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Health code apps developed for Covid-19 prevention and control are likely to be here to stay, although there is little integration of the patchwork of apps

By NewsChina Updated Jul.1

As the national focus has shifted toward getting the economy back up and running, local jurisdictions are turning to big data and apps to judge whether it is safe to downgrade risk levels and allow businesses to open. 
Health code software, developed by internet companies including Alibaba and Tencent using their existing e-money apps Alipay and WeChat Pay and based on big data and digital technology, are in widespread use to determine whether people can return to work, travel cross-country or even enter a restaurant or bar.  

The software generates a QR code which tracks whether the user has been in contact with people infected, or suspected of being infected, with Covid-19. The users input their personal details which generates a traffic-light QR code in green, yellow or red. Green means the person can move freely, yellow means medium risk which requires a seven-day quarantine, while red means high risk. This requires the user to undergo a 14-day quarantine.  

The widespread take-up of the health code app has proven effective in tracking local transmissions of the virus and is helping block a second wave of infections. Nevertheless, criticisms and technical problems have surfaced.  

Data Integration
Shortly after the Spring Festival holiday, Hangzhou, capital of East China’s Zhejiang Province with more than 10 million registered residents, was facing the challenge of the return of some 5.5 million workers from other parts of the country amid the need to balance virus prevention with reopening the economy.  

On February 7, Zhou Jiangyong, Party secretary of the Hangzhou Municipal Party Committee, proposed at a routine epidemic prevention meeting that the city needed to develop a public health code system. A nine-strong team that had been recruited from the municipal economic trust committee, health committee, big data bureau and development and reform commission to construct a platform for the resumption of work was expanded into a task force of 100 people. 

Four days later, Hangzhou’s health code system was rolled out, developed with the assistance of Alibaba and Ant Financial and their Alipay mobile payment platform. Alibaba is headquartered in Hangzhou. On the first day, 1.34 million people signed up. It works by using big data to assign a Covid-19 health status. Green code holders are free to go anywhere, but yellow or red code holders are prohibited from traveling. But only two days later problems came to light, including sudden changes in a user’s health status for no discernible reason. Users said that even though they had been at home all the time, their code suddenly switched to red. Others said the code repeatedly switched between red and yellow. 

Zhang Zhongcan, deputy secretary of Hangzhou Municipal Party Committee, told NewsChina that there were three indicators used by the health code to evaluate a person’s status: where you had been, when and interpersonal relationships. 

If you are in or have been to an epidemic area, or have been listed as confirmed virus-positive or if you have a high temperature, you will be assigned a red code. A yellow code is assigned to people who have self-reported symptoms such as fever, cough, fatigue, or have a record of symptoms. Everyone else gets a green code. Changing from red to yellow requires isolation for seven days, then after 14 days, the code changes to green.  

“The moment you start using the health code app, its big data system starts countless calculations and comparisons,” a member of the Hangzhou health code team who works in data quality told NewsChina under condition of anonymity. 

Those diagnosed with Covid-19 who have been under controlled isolation will have a red code. When a person’s health code is declared, the system will automatically compare the identification of the applicant with the existing information in a pool of databases, which determines whether to issue the applicant a red code. The background system will also automatically compare the applicant’s Alipay positioning data and the operator’s positioning data, to make an evaluation. The more data the app has to draw on, the more accurate it will be. 

Zhejiang Province has already launched an integrated database built on the health code system. According to a document titled “Principle for Zhejiang Health Code Management” obtained by NewsChina, Zhejiang has used population, close contact and other databases to form a health code sharing database. Furthermore, the Zhejiang health code system platform is authorized to access information from population, corporate electronic licenses, credit information and geographic information databases. 

The health code database sharing structure is managed by the Zhejiang big data administration which allows access to other provincial departments. 

App Overlap
The cities leading the way in adopting health codes, including Shenzhen, where Alibaba tech rival Tencent is based, Hangzhou and Shanghai are pushing ahead with internal database integration to further the opening and sharing of data. 

“Only shared data can generate greater value,” Qi Tongjun, director of the data resources department of Hangzhou Data Resources Administration, told NewsChina in late April. Qi said for example, sharing data from the Social Security Bureau with other city bureaus would better serve the public.  

Hangzhou was able to capitalize on the health code system to integrate administrative data. Experts interviewed by NewsChina said the launch of the health code system was tantamount to forcing governments to speed up data integration. 

The health code system has become the standard method to track and prevent outbreaks of Covid-19, but the approach is not uniform. There are almost 100 health codes promoted by cities and provincial regions. In East China’s Jiangsu Province, major cities like Suzhou, Wuxi and Nanjing have their own apps, as well as one for the whole province. There is confusion about which app to use, as many overlap. In Hubei Province, where the pandemic started, you may need five or six different apps.  

Zheng Lei, a professor at Fudan University’s School of International Relations and Public Affairs, told the reporter that administrations around the country at different levels - provincial, municipal and county - have their own concerns about nationwide health code interoperability, as each local government is cautious when it comes to health code evaluations done by other provinces. Integrating systems involves trust, and each government body has a conservative attitude toward ensuring virus prevention and progressing mutual recognition of the health code generated by other provinces.  

