JPT | 5 August 2017
How the Petroleum Industry Can Learn From the Ebola Crisis of 2014
The Ebola crisis of 2014 was one of the worst infectious disease outbreaks in recent history. It also occurred in a region with endemic medical risks and poor medical infrastructure. These two factors make it an important learning exercise for the global petroleum community. This paper reviews the Ebola outbreak from the viewpoint of an onshore and offshore petroleum operator, providing insight into the real threats the outbreak presented by looking past the media hype and diving into the real organizational effects of the outbreak.
West Africa experienced the most severe Ebola virus disease (EVD) outbreak ever recorded. The most-affected countries are Liberia (10,672 cases as of 16 August 2015), Sierra Leone (13,494 cases), and Guinea (3,786 cases). Other affected countries include Mali, Nigeria, and Senegal in Africa; and Italy, Spain, the United Kingdom, and the United States, although to a much lower level. Pictorial representation of the number of cases and deaths in affected countries as of 5 July 2015 is shown in Fig. 1.
Number of deaths and people affected by Ebola.
The World Health Organization on 6 August 2014 declared this Ebola outbreak in West Africa to be a public health emergency of international concern.
The West Africa Ebola outbreak has been the largest, longest, and most complex since the virus was discovered in 1976. It has had the highest number of cases and deaths ever reported for Ebola.
A functional health system is a prerequisite for any coordinated preparedness for and response to any possible outbreak. The 2005 revision to the International Health Regulations (IHR) is a legally binding agreement whose purpose is “to prevent, protect against, control, and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.” None of the most-affected countries were compliant with the IHR regulations, and this surely delayed the timely identification of the disease, the setting up of contact tracing and adequate surveillance measures, and the early implementation of infectious control measures in healthcare settings.
This epidemic served as a reminder of the possible negative consequences of globalization (i.e., rapid spread of infection across continents and oceans, putting the entire world at risk). The West Africa Ebola outbreak also reconfirmed that infectious diseases cannot be easily cordoned off to one country or continent. Rather, an outbreak will have an immediate and critical global effect if immediate prevention and control measures are not put in place.
In addition, countries with weak health systems and poor health infrastructure cannot withstand the effect of such rapidly spreading epidemics. In such situations, the country’s health systems will collapse, leading to more and more deaths because many patients with other diseases (e.g., malaria and HIV/AIDS) would not approach the clinics for fear of being exposed to the epidemic. This could lead to economic shutdown of the affected countries, leading to humanitarian crises. Thus, there is a significant need to strengthen and restructure basic public health systems in these countries, including primary healthcare facilities, laboratories, surveillance systems, and critical care facilities.
Another important lesson learned is the importance of collaboration with media in order to provide correct information. This is essential to avoid or control the spread of panic among the community. The additional threat to the population’s faith in government and international agencies can be fatal for both sides.
Lessons Learned for Companies Operating in Tropical Hot Spots at Risk of Zoonotic Infections
Companies operating in tropical hot spots—typically at high risk of zoonotic infections—that are interested in business continuity need vigilantly to understand the health and political context in which they operate in order to keep their employees safe and protected.
From a preparedness perspective, companies should undertake a thorough review of the capability of the country’s national health and veterinary system at the beginning of the project itself, supplemented by periodic reviews. A detailed health-impact assessment of the project should be conducted before the start of the project and for each major project expansion. This assessment should include a review of zoonotic infections and not be exclusively based on the epidemiology of the diseases already present in the country. Companies should develop flexible response plans informed by the characteristics of the disease or an outbreak and not merely based on fixed triggering factors. The response to the Ebola epidemic, in fact, could not rely on trigger matrices developed for other possible outbreaks because one single case would require a substantial and immediate response plan.
When coming up with a strategy to protect the premises and its employees, the company should keep in mind that the regular health, safety, and environment (HSE) emergency-response-plan (ERP) triggers will not always be appropriate in such infectious-disease outbreaks. This was one of the biggest stumbling blocks encountered in this Ebola outbreak (i.e., to get health, safety, and environment managers to understand that the response to this infectious disease epidemic is very different from that to any other threat that uses the normal HSE ERP and traditional triggers).
Risks Involved for Oil and Gas Companies: Offshore Suspected Cases
First Scenario. The biggest risk involved for oil and gas companies operating in affected countries is to have a symptomatic Ebola case offshore. It is very likely for a person who is completely asymptomatic, and who travels from an affected country after unprotected exposure, to become symptomatic while offshore. This would cause fear and panic among the rest of the team and expose the medical personnel available offshore until the diagnosis is confirmed either way. In such a scenario, the best prevention and control measure would be to isolate the suspected case. The medical staff members should protect themselves with the correct personal protective equipment but should still minimize physical contact with bodily fluids of the suspected case until help arrives from a specialist team.
The company should ensure that there are dedicated and trained teams available at the project sites that will be able to respond to such offshore emergencies almost immediately. This specialist team should be ready to move the suspected case, most likely by boat (helicopter providers will be reluctant to respond in such cases), and immediate directions should be given to clean and disinfect the offshore facilities as soon as possible.
Second Scenario. The company is operating in a nonaffected country, and people from affected countries are working offshore and there is a suspected case on the rig. The chances are that there will be no systems in place to deal with such a patient. There may be no laboratory facilities available, so even excluding EVD will be complex.
First, preventing this situation from happening should be the main objective. This can be achieved through training of all the workers who travel to and from affected countries. They should understand how to mitigate the risk and why it is so important to inform the employer about any potential contact with an Ebola-risk case. They should then be allowed to stay at home for 21 days and monitor their health, before going offshore.
A second important consideration is that no symptomatic individual from an affected country should be allowed to go offshore. Consideration should be given whether the company will allow people from affected countries to go offshore unless they have gone through a 21-day window period (in the case of EVD) outside of the affected country. The situation may turn out to be complex and controversial, but it depends on the rank of the individual or workforce and the level of understanding about the disease.
Although, at the time this paper was written, the current outbreak was still not completely over, systems are now in place in affected countries to ensure that the same uncontrolled spread of EVD among humans seen in 2014 will most likely never happen again. The lessons learned from this outbreak have definitely sensitized the world to the fact that the spread of EVD among humans becomes almost immediately a global threat and cannot remain confined to a country or a continent. The key is to respond rapidly and effectively at the early stages of the spread. This early-response system was already tested in Nigeria and Mali, where medical infrastructure is more or less the same as in the three heavily affected countries. But, because of the rapid response of the Nigerian and Malian governments, supported by the international community and nongovernmental organizations, the ongoing spread among humans was stopped very effectively, with only a few cases reported.
This was the biggest Ebola outbreak ever, with many lives lost, including healthcare workers in the line of duty. However, the long-term benefit from this outbreak is the development of vaccines that will save many more lives in the future. Such an unprecedented and uncontrolled outbreak is highly unlikely to occur again. These vaccines are still going through various test trials but thus far have demonstrated very positive results.