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Behind the Baidu Scandal: Baidu and the Putian Medical Group

The scandal revolving around Wei Zexi, the 21-year-old cancer patient who died after finding misleading treatment information on search engine Baidu, has uncovered a huge Chinese profit-driven healthcare market, in which Baidu and Putian Medical Group are running the show.

Manya Koetse

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The scandal revolving around Wei Zexi, the 21-year-old cancer patient who died after finding misleading treatment information on search engine Baidu, has uncovered a huge Chinese profit-driven healthcare market, in which Baidu and Putian Medical Group are running the show.

Baidu has been making headlines for the past days for its alleged involvement in the death of the 21-year-old cancer patient Wei Zexi. Wei, a frequent visitor of China’s online forum Zhihu.com, spent 200,000 RMB to receive an ineffective and contested form of immunotherapy at the Beijing Armed Police Corps No. 2 Hospital (武警二院) – a treatment that was promoted on China’s leading search engine Baidu.

Wei’s death sparked controversy on Chinese social media, where netizens are angered about Baidu’s practices of allowing medical institutions to pay to be prominently featured in their search results.

Further investigation has now exposed that the hospital where Wei was treated subcontracted the controversial therapy to the Putian Medical Group, which dominates most of China’s private hospitals.

Most Chinese are familiar with these hospitals or services, although they might not be aware of the fact they belong to the Putian group. Now that the relations between Baidu and Putian have become the focus of public attention, this might soon change.

A list of affiliated clinics and hospitals has become trending on Weibo under the hashtag ‘List of names of Putian Medical Group’ (#莆田系医院名单#).

Putian Medical Group

The Putian Medical Group (莆田系医院) refers to an organized group of entrepreneurs that originally come from the city of Putian, Fujian province, and who have set up private hospitals all over China. They specialize in anything varying from plastic surgery to gynecology, skin conditions or infertility clinics, but have become especially well-known for their treatment of sexually transmitted diseases (STDs).

How did one Chinese city become so influential in China’s healthcare industry? The city of Putian since long has a tradition of folk medicine, but Putian’s current monopoly in China’s private healthcare system goes back to the 1980s when a man called Chen Daliang came up with a successful remedy for treating scabies. In a post-Mao era where healthcare knowledge and facilities was fairly limited, Chen trained pupils from his town to also treat all kinds of diseases with limited medical knowledge. Putian soon grew into a town of ‘medical practitioners’.

Putian’s people discovered a medical goldmine by treating stigmatized conditions (such as STD’s) that were rarely treated at public hospitals. Throughout the 1990s, the medical network of Putian was opening up clinics across China. These hospitals were amongst the first to advertise their treatments (Week in China 2014).

In the 1990s, they also signed contracts with public hospitals to run specific departments. This system, known as the “hospital within a hospital”, was implemented all around China.

According to China Daily (2014), the Putian Medical Group sparked controversy in 1998 when bottles of medicine for STDs worth 10 RMB (1.5$) were discovered to be sold for 200 RMD (31$). A report by consumer advocate Wang Hai also questioned the Putian’s group eligibility and qualifications after healthy patients were reportedly diagnosed with STDs.

Despite controversy, the Putian group is the main player on China’s private healthcare market; of China’s 12000+ private hospitals, they hold around 8600 member hospitals – owning about 80% of all private hospitals in China.

Close ties between Baidu and Putian

The Putian Medical Group has helped Baidu make a fortune. Already in 2013, Putian’s Communist Party chief stated that Putian hospitals may have contributed 12 billion RMB (1.8 billion US$) of the total of 26 billion RMB (4 billion US$) in ad revenues reported by Baidu that year (Caixin 2015).

On the other hand, it is also because of Baidu’s top-ranking advertising space that the Putian Medical Group has been able to further expand their business and gain high profits within China’s healthcare industry. In this way, the online search engine and the medical group have a close-knit and mutually profitable relation.

According to a Caixin report from 2015, Baidu and Putian group previously had a dispute about Baidu’s “exorbitant fees”, after which 98% of Putian’s hospitals boycotted the search engine.

Baidu initially said that the boycott was a response to Baidu’s decision to block all Putian hospitals that had too many consumer complaints or were in violation of industrial regulations. But, Caixin wrote, a source at a Putian claimed that Baidu had pressured the hospitals to increase their ad spending by 10 to 20 percent annually. No matter what the source of their muddy dispute was, it was later solved and both parties continued their cooperation.

