Guest Post: Shanghai Quarantine Diary, Part 1
Covid lockdowns and quarantines are increasing across China once more. Here is a first-hand account of life inside one of them.
Carl Setzer is someone I knew by reputation and as a customer when I lived in China. I wrote about him briefly back in 2010 here. That was in his incarnation as founder and CEO of China’s most successful craft brewery, Great Leap. He is an American who had moved to China in his early 20s and lived and worked there for a total of 16 years.
In late 2020, when he flew from the United States to Shanghai on a business trip, Setzer was cleared by airport authorities and then voluntarily moved to the regular “quarantine hotel.” Three days later, after Covid tests came back positive, he was taken into custody and ended up spending many weeks, against his will, in a Chinese Covid-quarantine hospital and under other forms of surveillance. By the time he left the country in early February of 2021, he had decided to move permanently away from China. He and his family now live in Cleveland.
Immediately after his detention, Setzer wrote a diary of these observed realities of the Chinese health care system. As he says below, “I wrote it so I could start to forget.”
A year later, he has decided to publish his recollections. I read an earlier version of this diary last year and have stayed in touch with Setzer since then. I appreciate his trust in allowing me to share his writing here.
The specific detail of his account makes up much of its power. Even after a number of cuts and condensations, the Covid diary is more than 10,000 words long. I will post it in four roughly equal-sized installments, starting with today’s. I think they have cumulative power when read in order but also are vivid and different enough to be read one-by-one, on their own.
Reported Covid rates, and resulting lockdowns, are increasing in China again. This is an up-close report on some of the details and realities of that experience. My thanks to Carl Setzer for this chronicle. [Update: Part 2 is here, plus Part 3, and Part 4.]
My 30 Days in a Chinese COVID Hospital
By Carl Setzer
On February 3, 2021, I landed at Detroit Metro Airport after spending fifty-eight days in mainland China, fifty-three of which were spent under some sort of isolation and thirty-one of which were spent at a medical detention center on the outskirts of Shanghai. Conditions like the ones I was subjected to are common in China, which has a historical habit of controlling through isolation and quarantine. I wrote this diary the day after I was released from Jin Shan Medical Detention Center on the first day of a separate 14 day quarantine at a 2 star business hotel near the Pudong Airport. I wrote it so I could start to forget.
My sixteen years in China took me from being a “foreign expert” at an automotive manufacturer in central China in 2004, to the co-founder and CEO of China’s largest craft brewery. My time in China showed me the reality of what China is vs. what it projects itself to be.
The type of medical conditions I experienced on my last visit were not new to me. Anyone who has ever loved an elderly person in China knows the pain of dealing with hospital administration, the lines, the overcrowded rooms, the lack of nutritious food, the lack of clean restroom and shower facilities, the indignity of guarding personal belongings from theft and the over stressed nature of what we would call “essential workers” even under normal conditions. It becomes less of a shock, and more of an expectation the more you actually live in China.
My conditions were only shocking because under extreme periods of panic and anxiety, extreme norms become extreme extremes under the stress of bureaucratic hierarchy.
This diary was edited by my friend Anthony Tao and was shelved for a year for the direct purpose of publishing it out of retrospect and not out of bitterness or anger. Contextually, everyone has a cage that they fear. Mine wasn’t the worst, others have been in far worse cages for far longer, others live in their cage far beyond the day they are released.
This is a window into how other cultures and political systems approach threats and maintain control. It offers no answers or grand epiphanies other than those I learned about myself. In a perfect world cages wouldn’t exist. We do not live in a perfect world. If you choose to read this piece in its entirety, think about those that are in cages, from which they will never be released, and remember you are free.
The beginning, December 2020
‘An ambulance is on the way. Pack your things and be ready to go.’
My flight from Cleveland via San Francisco landed at Shanghai Pudong International Airport at 6:30 p.m. on December 13, 2020. I was administered a PCR test on arrival which was declared negative and cleared for transfer to my destination: a colleague had arranged a VIP quarantine hotel, which meant a quicker transfer from the airport and a nicer living space. I texted to thank him as a van transported me to a never-opened Wyndham-owned hotel 55 minutes from the airport near the skeleton of the 2010 Shanghai World Expo. An elderly man in a full-body personal protective suit scanned my temperature, watched me fill out paperwork, then showed me to my room.
I called Liu Fang, my wife of thirteen years, via FaceTime and told her I was OK. I was in the room and the clock was ticking on my two-week hotel quarantine, which all travelers entering China, regardless of nationality, had to do. I was restless the first two nights, but jetlag may have played a part. Food was bento box-style and acceptable, nothing noteworthy.
By the third day I felt time was moving quickly; I had figured out the input system for taking my own temperature and uploading it to the China Centers for Disease Control central database twice a day, once in the morning and once at night.
