Covid-19 Management

Equinor case study: What the industry can learn

The Norwegian oil and gas firm has shown impressive handling of infectious disease transmission cases and has shared deep company insights in disease management with the industry


The oil and gas industry is extremely wary of infectious disease transmission. The stakes are always high in the industry, which has for decades been managing outbreaks by having in place strong control measures whether onshore or offshore, writes Abdulaziz Khattak for OGN.

It was no surprise then that the reaction to the Covid-19 situation was extremely prompt and the industry immediately began organising itself even before a health emergency was declared.

All companies in the sector promptly activated crisis management and operators started sharing best practices amongst themselves.

The IOGP-IPIECA Health Committee convened over the issue for the first time in January and started sharing experiences throughout the sector. This gave the sector a good start to respond to the crisis.

Past events, such as the Ebola outbreak in 2014-15, had taught the sector how a health event if not promptly managed could become a crisis of a much bigger scale. The sector also learned that a key component of business continuity response was collaboration and partnership.

The Martin Linge installation

A case study everyone in the industry can learn a lot from is Norwegian oil and gas company Equinor’s response to a Sapovirus outbreak in 2018 on one of its installations.

In the Society of Petroleum Engineers’ (SPE) first Live Panel Session on ‘HSE and Covid-19’, Dr Fredrik Jervell, Leading Adviser Medical Services, Equinor, recounted the outbreak and laid out some important principles the company employed to control the situation besides having managed to keep all installations operational. Also cited was a solitary case of Covid-19 offshore.

Jervell, who is a specialist in occupational medicine, has been leading the Covid-19 crisis management for Equinor. He is also on the joint health committee for the International Association of Oil & Gas Producers (IOGP).

Equinor has a 40-year experience in health and safety, and managing infectious diseases offshore is nothing new for it.

Jervell said Covid-19 was novel, but not unknown to doctors, adding that the principles for its management were the same (as for other infectious diseases). These include:

• Prevent the infection from coming offshore.

• Contain it when it does.

• Safely medevac the afflicted staff.

Equinor has developed its own bowtie model, works hard on social distancing, does a lot of testing, and frequently quarantines and sanitises when there is a case.


SAPOVIRUS OUTBREAK 2018

Figure 1 ... Equinor's bow tie model

The incident happened on one of Equinor’s larger offshore installation during turnaround where 462 people were housed. The index event was a person vomiting in a common toilet on May 12 and then failing to self-quarantine. Four days later, on May 16, 15 people were found vomiting and having diarrhea in the cabins.

It was quickly identified as an outbreak and containment measures were introduced. Everything was shut down, the cleaning frequency increased, and testing for the virus was started.

Sapovirus is a relative of Norovirus and causes gastroenteritis mainly diarrhea. It’s important to know that the normal test procedure in Norway is only for Norovirus. So the diagnosis in this case was missed.

The agent wasn’t identified (as a Sapovirus) until May 20 when there was a new resurgence of the outbreak and up to 17 cases were recorded in a single day.

Jervell said that knowledge was very important since isolation for a Sapovirus patients is 48 hours instead of 24 hours as for a Norovirus. Additionally, the incubation and quarantine period for a Sapovirus is longer than Norovirus as well.

"That knowledge was used to strengthen the quarantine and containment measures, and we managed to break the outbreak over the following week," he added.

By June 8, the outbreak was over, and the containment measures were ended.

In retrospect, Jervell said the main factor for the outbreak was underreporting of symptoms. "The incident happened during turnaround when there are many contractors and subcontractors (offshore), who fear losing money if they don’t show up for work. So they simply didn’t report the symptoms and subsequently failed to self-isolate. That consequence of the incident was that it led to a delay of turnaround by three days and which made a considerable impact for Equinor," he explained.


COVID-19 MANAGEMENT

Distancing is key to disease management at Equinor

So far Equinor has reported one positive case (at the time of going to press) after testing 19 suspected cases on the Norwegian Continental Shelf.

According to details, the infected Equinor employee on the Martin Linge installation had returned from Austria and travelled offshore on March 4. After developing symptoms, he reported to a medic on March 9. This was followed by his isolation in his cabin, and contact tracing was started. Some 35 close contacts were quarantined, including most of the management team on the installation.

At the time, the platform was undergoing construction and the total number of persons on board was 776, including 2 floatels. This posed a big challenge.

The individual was tested and his sample flown to an onshore hospital. It took two days to get the result, which was confirmed positive for SARS-CoV2. The patient and one more contact were medevaced onshore.

The incident management team has already been mobilised and it was decided to demobilise non-essential staff, which numbered 650, by helicopter. The floatels were returned onshore as well.

Further testing of six close contacts with symptoms were done, but all turned out negative.

Remobilising of crew was initiated two weeks later after the entire installation was sanitised.

Jervell said measures taken during Covid-19 are similar to those taken during the 2018 Sapovirus outbreak (or any infectious disease outbreak for that matter). These include isolation, quarantining close contacts, maintaining safe operations, demobilizing non-essentials, and regaining control to remobilise.

An important basic rule is strict observance of distancing. As such gyms and common rooms are closed, meal times are staggered (no buffets served, workers work, eat and straightaway go to cabins, all meetings are by video/distance, and there is regular disinfection (several times a day).

Manning is also reduced to operational levels and a lot of non-critical maintenance is delayed. Further precautions include reducing number of passengers per flight to 12 from the usual 18 so as to maintain distancing and reduce possibilities of transmission.

People are very well aware that if they show symptoms, they need to self-isolate and call the medic and not show up for work.

As per Equinor’s management, a Covid-19 case is put into three categories:

• High probability: The case has a contact history and shows typical symptoms. He is isolated and tested, and all close contacts are quarantined.

• Medium probability: The case has no contact history and shows less typical symptoms. He is isolated and tested. Close contacts are asked to self-monitor but allowed to work.

• Low probability: The case has no contact history and shows atypical symptoms. The case is isolated until well (+1 day). Close contacts are not tested but are traced incase the situation develops.

Equinor has also created its own bow tie model. As figure 1 shows, the likelihood-reducing measures are on the left-hand side, consequences-reducing measures on the right, and the index event is in the centre.

The likelihood-reducing measures include first involving the local public medical infrastructure to reduce the likelihood or prevalence of the disease in the population; sick leave policy so that sick people don’t show up for work; travel restrictions to reduce likelihood of employees getting infected; employee awareness; and a travel/contact quarantine policy. Access control is the final barrier but it’s hard to screen for infection.

The consequence-reducing measures are employed to prevent further cases. Here social distancing and sanitation measures are undertaken; and close contacts are identified and quarantined. To reduce disturbance of operations, employee confidence needs to be increased. People need to be and feel safe so as to focus on their safety critical work rather than the disease.

Jervell said these measures are active on all Equinor installations and the results are that they haven’t had large disruptions of operations yet.




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