Taking advantage of patients

The qualifications of Putian-led hospitals are again questioned now that Chinese netizens expose that these clinics put commercial interests above the health of their patients. Well-known WeChat blogger Xinwenge (新闻哥) reported about the Baidu scandal on May 3, after which the blog received over 5000 messages, with many people sharing their personal experiences on how they were previously duped by healthcare providers linked to the Putian Medical Group.

Xinwenge shared a selection of the reactions of Chinese netizens, with many recounting how their appointment at a Putian-related clinic had cost them a lot of money even when the public hospital doctor later diagnosed they had no health problems.

Amongst the many messages were also those of people who previously worked at Putian hospitals. Some told that the expert doctors that were advertised in reality did not even work at the clinics, and that the staff was not qualified to do the abortion procedures they offered.

Sina News reported how a doctor was fired in 2005 for refusing to give out extremely high-priced prescriptions to patients.

Throughout the years, many patients have previously reported the Putian group for fraudulent affairs, Xinwenge writes. Although this has been covered by Chinese media, it has not changed anything about the conditions of these hospitals and their staff.

image

Most patients reportedly end up in a Putian-related clinic because they saw one of their ads, either on the Internet, on the television or in newspapers.

guanggao

For now, Baidu is under investigation, and the hospital where Wei Zexi was treated has closed its doors after an investigation by the health ministry.

On Weibo, many netizens are shocked with the facts that have been exposed over the past few days: “The Wei Zexi affair has exposed different evil actors,” one netizen writes: “First, the swindlers of Putian Medical Group; second, the hospitals; third, the administrative health inspecting departments; fourth, those responsible for the Internet. In the fifth place, it is Baidu and other such platforms who are responsible.”

“There are people saying that Baidu has no fault in this, that the hospital has no fault in this, and that only the cancer is to blame,” one Weibo user says about the Wei Zexi affair: “But this is just an excuse for Baidu and the Putian medical group to continue selling people hope to incurable diseases.”

– By Manya Koetse

Featured image: by Xinwenge.

©2016 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

Manya Koetse is the founder and editor-in-chief of whatsonweibo.com. She is a writer, public speaker, and researcher (Sinologist, MPhil) on social trends, digital developments, and new media in an ever-changing China, with a focus on Chinese society, pop culture, and gender issues. She shares her love for hotpot on hotpotambassador.com. Contact at manya@whatsonweibo.com, or follow on Twitter.

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2 Comments

2 Comments

  1. Avatar

    John Wang

    January 2, 2020 at 9:45 am

    Sad story for Baidu…. Baidu is really far away from Google in the west, because of trust problem.
    The search engine is too much money oriented and not enough users oriented.

  2. Avatar

    Olivier

    December 20, 2020 at 2:46 pm

    This sad story is still effecting Baidu performance in China, from consumers to Investors.
    Baidu lack of real innovation, and “good” stuff to create trust with consumers.

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Backgrounder

Explainer: Ten Key Terms and Concepts of the 20th CPC National Congress

Take a look at the essential keywords and concepts surrounding the 20th Party Congress.

Manya Koetse

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What are the key terms and concepts mentioned in Xi Jinping’s speech that are propagated all over Chinese social media this week? Here, we explain ten important concepts and keywords that you are probably going to see much more of in the coming five years.

It is the week of the 20th CPC National Congress, China’s quinquennial major political event that is all about discussing and deciding on important Party issues, appointing Party leadership and officially announcing new governance concepts, thoughts and strategies proposed by the CPC Central Committee.

The Party Congress opened on Sunday, October 16, when Chinese leader Xi Jinping delivered his nearly two-hour-long speech reflecting on the recent past and the future of the Communist Party and the country at large, signalling the direction China will be heading.

In our earlier article covering Xi Jinping’s speech, we focused on how Chinese official channels turned parts of the work report into hashtags that were promoted on social media and then became trending topics.

Here, we will go over some of the terms and words that were used in the political report delivered by Xi and were propagated on Chinese social media as ‘key terms’ through general hashtags such as “Understanding These Key Terms from the 20th Party Congress Report,” “Studying the Essence of the 20th Party Congress” or “The New Era and Journey of the 20th Party Congress” (#看懂二十大报告中这些关键词#, #学习二十大精神#, #党的二十大新时代新征程#).