It was around 10 a.m., after my breakfast of starch and fruit, that I got a call on my China number. I answered to a very official-sounding voice who said a lot of words I didn’t want to understand — which bureau he represented and why he was calling.
But he uttered some words that Liu Fang had trained me to listen for before I boarded my flight: He was trying to tell me that I had tested positive for COVID-19. An ambulance was on the way, pack your things and be ready to go.
I called Liu Fang immediately. It was just after 9 p.m. in Cleveland, and I delivered the news as unemotionally as I could, but she flew into denial. No. No. No. This can’t be happening. You were tested within twenty four hours before you got on the flight. How could this be happening? They cleared you at the airport when you arrived!
I knew already that it didn’t matter how, it only mattered that it was, indeed, happening. I gave her the number they called from and we decided that we needed to tell as few people as possible. Our HR director would be the only person at our company who would know for now. Our HR director was a Chinese woman in her early 40s, cheerfully patriotic in the way that so many of her generation are, those who have only known growth and the acquisition of pride and strength. She had been with our company for five years. After she confirmed that I understood the caller correctly, she added that they claimed it was a “weak positive,” and I would be taken to a triage hospital for more tests and a CT scan.
For the next hour, my wife tried to assure me that it was a mistake and I would be back at the hotel later that night. I knew she believed it. At 1 p.m., my room’s landline rang and a contact tracer from the Shanghai Regional Center for Disease Control told me he needed all my information. I added him on WeChat, an app which no one can go without in China. Through his questioning and tone I felt like I was being accused, like I intentionally brought COVID to China.
Before this trip, I spoke with a friend about our shared fear of just this moment. This is why my wife and I left Beijing, where I have a business and where I had lived for more than a decade, in February, 2020. I don’t do well in situations of extreme control. China may tout its anti-COVID measures — a combination of strategic lockdowns, contact-tracing apps, and the world’s strictest border controls — but rarely do we hear about those who test positive, what they’re subjected to and how they’re treated.
This is how.
‘You should feel lucky.’
At 1:30 p.m., I opened the door to two men in head-to-toe PPE. I am big enough to play college football, and it’s hard to find two men my size in China, but these men came close. I had no intention of resisting. I was loaded into the back of an ambulance by myself and transported to a triage hospital in Shanghai Pudong district’s outer urban reaches. It felt like we drove for an hour. It could’ve been just three blocks. The ambulance pulled into a fenced-in parking lot, where there was one other person, a young Chinese woman who had just flown in on United Airlines (I could tell from her luggage tags). I asked her if she had also come from the “Old Golden Mountain,” as San Francisco is called in Chinese, and she responded simply with “correct.”
We were then subjected to a spell of illogic that hinted at what I would experience over the next month. This woman and I supposedly had one of the most feared diseases in modern history, so we were left outside on a December afternoon for four and a half hours. I put on any extra layers I had in my luggage while the damp cold slowly infiltrated my bones. I stood stomping my feet as the minutes, then hours, ticked by. And then I worried. Worried into my phone and worried to myself. My wife stayed up as long as she could back in Cleveland, but I lost her to sleep while I idled in that sealed-off parking lot. Finally, at 6:50 p.m., someone called for us to enter.
There were about 15 people who came and went in front of us before the staff processed me and my United premium services buddy. I don’t know why we were last, I didn’t ask. I just assumed it was because I wasn’t important enough to be first.
The PCR nose-probe test was deeper than any I had yet taken, which was a challenge as the one I received at the airport already held that record proudly. I had a CAT scan in a room that was colder than outside (that’s not abnormal, since buildings in southern China lack central heating). My legs were tired. I was cold. I couldn’t tell if I was getting sick. I had Clif Bars and a water filter in my bags and wanted to get to them. I just needed to feel some progress. Limbo is worse than anything else when you feel ready to surrender.
The triage center’s on-call doctor came and told the young lady she was definitely infected and the presence in her lungs was aggressive. He came to me and said the equivalent of “I heard your Chinese is pretty good.” I said it was about as bad as my French. He laughed and said that my lungs were clear, but there might be some spots. I told him I had asthma and took an inhaler, and he said that the PCR test wouldn’t be back until tomorrow so I would have to stay at the triage hospital’s dorms. I told him I understood, and he sent me to pay for the tests.
The dorm was a converted hospital that had rooms with two beds, but only one person was assigned per room. The bathroom had a toilet and a sink, but no shower. Doctors communicated with me through a door with a glass window. I showed them my medications and answered their questions.
By the time I checked WeChat, there were hundreds of messages in a group chat between my wife, our HR director, and the Chinese contact tracer. He wanted to know every place I’d been in the past 48 hours before leaving America. Gas stations where I filled up, hotels we stayed at, restaurants where we bought food, and any scheduled or unscheduled stops for the bathroom. If I had to answer all his questions, I would’ve struggled to keep my temper under control.
