key: cord-0994750-9v0z2chz
authors: Cheng, Yuan (Daniel); Yu, Jianxing; Shen, Yongdong; Huang, Biao
title: Coproducing Responses to COVID‐19 with Community‐Based Organizations: Lessons from Zhejiang Province, China
date: 2020-05-26
journal: Public Adm Rev
DOI: 10.1111/puar.13244
sha: 18bccb8bf1f3a9d651a9a884fc5570baa64d61c9
doc_id: 994750
cord_uid: 9v0z2chz

Zhejiang Province achieved one of the best records in containing the COVID‐19 pandemic in China, what lessons can the world learn from it? What roles do community‐based organizations play in its success story? Based on more than 100 interviews during and after the outbreak in Zhejiang, this article provides a roadmap of how community‐based organizations were involved in the three distinct stages of Zhejiang's responses to COVID‐19. We recommend that public sector leaders strategically leverage the strengths of community‐based organizations in multiple stages of COVID‐19 responses; incentivize volunteers to participate in epidemic prevention and control; provide data infrastructure and digital tracking platforms; and build trust and long‐term capacity of community‐based organizations. This article is protected by copyright. All rights reserved.

facilitate the participation of their citizens and community-based organization in crisis management and response.

After the outbreak of the COVID-19 pandemic, no country can fight it alone, especially in such a globalized world. China is the first country to report and put in place strong wartime-like command and control mechanisms to control the virus. According to the latest information on the cumulative case totals across the most affected countries (see Accepted Article further prevent other countries from learning the more comprehensive picture of how COVID-19 was successfully contained in China through complex networks of community-based organizations working in collaboration with the state. For example, In response to the early criticism toward information disclosure and the resulting information credibility deficit, Li (2020) illustrated how the Chinese government was able to rely on experts and voluntary groups to increase information credibility and quickly restore public trust after the initial COVID-19 outbreak in Wuhan.

We argue that solely crediting the central government for the successful effort at containing COVID-19 in China is not only dangerous on ideological grounds but also misleading in terms of how the world can learn from these experiences in China.

Despite the strong policy directives and commands from the central government, not every province in China faced the same level of pressure from COVID-19 because of their varying levels of economic development and different geographical locations.

They also presented different patterns about how they contained and responded to COVID-19. These variations can hardly be attributed to central government actions.

We argue how community-based organizations worked with their local governments to coproduce responses to COVID-19 was a key determinant of whether containment strategies were effective at the local level.

The importance of community-based organizations in shaping public service outcomes and strengthening disaster response is well articulated in the academic literature. McGuire and Schneck (2010) note the strategic collaboration between public, private, and nonprofit organizations is the first principle that the Department of Homeland Security lists for emergency management. Elinor Ostrom and her colleagues at Indiana University develop the concept of coproduction to describe the nature of public services: "All public goods and services are potentially produced by the regular producer (government agencies) and by those who are frequently referred to as the client…. Coproduction implies that citizens can play an active role in producing public goods and services of consequence to them" (Ostrom, 1996 (Ostrom, , p. 1073 ). Community-based organizations play important mediating roles in helping citizens involved in public service provision and the work of local governments (Cheng 2019) .

The response to COVID-19 is a perfect example of why coproduction and community-based solutions are important. For a locality to develop a successful strategy in coping with the virus, it requires both government intervention and voluntary cooperation from its citizens. From self-quarantine to practicing physical distancing, from wearing masks to using hand sanitizers, the government cannot control every action taken by its citizens. In fact, decentralizing containment strategies to neighborhoods and communities is regarded as one of the keys to China's success story. According to the latest report on China's Fight Against (China Watch Institute 2020), universal participation with social cohesion is considered one of the four most important tools that China leveraged in the fight against COVID-19. This report synthesizes opinions and contributions from more than 70 experts within and beyond China. It highlights the importance of the active response of citizens to the government's call for action, their self-discipline, and community-based management. Due to its success, we chose Zhejiang Province in China to illustrate how community-based organizations were involved in different stages of the COVID-19 response. These practices provide lessons for other localities to adapt and adopt.