During the 19th CPC National Congress in 2017, Party newspaper People’s Daily published a vocabulary list containing 100 relevant words and terms. That list included terms such as “5G Era” (5G时代), “Sharing Economy” (分享经济), “The 20th anniversary of Hong-Kong’s return to China” (香港回归祖国20周年), “Made in China 2025” (中国制造2025), and other key terms that were deemed relevant in 2017 for China’s nearing future.

This Congress, there has not been a comparable official vocabulary list, but there have been various shorter lists and hashtags encouraging netizens to study key terms that are important to this year’s Congress and the Party goals. Many of these terms are visualized in infographics or explained in online posts and articles.

We’ve gathered some of these key terms from Xi’s speech here that are important to understand, not just for the fact that they are mentioned in Xi’s speech but also because they are specifically highlighted by various official channels.

 

1. Modernizing the Chinese Way 中国式现代化

This concept was mentioned at least five times throughout Xi Jinping’s address and it is one of most important themes of this Party Congress: “Chinese modernization” or “Chinese-style modernization” (中国式现代化 Zhōngguóshì xiàndàihuà).

While the 19th Party Congress was all about China’s ‘new era’ (新时代), this 20th Party Congress term grasps the idea of further modernizing the country in a ‘Chinese way,’ meaning a type of modernization in which typically Chinese features and characteristics (“中国特色”) are maintained.

This is a relatively new term. A tool that shows searches on the Chinese search engine Baidu indicates that it did not receive any significant amount of searches before spiking during the week 20th Party Congress.

Baidu trend search shows that the term “Chinese-style modernizarion” “中国式现代化” did not receive any significant searches before October 2022.

The concept, however, did pop up in Chinese official media discourse since late 2021, such as in one article published by Xinhua News on September 27 in 2021 titled “Grasping the Main Features of the New Path of Chinese-Style Modernization” (把握中国式现代化新道路的主要特征)

The idea of Chinese-style modernization is closely related to other key concepts such as “common prosperity for all” (全体人民共同富裕 quántǐ rénmín gòngtóng fùyù) and “harmony between humanity and nature” (人与自然和谐共生 rén yǔ zìrán héxié gòngshēng).

 

2. The Central Mission 中心任务

The term “central mission” (中心任务 zhōngxīn rènwù) was mentioned at least once in Xi Jinping’s address to convey how the central task of the CPC is to “unite and lead the people of all nationalities to build a strong socialist modern country,” and to “promote the great rejuvenation of the Chinese nation with Chinese-style modernization.”

Although the term “central mission” itself is not particularly tied to the 20th Party Congress at all, it is now because of how it is being used in the new context of the Party’s ‘main goal’ in China’s ‘new era.’ People’s Daily also promoted a hashtag including this term: “The Communist Party of China’s Central Task from Now On” (#从现在起中国共产党的中心任务#”).

 

3. Top Priority 第一要务

The key term ‘top priority’ (第一要务 dì yī yàowù) refers to the Party pursuing the kind of “high-quality development” (“高质量发展”) that will lead to the further modernization of the country.

“High-quality development” was also mentioned in the 19th Party Congress report in 2017 to indicate a shift and a new phase in China’s economic development from a focus on high-speed growth to a focus on more high-quality development, which is also outlined in the 14th Five-Year Plan (2021-2025).

This means, among others, that there will be more focus on innovation-driven industries and technological advancement.

 

4. The “Two-Steps” Strategy “两步走”战略安排

In the segment of Xi’s speech where he addresses China-style modernization in the new era, he also mentions the “two steps” strategy (“两步走”战略安排 “liǎng bù zǒu” zhànlüè ānpái). This is not a new term and it has been previously introduced as part of China’s journey to becoming a strong, rejuvenated country – making China great again.

The two steps of this strategy are to realize ‘socialist modernization’ by 2035 and then to enter the next phase from 2035-2050 to build China into a “strong, democratic, civilized, harmonious and beautiful socialist modernization country.” The year 2049 will mark the 100th anniversary of the People’s Republic of China, and this is the moment when China’s “great rejuvenation” should be completed.

 

5. The Road to Follow 必由之路

At the end of Xi Jinping’s speech, he mentioned “the road to follow” (必由之路, bìyóuzhīlù) five times. On social media, the “road to follow” has been reiterated multiple times as well by official channels, including in a propaganda video published by CCTV.

