Explaining China’s Uneven Response to COVID-19: The Role of Hybrid Bureaucracy

• In Event: Chinese Politics Mini-Conference: China’s Response to COVID-19: Bureaucracy, Governance and Public Opinion

Abstract

China’s response to COVID-19 has been uneven. In the first phase of the outbreak, from early December 2019 to January 20, 2020, the Chinese government was slow to address the outbreak, while censoring public discussion of the virus. However, whereas the first phase of the outbreak was characterized by a suboptimal government response, during the second phase (from January 20 2020 until April 8 when Wuhan was reopened), the central government directly steered a set of interventions which have proved to be effective in containing the epidemic. What accounts for this significant variation in government responses across the two phases of the COVID-19 outbreak in China?

Existing accounts point out two elements that have shaped China’s uneven response. First, information flow and inter-ministerial coordination in China’s authoritarian bureaucracy were ineffective when the outbreak started. Yet, the same authoritarian, top-down system facilitated a swift implementation of stringent containment measures afterward. Second, increased investments in China’s public health infrastructure since the SARS debacle in 2003 have allowed for public health preparedness, leading to an effective response.

This paper argues that a hybrid bureaucracy, which combines both legal-rational elements and features of fragmented authoritarianism, can account for China’s uneven responses to COVID-19. Elaborate public health regulations, which were formulated during the Hu Jintao era, have informed an effective response to COVID-19. However, since these regulations have been layered on top of a fragmented bureaucracy, information sharing, which was necessary for an early containment of the virus, was wanting.

The analysis of China’s bureaucratic response to COVID-19 focuses on three key policy domains, health system/public health, Personal Protective Equipment, and contact tracing. In each domain, the paper explains how two contradictory elements, robust regulatory structure and fragmented authoritarianism have shaped China’s uneven response to COVID-19. To study these three policy domains, this paper consults a variety of Chinese language sources including, central and local government public health emergency laws, regulations and contingency plans, local health systems audits, media reports as well as public health and primary care budgetary data. Using these data, the paper demonstrates that interventions and public health emergency procedures which are stipulated in the regulations have informed concrete government actions to contain COVID-19.

This study makes two key contributions to the study of epidemic responses. Theoretically, the paper’s theorization on the rational-legal elements in China’s public health bureaucracy brings into the fore an aspect of China’s successful response that very few outside observers of China have taken notice of. Empirically, the paper’s analysis of China’s hybrid bureaucracy uncovers new and important coordination issues. Whereas existing accounts of China’s response have emphasized the absence of vertical coordination between China’s central and local government as an impediment for an early response, this paper explores the impact of horizontal coordination within China’s health bureaucracy on China’s laggard early-stage response. Further, the paper unveils how existing regulations facilitated coordination between the government and the private sector, in particular big tech, permitting effective contact tracing operations.

Authors

• Jiwei Qian, National University of Singapore

• Yoel Kornreich, Tel Aviv University