Zhejiang, located on the eastern coast of China, has 11 cities and 89 counties/districts 1 (see Figure 2 ). It is regarded as one of the most densely populated and developed regions in China. The population density of Zhejiang is around 540 people per square kilometer, two times and five times that of Britain and France, respectively. Because of the active development of private businesses in Zhejiang, it is also one of the major destinations for migrant workers. In 2018, the net population inflow into the province reached 800,000. After the interviews were transcribed, the research team first synthesized the key roles played by community-based organizations as they emerged from the interviews and then mapped these roles to different stages of COVID-19 responses.

The long-established collaborative relationship between the university and local governments in Zhejiang helped the research team quickly gain trust and support from top government officials to facilitate the implementation of this research 3. Five major cities and seven counties/districts within these cities 4 were visited by the research team, with on average two days spent in each city 5 . The field interviews are still ongoing in cities and counties/districts in Zhejiang as the date this article is being written. These field interviews provide firsthand insights from government officials and communities who are at the forefront of this crisis, especially those cities and counties/districts with the highest risk of COVID-19 transmission in Zhejiang.

Our interview findings generate a strong convergence towards the recognition of the important role of community-based organizations in every stage of COVID-19 responses: comprehensive epidemic prevention and control, balancing epidemic control and social functions, and the normalization of epidemic prevention and control. Table 1 presents the examples and the key roles community-based organizations played in each stage of Zhejiang's response to COVID-19.

Insert Table 1 About Here

Because of its vibrant private economy, Zhejiang has the most active social sector in the country. These community-based organizations have been historically active in response to various natural disasters, especially typhoons. Although the outbreak of COVID-19 presented a unique set of challenges compared to a typical natural disaster, these community-based organizations were able to organize quickly and work with local governments to respond to the disease. Official statistics have revealed that 34,000 community-based organizations within Zhejiang responded to the COVID-19 crisis, and over 2.8 million volunteers were mobilized to join community service activities (Zhejiang Civil Affairs Bureau 2020). The major roles of community-based organizations during COVID-19 included mobilizing volunteers to trace the source and spread of COVID-19, collecting donations and supplies for epidemic control, providing necessary social and community services, offering welfare services, assisting enterprises with production resumption, exerting psychological counseling and social work, and building collaboration platforms to promote sustainable economic development.

The first stage of the COVID-response was featured by the rapid increase of infections and the comprehensive tracing and control of COVID-19 sources. During the stage of comprehensive epidemic prevention and control, community-based organizations played three major roles: mobilizing volunteers to trace COVID-19 patients and those residents who were in close contact with the patients, collecting donations and supplies related to epidemic prevention and control, and providing community services to help people who were staying at home receive basic life support.

Emergency community-based organizations assisted local governments in searching and testing for COVID-19 cases and setting up checkpoints at the entrances of the province and communities. Since Zhejiang suffers from typhoons and floods in summer and autumn almost every year, community-based organizations and local governments have accumulated rich experiences in working together. In this stage of responses to COVID-19, local governments mainly worked on pooling strengths and providing resources to the most affected areas. Emergency community-based organizations were responsible for rendering specific services to townships, towns, and villages. According to the Zhejiang Civil Affairs Bureau (2020) Center, organized 12,800 volunteers to aid transportation and public security. They established temporary tents to screen people for COVID-19 through temperature checks at expressway entrances, railway stations, road entrances to villages and supermarkets. These efforts effectively prevented the epidemic from spreading.

Community-based organizations created a cross-department collaboration network with local governments and private enterprises, building a quick response mechanism for material demands related to epidemic prevention and control. By 

This article is protected by copyright. All rights reserved.

Starting from February 10, people began to resume work and production, marking that epidemic prevention and control in China entered a new stage. The Chinese Central Government asked local governments to restart economic and social development while ensuring epidemic prevention and control. During the stage of balancing epidemic control and social functioning, community-based organizations in Zhejiang adopted information technology and digital tools to closely monitor the status of COVID-19 patients or people in close contact with these patients, assist enterprises to gradually resume production.

The implementation of the Zhejiang health QR codes was a game-changer for how community-based organizations were involved during this stage of COVID-19 responses. The Zhejiang health QR codes was a digital innovation Zhejiang adopted to use three colors (green, yellow and red) to manage and monitor the health conditions of their residents and everyone who wants to enter communities in Zhejiang (see Figure 4 ). This information technology-based health surveillance system provides an efficient and flexible mechanism to generate individual-based solutions in the prevention and control of COVID-19 (Wu, Xu, and Wang 2020) .