The five ‘roads to follow’ mentioned in the Party Congress and in the state media videos are the following that are together presented as “the only road” the country and the Party must take. They are all linked together and are actually somewhat circular, namely:

– to develop socialism with Chinese characteristics, they must adhere to the overall leadership of the Party
– to achieve the “great rejuvenation” of China they must stick to socialism with Chinese characterics
– to reach this historic undertaking, they must be united in struggle
– to allow China to grow and develop in the ‘new era,’ they must implement the new concepts for development
– to be able to take this new road together & keep the Party full of vitality, they must follow the way of comprehensive and strict Party governance

 

6. Building Beautiful China 建设美丽中国

In the 20th CPC National Congress report, the idea of “building beautiful China” (建设美丽中国, jiànshè měilì Zhōngguó) was mentioned in the segment dedicated to the “green development” of China as part of its overall modernization. This includes environmental protection, pollution control, carbon reduction, and climate change awareness.

‘Beautiful China’ as a concept was first introduced during the 18th Party Congress in November of 2012 as part of China’s long-term environmental protection plan within the context of people’s welfare and the future of China.

 

7. Whole-process People’s Democracy 全过程人民民主

This concept of ‘whole-process people’s democracy’ (全过程人民民主, quán guòchéng rénmín mínzhǔ) is mentioned at least five times in Xi Jinping’s 20th Party Congress speech and it is one of the political concepts and terms proposed by Xi himself as part of Xi Jinping’s Socialist Thought with Chinese Characteristics for a New Era. It was mentioned in the speech Xi gave during the celebration of the Party’s 100-year anniversary in 2021.

This so-called ‘whole-process people’s democracy’ is officially presented as a ‘process-oriented’ democracy that, despite being different from Western democracy, supposedly “covers all aspects of the democratic process and all sectors of society” through a combination of elections, consultations, decision-making, management and oversight.

This idea of China having its own particular kind of democracy – or perhaps having invented a Chinese version of what ‘democracy’ actually means – also suits the idea of Chinese-style modernization, in which China’s path to the future will not be like the route Western countries are taking, but instead combining modernization with Chinese features.

 

8. Socialist Culture 社会主义文化

‘Socialist Culture’ (社会主义文化, shèhuì zhǔyì wénhuà) comes up at least four times in the 20th Party Congress report. The term represents a cultural side of China’s modernization, and emphasizes that, in order to build a strong socialist country, there must also be a strong socialist culture.

Although not explicitly stated, official media propaganda inescapably plays an important part in the cultivation of a strong ‘socialist culture’ that is all about cultural self-confidence, cultural innovation, creativity, and ‘spiritual energy.’

At time of writing, the Baidu Trends tool did not have enough information to show any relevant data on the search engine interest in this particular term, but the idea of ‘socialist culture’ is by no means a new one. “Socialist culture with Chinese characteristics” was already proposed by Jiang Zemin (江泽民) at the 15th CPC National Congress in 1997.

The idea that building a strong socialist culture is important for the further development of China has been further cultivated over the past few years under Xi’s leadership. Also read this article in English titled “How to build a strong socialist culture” in Qiushi, the CPC Central Committee bimonthly.

 

9. Improve the Distribution System 完善分配制度

This phrase comes up once in the part of the 20th Party System report that disusses a fairer economic system with more equal employment & income opportunities and regulated wealth accumulation, encouraging hard work to get rich.

Although it is the first time that a regulation of wealth accumulation has come up in this way (and it is not explained what this actually means), the idea behind these concepts of the distribution system and wealth accumulation standardization is that of ‘common prosperity,’ one of the most important concepts guiding China’s recent policymaking.

‘Improve the distribution system’ (完善分配制度, wánshàn fēnpèi zhìdù) was explicilty mentioned as one of the key concepts for this week’s meeting by various channels, but it mainly is ‘the regulation of wealth accumulation’ that is featured in social media hashtags (#中国将规范财富积累机制#).

 

10. Focus 着力点

Many of the words or phrases propagated as ‘key terms’ for this 20th Party Congress are insignificant by themselves but are merely used to represent a bigger body of thoughts. The aforementioned “Top Priority,” “Central Mission,” and “Road to Follow” are all just words that only mean something within the context of Xi Jinping’s speech.

