QR Codes Now Dominate Everyday Life. Seniors Feel Left Behind.

In China’s major cities, residents now have to use “digital health codes” to do pretty much anything: from entering a restaurant to using a public restroom. For the many seniors who don’t have smartphones, that’s a big problem.

By Gu Peng and Fan Yiying

SHANGHAI — For years, Gu Hong has enjoyed visiting the local deli near her home. Whenever the 73-year-old didn’t feel like cooking, she’d wander down the street to buy a steaming plate of sweet-and-sour ribs.

Then Shanghai went into lockdown, and everything changed. When Gu returned to the deli in June, she found herself barred from entering.

“The staff said I had to scan the venue code with my cell phone before I could order,” an indignant Gu tells Sixth Tone. “This is the rule, and they just follow the rules.”

The encounter was just the start of Gu’s problems. Like many Chinese seniors, she doesn’t use a smartphone. Yet it’s now becoming almost impossible to live a normal life without one.

China has been using personalized digital QR codes — known as “health codes” — to track and trace COVID-19 infections and close contacts since the start of the pandemic. But in recent months, as the highly infectious Omicron variant has spread nationwide, this digital surveillance system has gone into overdrive.

Before Shanghai went into lockdown in April, residents only had to show a green code to gain admission to a few large-scale venues, such as shopping malls, airports, or government buildings. Now, it’s compulsory when doing pretty much anything: from riding public transport, to entering a store, restaurant, or café. Even public restrooms require a green code.

What’s more, the system has become far more complex. Residents are now required to take a nucleic acid test every 72 hours to access public places, which are tracked using the health code and a special “nucleic acid test code.” Then, to enter a venue, they have to scan a “venue code” at the entrance that logs their location, personal information, and COVID testing history. Anyone arriving in a new city, meanwhile, has to present a separate “travel code” that carries a record of their travel history.

The new rules have been effective at preventing a rebound in cases, but they have also caused huge disruption — especially for the millions of seniors like Gu who struggle to operate digital devices. In many cases, they’re intensifying the social isolation elderly people already face in many parts of China.

Gu has been left feeling increasingly marginalized. Her daughter gave her a smartphone in June and tried to teach her how to use it, but Gu gave up after a few attempts. The multiple codes with their differing uses were too confusing.

“I haven’t used high-tech gadgets my entire life, so it’s not realistic to ask me to show various codes on my phone all the time,” says Gu. “As we age, our ability to understand things becomes more limited. I feel very powerless.”

Indignities have piled up. When Gu went to a shopping mall to meet her family, she took a printout of her health code — a measure Shanghai introduced to help people without phones. But the staff asked her to walk around the building to a different entrance, as staff at the main gate couldn’t scan paper codes.

“It’s a long walk,” Gu says. “In addition to the inconvenience, it makes me feel inferior to others.”

Shortly after that, Gu witnessed a man in his 80s pee his pants outside a public bathroom, as the staff refused to let him enter without scanning the venue code. Gu winces as she recalls the man’s hands shaking while he fumbled with his phone.

“A group of people saw that, and we were all judging the staff,” says Gu. “This could happen to any senior, and I can’t even imagine how humiliated I would have felt if it had been me.”

After these bad experiences, Gu no longer feels like going out as much, especially when she’s on her own. She has become more dependent on her daughter, asking her to accompany her on errands and drive her around.

“I’m worried about my mom’s mental health,” Gu’s daughter, surnamed Li, tells Sixth Tone. “She used to be outgoing and independent, but now she rarely smiles.” 

Gu is far from alone. China had over 1 billion internet users as of December 2021, including 119 million users aged 60 or over, according to a government report. But that means that more than half of China’s elderly population — around 145 million people — remain “offline.” Over 30% of seniors are unable to access their health codes by themselves, the report adds.

Reports of seniors suffering due to the strict virus-control rules have proliferated in recent months, sparking public backlash. In early June, a video went viral on Chinese social media showing an elderly man in Shanghai being forced to get off a bus after failing to scan the venue code. He spends two minutes trying to scan the code, before finally giving up. “I won’t bother you then,” he says as he exits the bus.

Weeks later, another viral clip emerged showing a 90-year-old woman trying to buy sliced noodles for her birthday from a store in Shanghai. The staff, however, refused to serve her because she was unable to scan the venue code. In Wuxi, a city in eastern China’s Jiangsu province, meanwhile, a man in his 70s reportedly got trapped inside a railway station for three days because he was unable to scan the venue code.