While community-based organizations in Zhejiang kept maintaining checkpoints in residential areas during this stage, the implementation of the health QR codes greatly improved the efficiency and scale of their work. For example, more than 230 community-based organizations in Yinzhou district came to communities for 24-hour health codes checking and temperature measurement. The head of Yinzhou district treated this close partnership between community-based organizations and local This article is protected by copyright. All rights reserved.

Accepted Article governments as the core force in fighting against COVID-19 9 .

Insert Figure 4 About Here Economic organizations also teamed up with industrial and business associations to collect resources and provide services for responding to enterprise needs, so that small and micro enterprises could resume production in an orderly way. The great number of small and micro enterprises in diverse industries are the economic foundation of Zhejiang, accounting for 80% of the province's GDP. These small and micro enterprises are vulnerable, however, to market risks and had difficulties in quickly resuming production. Industrial and business associations played an instrumental role in organizing these enterprises to support each other during the economic downturn.

The head of Wenzhou city said that during epidemic prevention and control, industrial and business associations grouped member enterprises to alleviate their burdens 10 . For example, the Wenzhou Glass Industry Association and the Wenzhou Clothes Business Association inventoried enterprises' needs for temperature measurement equipment, masks, and other protective materials, after which they conducted collective procurement, which greatly reduced the cost. In addition, they updated information on production resumption to fix the raw material supply chain and product distribution chain. Industry associations established financial service platforms and channels for legal aid, benefiting member enterprises with high-quality and convenient counseling services. Business associations initiated fee reductions to lighten rent burdens on member enterprises. Collectively, the efforts of industrial and business associations in Zhejiang accelerated the production resumption of small and micro-enterprises. On February 26, 2020, a total of 99.3% of the 777 small and micro business industrial parks reopened, and the production resumption rate of the businesses located in these parks reached 67.3% (Zhejiang Daily 2020).

Starting from March 1, the economic and social life in China gradually returned to normal, as 28 provinces celebrated zero increases in confirmed COVID-19 cases.

Zhejiang had not detected any new COVID-19 patients since February 21, while those discharged from hospitals accounted for 78.3% of the total confirmed cases by then.

The response to COVID-19 thus entered a stage of epidemic prevention and control normalization. How can public sector leaders in other localities and countries learn from Zhejiang's experience? We propose the following recommendations for public sector leaders to better engage their citizens and community-based organizations in their responses to COVID-19.

Community-based organizations played varied yet coordinated roles in Zhejiang's response to COVID-19. For example, emergency response organizations (e.g. Dolphin Emergency Rescue Team of the Hangzhou Dishui) played major roles in mobilizing resources and providing supplies, while industrial and business associations (e.g. the Wenzhou Glass Industrial Association) played important roles in economic recovery. It is crucial for public sector leaders to think strategically and to create space to leverage the strengths of community-based organizations in the different stages of the overall COVID-19 response. Local government leaders should design a public governance mechanism which is inclusive to organizations and stakeholders outside the bureaucratic system and provide rules to facilitate their coproduction of quality public services, in this case, the response to COVID-19 (Gao and Yu 2020) .

During the first stage of the COVID-19 response, there was considerable uncertainty about this new crisis. Therefore, citizens were not likely to serve as active volunteers. Innovative programs such as volunteer banks and those that had This article is protected by copyright. All rights reserved.

Accepted Article government officials serve as volunteers incentivized local residents to participate in the prevention and control of COVID-19. These programs also built long-term volunteer pools for subsequent efforts by local governments and community-based organizations. Public sector leaders should design similar innovative programs to encourage and facilitate volunteering and citizen participation.

The implementation of the Zhejiang health QR code created the data infrastructure and digital tracking platform for community-based organizations to participate in the prevention and control of COVID-19. Individual citizens could also use their cell phones and the code to guide their own activities and behavior. This innovative use of big data and information technology connected the groundwork of community-based organizations to the macro-level management of local governments.

The public sector should consider similar initiatives to provide necessary and direct information for citizens and community-based organizations to jointly participate in the prevention and control of COVID-19.