Another example is “Major Principles” (“重大原则” zhòngdà yuánzé) which is also included by CCTV in this list of most important keywords, but which actually just goes back to the same ideas that are referred to in the other terms, namely strengthing the overall leadership of the Party, adhering to the road of socialism with Chinese characteristics, emphasizing people-centered ideology, etc. – which is similar to the idea behind the “Road to Follow” (必由之路) keyword.

Explanation of ‘Major Principle’ concept in English and Chinese by People’s Daily, posted on Weibo.

Then there is the keyword “focus,” 着力点 (zhuólìdiǎn), which is about the focus of China’s economic development.

In China’s coming years, the economic focus should be placed on the real economy (实体经济). This literally is also a hashtag promoted on Weibo by CCTV this week (“Put the Focus of Economic Development on the Real Economy” #把发展经济的着力点放在实体经济上#).

Different from the Financial Economy, the Real Economy is the realm of economy that is about businesses, production, and the direct exchange/purchase of goods or services.

Also part of this ‘focus’ is China’s new industrialization, manufacturing, product quality, aerospace, transportation, new technology, and digital China. Another related term that is proposed as one of the keywords of this Party Congress is ‘innovation’ (创新, chuàngxīn).

Please check in with us again this week as we will keep an eye on social media trends surrounding the CPC National Congress. Don’t forget to subscribe. For previous posts on the Party Congress, check here.

By Manya Koetse 

 

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Backgrounder

“Guarding the Green Horse” – How China’s Health Code System Provided Solutions and Generated Problems

The Health Code system and the ‘Green Horse’ meme have become part of everyday life in a zero-Covid China.

Manya Koetse

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Since 2020, China’s Health Code apps have become utterly ingrained in everyday life as a pivotal tool in the country’s ongoing fight against Covid-19. What is the health code system, what are its implications, and why have so many Chinese netizens become obsessed with holding on to their ‘green horse’?

 

This is the “WE…WEI…WHAT?” column by Manya Koetse, forthcoming publication in German by Goethe Institut China, visit Yì Magazin here.

 

There is the Grass Mud Horse,1 the River Crab,2 and now another mythical animal is living in China’s social media jungle: the Green Horse. The Green Horse is a cute bright green horse-like animal, a treasured creature that will protect you during your travels and keep you safe from quarantines and lockdowns at a time of China’s zero-Covid policy. The Green Horse will watch over you, but in return, you have to do everything you can to defend it.

‘Green Horse’ in Chinese is 绿马 lǜmǎ, which sounds exactly the same as the word for ‘green code’ (绿码), referring to the green QR code in China’s Covid health apps, which have become a part of everyday life in China since 2020. In a social media environment where homophones and online puns are popular and ubiquitous, it did not take long for the ‘green code’ to turn into the ‘green horse.’

The Green Horse, image via Weibo.

China’s health code system was designed as a solution to resume work and daily life during the pandemic and is widely praised in the country as a pivotal tool in combating the spread of the virus. But it has also given rise to new problems and has triggered resistance against a new kind of digital governance.

 

A SHORT INTRODUCTION TO CHINA’S HEALTH CODE SYSTEM

 

In February of 2020, when China was in the midst of the fierce battle against the novel coronavirus, the country’s tech giants competed over who would be the first and the most efficient in providing digital solutions to aid the anti-epidemic fight.

Within eight weeks after the start of the initial Wuhan Covid outbreak, Alibaba (on Alipay) and Tencent (on WeChat) developed and introduced the ‘Health Code’ (jiànkāngmǎ 健康码), a system that gives individuals colored QR codes based on their exposure risk to Covid-19 and serves as an electronic ticket to enter and exit public spaces, restaurants, offices buildings, etc., and to travel from one area to another.

Scanning a green code (image via Tech Sina, 2020).

Hangzhou, Alibaba’s hometown, and Shenzhen, Tencent’s home base, were the first cities in China to introduce the Health Code in early February of 2020, and other cities soon followed in collaboration with either Tencent or Alipay. By late February, a nationwide health code system was first embedded in WeChat (Chen et al 2022, 619).