Yang Wenzhuang, director of the Population and Family Department of the National Health Commission, told NewsChina there are three main reasons why health codes cannot be mutually recognized by different places. First, there are different standards for risk levels, response levels and prevention and control requirements in provincial regions. Also there are different standards for the generation of health codes, while health codes can only show the condition of the user at that specific moment. The health status afterwards cannot be secured simply on this basis. As the main technology developers behind the health code software, Alibaba and Tencent both used ElasticSearch, an industry-wide database system which powers applications with complex search features and requirements. 

But since different regions have different requirements as the Covid-19 situation varies, the health code varies too. A red code in one area might not be red in another. For example, in Shaanxi Province, people who had close contact with confirmed patients in the past 14 days are assigned a red code, but Heilongjiang Province assigns a red code to those who had close contact with confirmed cases, suspected cases or asymptomatic cases.  

While most parts of China have lowered their risk levels and it should be easier to integrate all the different health code apps, the challenge lies in barriers among codes across different provinces. 

Qi Tongjun said that technology and standards are a superficial barrier to app integration, but the real barrier is the lack of willingness and determination to cooperate among government departments. 

As of early May, provinces with large numbers of outgoing workers such as Guangdong, Zhejiang, Sichuan and Hunan have signed agreements on mutual recognition of health code certificates so work can resume.  

At the national level, data sharing is also enhanced. According to the established “national integrated government service platform epidemic prevention and health information code interface standard,” each department in each province can check the national database of confirmed diagnoses, suspected cases and close contacts, as well as the county-level risk grade database.  

On March 20, Mao Qun’an, director of the planning department of the National Health Commission, said at a State Council press conference that health codes in most parts of the country are mutually recognized, but there is a long way to go before there is a unified nationwide system. 

A poster explains how people can check their travel status by scanning QR codes provided by their telecom operators, Beijing, May 11, 2020

Upgrading Possibilities
As of March 16, the latest date for which data is available, the Tencent health code system based on WeChat Pay was rolled out in nearly 20 provincial regions, covering more than 300 cities and counties. Alibaba’s rival system based on Alipay was in more than 200 cities in 24 provinces.  

Local governments determine the algorithms and rules for setting up the health code system, while enterprises provide technical support. Zhang Mengxia from the Hangzhou health code team told NewsChina that the government chose the Alipay and WeChat Pay platforms because of their already huge reach. For local governments, market coverage of the platform is a priority when launching public emergency services such as the health code system. 

“In fact, the government doesn’t want to give the data out,” said Le Wenzhong, director of the big data center in Longgang District, Shenzhen. Le told NewsChina that the requirement for users to sign up to platforms using their real names is what appeals most to the government. 

Professor Zhou Tao from the University of Electronic Science and Technology, told NewsChina that internet giants such as Alibaba and Tencent expect to be able to capitalize on the health code system to lay out future chronic disease management and healthcare strategies. 

Apart from the two dominant enterprises, other internet companies including Meituan and Baidu have joined with government departments to launch health code systems.  

The final implementation of epidemic prevention and control policies are in the community, while internet companies are hoping to be able to access the community, and then obtain accurate community data through this opportunity. It is a “new portal” that internet giants have struggled to obtain. 

In an interview with NewsChina, Chen Dongping, president of Shenzhen Institute of Smart City and Big Data, questioned the wide dimension of health code data collection, saying it goes beyond the actual needs of epidemic prevention and control. In Chen’s view, problems include lack of top-level design at the national level and lack of proper communication with the general public during the process of mandatory data collection. These all add to public concern over privacy leaks when private databases are adopted.  

He Lingnan, deputy chief of the big data and communications lab at Sun Yat-sen University in Guangdong Province, told the Global Times in March that there has never been a large privacy leak in one of China’s big tech companies. Beijing city officials said at a press conference in early March that the data held will become outdated eventually.  

Local governments which invested administrative resources and money in the apps are considering how they can translate their investment into wider uses that will bring returns. On February 21, Hangzhou’s health code system was connected with electronic health cards and social security cards, the first city to use health codes to access medical services. 

Guangzhou has extended the provincial health code into lifelong identification certification, while Shanghai has expanded the health code into citizens’ or enterprises’ work, life, business and other behaviors to provide real time data services.  

In Le Wenzhong’s view, various identification certifications including health cards, electronic cards, social security cards and driver’s licenses now combine to give an entire portrait of the citizen. Although e-government nowadays allows these identity certificates to be paperless, in different scenarios, a person still needs to present different codes. The process is yet to be simplified.  

In Le’s vision, showing one QR code will be enough to fulfill diverse purposes including medical treatment, a driver’s license, school registration or bank business in the future. It can allow immediate access to the corresponding data for both the onsite service and background data operational work. This had been Le’s vision for the future. However, the pandemic may lead to it coming true faster than people ever expected.

A passenger shows a guard his health code at Wuchang Railway Station, Wuhan, Hubei Province, April 7, 2020