Community-based organizations' quick and effective involvement in Zhejiang's responses to COVID-19 were largely built on their previous experiences in working with local governments in response to natural disasters. Therefore, the public sector should build trust with community-based organizations and invest in their long-term organizational capacity. This is crucial for effective community responses to future disasters and emergencies. The research process of this study is also an example of how well-established university-government partnerships could help researchers and public managers build trust and jointly carry out important applied research project to facilitate policy innovation and diffusion.

The COVID-19 crisis presents paramount challenge to our society and exposes many problems of our administrative system. Solving these problems require scholars and practitioners to revisit the key assumptions and issues in public administration.

More than ever before, COVID-19 teaches us the lesson that successful societal responses to the crisis require both effective governmental actions and citizens' voluntary cooperation (Moon 2020). The evidence and experiences in Zhejiang highlight the importance of community-based organizations in facilitating the coproduction of COVID-19 responses between the government and its citizens.

For scholars who study coproduction and government-nonprofit relations, the experiences in Zhejiang offer invaluable opportunities to advance our general understanding of coproduction and the role community-based organizations in disaster response. Cheng (2020, p.4) proposed one of the key questions for studying coproduction from a comparative perspective is "how should we envision coproduction when the scale of population moves to another order of magnitude in Asian and African countries?" In Zhejiang, digital governance and the implementation of Zhejiang health code provides the information platform to help address the scale problem for coproduction. However, will the digital divide and privacy concerns further complicate the social equity implications of coproduction, especially in localities where citizens are less equipped with digital devices and capacities (Clark, Brudney, and Jang 2013; Gazley, Lafontant, and Cheng 2020) ? More studies are needed in this intersection between administrative reforms and coproduction. Local experimentations stimulated by the COVID-19 crisis provide an ideal context to study these complex interactions for coproduction research.

Facing such a large-scale natural disaster like COVID-19, no sector or country can respond to it on its own. The evidence and experiences in Zhejiang suggest that there are solid steps public managers can take to better integrate citizens and community organizations in their responses to COVID-19. These lessons are not only important for provinces and localities in China, but also other countries and regions around the world as our fight against COVID-19 continues.

Notes 1 In China, county or district is the lower administrative division of city.

2 Key interview questions about the role of community-based organizations in COVID-19 responses include: how do you evaluate the responses to COVID-19 in your community? What were the key factors in shaping the responses to COVID-19 in your community? How unique are these factors and to what extent can experiences in your community be copied and implemented in other communities? What role did community-based organizations play in your community's responses to COVID-19 (probing questions asked for different stages of the responses)? How did you collaborate with community-based organizations in these responses and what were the main challenges/outcomes of such partnerships? 3 Zhejiang University helped facilitate some of the major administrative reforms in Zhejiang, including the recently famous "Run at Most Once" reform (Yu 2019) . 4 We visited the following cities and counties/districts in our field research: Hangzhou City, Jiaxing City, Wenzhou City, Taizhou City, Ningbo City, Fuyang District and Yuhang Distrct in Hangzhou, Nahu District and Tongxiang County in Jiaxing, Yongjia County in Wenzhou, Huangyan District in Taizhou, and Yinzhou District in Ningbo. 5 In a typical two-day visit in a city, we spent the first hour meeting the head of the city, then having a roundtable interview and discussion with the directors of key agencies in COVID-19 response. After the interview with the city government, we went to the counties to meet civil servants and community residents to understand how COVID-19 responses were implemented on the ground. All of the interviews were transcribed after getting permissions from the interviewees. 6 Interview conducted on18 February 2020. 7 Interview conducted on 20 March 2020. 8 Interviews conducted on 21 March 2020. 9 Interviews conducted on 21 February 2020. 10 Interview conducted on 17 April 2020. 11 Interview conducted on 25 February 2020. Note: Zhejiang implemented a color-based health code system through cellphone app. People with a green code could travel within Zhejiang and visit or leave Zhejiang by showing their codes. Red and yellow code holders had to go into government quarantine or self-quarantine for 14 or seven days, respectively, and their codes would switch green after consecutive health reports within this period. 

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Accepted Article

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National Average Note: Hubei is excluded from the national average because of the complete lockdown of major cities in that province

Number of diagnoses (Zhejiang) Number of diagnoses

The authors wish to thank our reviewers for their helpful comments and our interviewees for their cooperation in this research. Any errors are our own. This