Now, people can receive their Covid-19 QR codes via ‘mini programs’ in Alipay or WeChat, or via other provincial government service apps. Apart from the personal health code apps, there is also the ‘Telecommunications Big Data Travel Card’ (通信大数据行程卡), better known as the ‘green arrow code,’ which tracks users’ travel history and is also available inside WeChat or can be downloaded as a standalone app. Its goal is to track if you’ve been to any medium or high-risk areas over the past 14 days.

The Green Arrow Code is used to track people’s travel history of past 14 days (Image via 人民视觉).

The health code system is not as centralized as you might expect it to be. Instead, it is fragmented and sometimes complicated. There are basically two kinds of Health Codes in China. One is the ‘Health Information Code’ (防疫健康信息码) provided by China’s national government service platform (link) which can also be used by those without mainland ID cards (including people from Hong Kong, Macao, and Taiwan).

The other kind of Health Code, which is the one that is most used across China, is the local version of the health code system provided by each province/municipality. There are at least 31 different regional health code applications, from Beijing’s ‘Health Kit’ (北京健康宝) to Shanghai’s ‘Suishenma’ (随申码), from Jiangsu’s ‘Sukang Code’ (苏康码) to Anhui’s ‘Ankang Code’ (安康码). There are sometimes also separate health code apps being used within one province (e.g. in Shenzhen both the local Shen-i-nin 深i您 app as well as the Yuekang Code 粤康码 are being used).

These local Covid health apps are developed by different provinces and cities, and they are not always compatible with each other. This means that those traveling to different provinces or municipalities need to go through the inconvenient process of applying for different local health code apps depending on where they go. Although one single centralized system has been proposed ever since 2020, the process to unify the system is not easy since the various apps have varying functions and are managed by different local government departments (JKSB 2022; Lai 2022). In early September of 2022, China’s National Health Commission announced that it was working with relevant departments to improve the interoperability and mutual recognition of health apps across the country.

Do you get a Green, Yellow, or Red QR code? That all depends on personal information, self-reported health status, Covid-19 test results, travel history, and more – the health code system operates by accessing numerous databases. The Green color means you’re safe (low-risk) and have free movement, the Yellow code (mid-risk) requires self-isolation and the Red color code is the most feared one: it means you either tested positive or are at high risk of infection. With a red code, you won’t have access to any public places and will have to go into mandatory quarantine. Once the quarantine is finished and you’ve consecutively tested negative, the code will switch back to green again.

Three color codes in the Health Code (image via Tech Sina, 2020).

By the end of 2020, around 900 million Chinese citizens were using Health Code apps and although there are no official records of the latest numbers, virtually anyone visiting or traveling anywhere within China will now use the health code system. Besides keeping records of your latest nucleic acid test results, the Health Code app also includes Covid vaccination records since 2021.

 

LEAVING THE ELDERLY BEHIND

 

Despite the efficiency of China’s health code system, it has not been without controversy. One major issue is that it basically forces Chinese citizens to have a smartphone and to download and properly use these apps. This creates a problem for younger children, those without access to smartphones, or those with lower levels of digital skills, including senior citizens.

Although the use of smartphones, the internet, and QR codes are widespread in China, where mobile payments are far more common than cash, more than 60% of Chinese aged 60 years and over still did not use the internet in June of 2020. In China’s ‘Zero-Covid’ era, it is becoming almost impossible for China’s digital illiterate to live a ‘normal’ life.

Chinese authorities have attempted to simplify things for Chinese seniors by making platforms more user-friendly and introducing alternative ways to enter venues, such as offline codes. But at a time when systems differ per region and some venues do not have the tools to check offline (paper) codes, many elderly still struggle (see Gu & Fan 2022).

“They did nucleic acid testing in my grandma’s community compound today,” one woman from Shanxi writes on Weibo: “There are many elderly people in my grandma’s area, and I saw that so many of them had no smartphones, just senior mobile phones, but now they have to swipe a code to make an appointment for testing. One grandpa asked a staff member what to do without a smartphone, they just said it would be better to bring your son or daughter to do it for you. But all results also are processed digitally, so there’s no way for them to see it, and it’s really not easy for them to go to public places.”

On Chinese social media, there are many stories showing the difficult situations that some senior residents are caught up in because they do not have a smartphone or do not know how to get a Health Code.

In August of 2022, there was one viral story about an elderly man from Shandong walking ten kilometers every day because he could not take the bus without a health app. There was also another story about a visually impaired Hengyang resident who was unable to set up the code and was barred from using public transport. In May, a 70-year-old man got stuck inside the Wuxi train station for three days because he had no smartphone and had to scan a code in order to leave.

