only the affected part of a neighborhood is locked down or subjected to strict containment measures-whereas in rural and remote, mountainous regions, lockdown and other containment measures can be implemented on wider areas.

This shows a unified digital certificate system for the whole country does not necessarily mean better prevention and control measures. But if an integrated digital certificate is not the answer to the problem, how do we improve the current system?

The first job is to regularly update data according to people's needs. In cities such as Hangzhou, digital certificate can be replaced by ID card to travel by bus or the subway, because it will make life a little more convenient for senior citizens unfamiliar with smartphones. Contingency plan is another factor. In Tianjin, for instance, the local Center for Disease Control and Prevention gathered nucleic acid test results manually when the certificate system ceased working temporarily.

We hope more inclusive and collaborative functions, including information on food supply shortage during a lockdown, will be realized through the digital certificate system. True, digital technology is an NPI tool to contain communicable disease outbreaks, but it is not (and should not be) the only tool or method to do so. And since disease prevention measures have become part of our daily life, a more friendly and humane prevention policy is needed to enhance people's well-being.

The views don't necessarily reflect those of China Daily.

The author is a professor at the China National Academy of Governance.

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