The COVID-19 pandemic poses unprecedented challenges to public healthcare systems and demands intergovernmental coordination to cope with the resulting medical surge. This article analyzes the operation of Paired Assistance Programs (PAPs) in China, offering a timely comparative case for researchers and practitioners to examine when reflecting on the classic debate over the hierarchical versus network approaches to coordination in emergency management. PAPs highlight the importance of network management and necessity of institutionalizing mechanisms of governance to facilitate coordination within multilevel response systems. This article is protected by copyright. All rights reserved.