In another video that went viral, an old man got on a bus in Shanghai but had a hard time using his mobile phone to do the ‘venue check-in’ (场所码). When the bus driver got impatient, the man eventually got off the bus, saying he felt bad about delaying the other passengers.

“Heartlessness is scarier than the epidemic,” some Weibo commenters wrote in response.

 

RED CODE: CONTROVERSIAL DIGITAL GOVERNANCE

 

Another problem that concerns netizens in this Health Code era is that the code could pose an infringement of privacy and could be abused to limit citizens’ freedom of movement for reasons that are unrelated to Covid-19. There are still unclarities surrounding the app, such as what kind of information is exactly being collected, who is authorized to access the data, and how the data is processed and stored (Zhang 2022, 2).

Some people complain on social media that they do not understand why their Health Code is changing colors: “After I did a Covid test the other day, my Health Code was green. The day after, I woke up to a yellow code and after I had done my nucleic acid test again, it was still yellow. On the third day, it turned green. In the afternoon it turned yellow again. On day four, it was green again. Besides doing tests, I’ve been at home all this time. I’m stupefied.”

One incident where people who came to the city of Zhengzhou to protest suddenly saw their Health Codes turn red sparked major outrage on Chinese social media in June.

Earlier this year, thousands of Chinese depositors struggled to recover their savings in light of a major banking scandal in Henan Province. When dozens of affected depositors traveled to the provincial capital of Zhengzhou in June of 2022 to demand their money back, they suddenly saw their Health Codes turn red. The red code was unexpected and strange, considering that there were no new reported Covid cases in their vicinity. Accompanying family members who made the exact same journey reportedly did not see their Health Codes change, raising suspicions that the duped depositors were specifically targeted and that their Health Codes were being manipulated.

“Who is in charge of changing the Health Code colors?” became a much-asked question on social media platform Weibo, with many blaming local Henan authorities for abusing their power and trying to stop rural protesters from raising their voices in Zhengzhou. Although Henan authorities claimed they did “not understand” what had happened, five local officials were later punished for their involvement in assigning red codes to bank depositors without authorization (Wu 2022).

The incident sparked more discussions on the legal and privacy risks surrounding the health code system. Although many people in China support the use of Health Code apps (also see Chen et al), there is also a fear that a lack of transparency and management could allow the health code system to turn into a surveillance tool used by the wrong people for the wrong reasons.

The influential media commentator Hu Xijin also gave his view on the matter, saying that Health Codes across the country should only be used for “pure epidemic prevention purposes.”

“The fact that Henan can make the health codes turn red of people who come to the city to protest says a lot about the power of the IT,” one Weibo tech blogger wrote. Another Weibo user wrote: “As ordinary people, we have voluntarily given up too much of our personal privacy and rights in order to cooperate with the epidemic prevention. The current abuse and misuse of health codes have caused serious infringement on the legal rights of citizens (..) The state should quickly incorporate health codes into a unified system and place it under strict management, and once the epidemic is over, the health code system should stop running immediately.”

 

A GREEN HORSE FUTURE?

 

But will the Health Code and the ‘Green Horse’ ever disappear from daily life in China? And if so, how would the collected data be handled? Although the pandemic era is not over yet (and the question remains what would qualify as ‘the end’), local Chinese governments and tech firms are already looking to see how the health code system could be implemented and how its uses could be expanded in a post-pandemic future (Chen et al 2022, 619).

Back in 2020, the China Healthcare platform (健康界) already published an article exploring the post-pandemic use of the health code system as a digital health passport and information system that could continue to play a significant role in medical care, social security, public transportation, and tourism.

On social media, some people worry that the health code system – and everything that comes with it – is here to stay indefinitely. One Henan-based blogger wrote: “In the future, I hope my son will visit my grave and tell me, ‘dad, now we no longer need our Health Code, nucleic tests or masks when we go to the malls and take trains or airplanes.'”

“If I would wake up tomorrow in a world without health codes, travel codes, Covid tests, lockdowns, wouldn’t that be great,” another person wrote on Weibo, another netizen adding: “My health code is normal. My nucleic acid test is normal. It’s just my mental state that has become abnormal.”