That night and the next morning, the intercom in the room squawked at me about taking my temperature. And then, around 9:45 a.m. the next day, a woman came in and asked me why I hadn’t packed. I told her I wasn’t aware I had to go anywhere. Her eyes flashed. She said I was being transferred to the Jinshan Medical Detention Center for an indefinite stay. “It’s a three-star facility, you should feel lucky to be treated there,” she said.
There were four of us in the ambulance from the triage center: myself, a South African, and two Chinese women, including my travel buddy from San Francisco. The ride was a quiet one. I had not actually noticed how many of us were in the back of the ambulance until we arrived at our destination, such was my state of mind.
From the outside, the medical facility looked like it had been built for community public health services and training before being repurposed for COVID-19 isolation. The buildings on the campus were in a style that was popular in the early 2000s; they were not aging well. The face of the original buildings stood in stark contrast with the newer modifications, speaking to the hasty repurposing.
Our ambulance driver, monitored by security personnel, led us through a front door, where we were handed over to the facility’s intake staff. Everyone was in head-to-toe PPE. The two Chinese women were taken to their rooms first, but the other foreigner and I were told to keep moving. On my floor, there were 25 to 30 rooms. I imagine everyone who gets sent to this facility, local or foreign, feels like Andy Dufresne on his first day in Shawshank, convinced it’s a mistake.
‘The reality sank in. We were here, and there was nothing we could do about it.’
The other foreigner and I were taken to the last room in a ward on the first floor. When the door opened, we both stood in shock. This was the first time anyone had told us that we would be locked up with multiple people. Even if there had been a mistake in our test, a realization slapped me in the mouth: If you share a room with two other patients in a hospital built only for COVID-19, there’s no way you aren’t going to get the virus.
The room was four meters by eight meters. No part of the room had access to direct sunlight. The bathroom had a Western toilet, a small sink, and a shower. It also had a cockroach problem, which was frustrating. There were three beds, spaced 60 centimeters (two feet) apart, though leaving some generous space by the door for food deliveries and announcements. We were not allowed to leave unless we had an escort, and any requests to leave without an escort were denied.
There must have been about 30 people who passed outside in the hallway every hour, or someone every two minutes. They were able to look directly into the room and see me at any moment, awake or asleep. This was the most shocking part of my first week there. Imagine being an illuminated side show for people to gawk at while you try to sleep. The lights in the hallways were left on 24 hours a day.
It was clear that when this facility was built, the maximum occupancy was two per room: from the door to the window, the beds were numbered 75, +36, and 76. The beds were 80 centimeters wide and 2.1 meters long, just enough for me to lay with my head on the pillow, on my back, without my feet touching the foot board.
I was assigned Bed 76, by a window that was approximately 1 meter wide and 1.25 meters tall. From that window, I could look out on the main hallway, which hospital staff used. No patients were ever seen traversing that hallway. There were no curtains on any windows. The walls were metallic, which I discovered several days into my stay. My phone-sized Faraday bag has a magnetic flap that forms a seal and functions as a way of blocking digital and radio transmissions. I figured out that I could use it to block the light and slide it up and down based on my position in the bed.
My traveling companion got Bed +36, which was the center bed. I never learned his name and he never asked mine. We were both content commiserating in as limited a way as possible. When we arrived, there was a patient in Bed 75 of Slavic origin. I was not able to communicate with him directly. He kept to himself after an initial declaration that he didn’t speak English — a point that he had to make over and over to the staff, because all white people in China are assumed to speak English. He identified himself as Russian. He communicated with nurses via handheld translators, and it was through these exchanges that I learned he had arrived four days earlier. Our room — a Russian, a South African, and an American — could have been the basis of a sitcom if the situation weren’t so woeful.
“When can I be released?” the South African asked right away. The welcome staff comprised two nurses and a female administrator, who informed us that the shortest average minimum stay on our floor was 8 to 10 days, but sometimes longer. No one got out earlier than eight days.
We were informed that upon release, we would have to restart our hotel quarantine of an additional 14 days. This was legitimately shocking news to both myself and the South African. When the women left, reality sank in: we were here and there was nothing we could do about it.
To be continued, in installment number 2.
Several years ago, when I lived in Shanghai, I tested positive for malaria. A taxi came in the middle of the night to take me to a medical isolation facility about 2 hours outside the city. The photo looks just like the hospital room I was given. I had a room of my own, but many of the details of this account (no privacy, the food, the cool efficiency of the staff) are very familiar.
I can also say that I have eaten many times at Great Leap, which is celebrated for its burgers by foreign and Chinese diners alike.
What an incredibly miserable situation. I'm glad he wrote it up--hopefully others will be spared, although I don't know how that will come about. I have a cousin who I think still lives in China, with his Chinese wife and their children.