So far, there has been little research published on how China’s pandemic-control measures have impacted the elderly population’s mental health. One paper released in May 2021, however, noted that elderly people who have difficulties using smartphones are likely to experience feelings of anxiety and depression.

Chinese authorities have made some attempts to make the system easier for seniors to use. As early as November 2020, the State Council issued new rules requiring all venues to stop relying solely on the health code as a way to verify visitors’ COVID status. Instead, there should always be an alternative method available, such as checking a person’s ID card or a paper certificate.

A month later, national authorities also ordered tech companies to adjust their platforms to make them more user-friendly, offering larger fonts, simpler interfaces, and voice recognition that recognizes regional dialects in addition to standard Mandarin.

Shanghai, meanwhile, created an “offline code” — a print version of the city’s health QR code — that seniors can use to access venues in August 2021. Last month, the city also launched a service that connects seniors’ ID cards with their travel cards, which should allow them to access public transport by presenting their offline code rather than scanning a venue code.

But many seniors continue to struggle. For one thing, a large number of venues — especially small-scale private businesses — don’t have the equipment to check offline codes. Plus, China’s “zero-COVID” system remains fragmented and complicated. Each city has its own digital monitoring system, which often includes several different codes. It’s not just confusing and inconvenient for the elderly.

Zheng Lei, a professor at Shanghai’s Fudan University and director of its Lab for Digital and Mobile Governance, says that the authorities need to simplify their systems. He proposes a “complete” transformation, with the government moving toward a “use one code to access everything” system, rather than “requiring multiple codes in succession.”

“Digitization and informatization are meant to make life easier,” says Zheng. “It should be a tool to serve people, not the other way around.”

Zheng adds that the authorities should overhaul their systems so that they are more intuitive to use. At the moment, local health codes tend to have abstract, formal names, meaning that people often don’t understand what they are for.

“We could call the ‘offline code’ an ‘epidemic travel card,’ so that the elderly can understand,” he suggests.

For now, seniors are finding their own ways to cope with the new rules. In late July, Sixth Tone rode a dozen buses in Shanghai to observe how accessible the public transport system is for elderly passengers. Most residents over 70 had printed out an offline code to ride the bus, while others used their phones to scan the vehicle’s venue code.

One passenger, surnamed Ma, held a shopping bag in one hand while gripping her phone in the other. “I don’t have my glasses with me today, so I was a little nervous since I can’t see the screen clearly,” says Ma. “Sometimes the phone freezes, which makes me anxious, and sometimes I even get dizzy.”

Though Ma finds it difficult to access the health codes via her phone, the 61-year-old has decided against applying for a printed offline code. “Deep down inside, I feel if I hold an offline code, it implies I’m old and incapable,” she says.

Zhuang Yinghua, 65, spoke with Sixth Tone as she scanned the venue code to enter the metro. She had asked her son to buy her a new phone in June, so that it was easier for her to access the various codes. “I specifically said I want the same brand,” she says.

On a piece of paper, Zhuang has written down step-by-step instructions for turning on the phone and accessing each code. She practices several times before leaving the house each morning, she says.

Wang Zengcheng, a student at Fudan University, has been teaching local seniors to use smartphones since last May, organizing free classes for the elderly in residential communities. Until the lockdown in April, most of her students were able to learn how to use the health code without much difficulty, but things are trickier now, she says.

“It was before the outbreak, so they only had to learn one code,” says Wang. “There is now a variety of codes, which is difficult for them to adapt to.”

Zheng, the professor, says these kinds of classes can be useful, but stresses that they should be voluntary. “The elderly should be able to choose not to learn about cell phones, instead of being threatened with exclusion if they don’t learn,” he says. “For elderly people with poor eyesight and no desire to learn how to use a smartphone, we should provide some alternatives.”

A medical worker scans the nucleic acid test code of an elderly resident in Shanghai, April 4, 2022. VCG

Starting from September, Shanghai will upgrade the scanning equipment on all buses, so that passengers’ travel cards, ID information, and COVID test histories are all linked and can be checked simultaneously. This should mean that passengers who swipe a travel card linked to their ID card will no longer need to show an offline code or scan a venue code when riding the bus.

For seniors like Gu, it’s a small step back toward normality. The septuagenarian is taking any small victories where she can, noting that she now only has to attend two — rather than three — mandatory weekly COVID tests in her residential complex.

“I think it’s a good sign,” Gu says. “I hope soon enough we won’t need to travel and live based on nucleic acid tests and health codes.”