The fears of receiving a ‘Red Code’ are also palpable. Earlier in summer, videos showed people in Shanghai fleeing out of a local mall once they heard that someone in the building had received notice of an abnormal test result.  The same happened at a local IKEA store. Afraid of Health Codes turning red and getting locked in, people rushed to get out as soon as possible. Some even compared the scenes to a ‘zombie apocalypse.’

People fleeing from a local IKEA store after someone in the building got an abnormal test result.

Although there are serious concerns regarding the health code system, social media users also make light of it through the ‘Green Horse’ meme. The phrase “Bàozhù lǜmǎ” (抱住绿码/马) is often used on Chinese social media, a wordplay meant to mean both “Keep your code green” as well as “Hold on to your Green Horse.”

Selection of ‘Holding on to the Green Horse’ memes.

Following the trend, Wuhan set up a giant green horse at a public square in the city, which soon became a popular place for people to take selfies. The meme is also a profitable one for businesses. On Chinese e-commerce sites, you’ll find there are ‘Green Horse’ keychains, stickers, toys, mooncakes, and coffee mugs.

Green Horse merchandise on Taobao.

As cases of Covid surged again in Chengdu, Shenzhen, and elsewhere in late August and September, worries over ‘keeping the green code’ grew again among those living in affected regions. One local Weibo blogger wrote: “I just couldn’t sleep the past few days, I kept checking my green code and latest Covid test results. It makes me anxious.”

“I feel safest at home,” others write: “This is where I can guard my Green Horse.”

“I hope this epidemic will go away soon,” one netizen wrote: “I hope we can all have our Green Horse and just keep it.”

 

By Manya Koetse
Follow @whatsonweibo

 

1 Grass Mud Horse or Cǎonímǎ (草泥馬) is one of China’s social media ‘mythical creatures’ and an online meme. It is a word play on the vulgar Mandarin term càonǐmā (肏你媽), which literally means “f*** your m*m.”

2 River Crab is another ‘mythical creature’: Héxiè (河蟹) is literally ‘river crab’ but sounds the same as héxié (和谐),”to harmonize,” referring to online censorship.

 

References (other sources linked to inside the text)

Chen, Wenhong. Gejun Hang, and An Hu. 2022. “Red, Yellow, Green, or Golden: The Post-Pandemic Future of China’s Health Code Apps.” Information, Communication & Society 25 (5): 618-633.

China Healthcare 健康界. 2020. “国家卫健委推行”一码通”健康码未来不止于”通行.”” CN Healthcare, 21 December https://www.cn-healthcare.com/article/20201221/content-547951.html [Accessed 22 Aug, 2022].

Gu, Peng and Yiying Fan. 2022. “In ‘Zero-COVID’ China, the Elderly Are Becoming Ever More Marginalized.” Sixth Tone, 9 Aug https://www.sixthtone.com/news/1010908/in-zero-covid-china-the-elderly-are-becoming-ever-more-marginalized [Accessed 22 Aug, 2022].

JKSB 健康时报网 [Health Times]. 2022. “国家健康码和地方健康码区别何在?专家:国家平台更接近理想状态.” JKSB, August 27 http://www.jksb.com.cn/html/redian/2022/0827/177853.html [Accessed 1 Sep, 2022].

Lai, Xianjin. 2022. “Unified Health Code Can Bring More Convenience, Efficiency.” China Daily, April 6 https://global.chinadaily.com.cn/a/202204/06/WS624ccc73a310fd2b29e55269.html [Accessed 31 August].

Liang, Fan. 2020. “COVID-19 and Health code: How Digital Platforms Tackle the Pandemic in China.” Social Media + Society (Jul-Sep): 1-4.

Wu, Peiyue. 2022. “Zhengzhou Officials Punished Over Red Health Code Saga.” Sixth Tone, 23 June https://www.sixthtone.com/news/1010627/zhengzhou-officials-punished-over-red-health-code-saga- [Accessed 22 Aug, 2022].

Zhang, Xiaohan. 2022. “Decoding China’s COVID-19 Health Code Apps: The Legal Challenges.” Healthcare 10 (1479): 1-14.

 

Featured image by Ama for Yi Magazin.

This text was written for Goethe-Institut China under a CC-BY-NC-ND-4.0-DE license (Creative Commons) as part of a monthly column in collaboration with What’s On Weibo.

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