Abstract

The Severe Acute Respiratory Syndrome (SARS) in 2003 is an emerging disease that spread rapidly worldwide. Remote and offshore operations appeared particularly at risk for various reasons. Medical teams were not prepared for the management of outbreaks. The density of population made close contact transmission possible. Remoteness resulted in misinterpreted information, weak and delayed adapted support, and improbable medical evacuation.

As a result, companies immediately set travel policies and screening procedures to decrease the probability of having someone on site presenting early signs of SARS. In cooperation with site management, alert level policies were implemented to plan responses adapted to pre-defined thresholds of risk. Information and training focused on prompt detection and isolation of cases, strict infection control in medical facilities, and the tracing and quarantine of contacts. Specific SARS management kits were elaborated to address the treatment of suspect cases, the organisation of isolation and the protection of medical teams. Medical evacuation of cases became a challenge due to medical transportation issues, operational limitations and international administrative constraints. Information dissemination services and email alerts were set up via a SARS dedicated web site in order to provide compiled data and operational information to medical directors.

This paper will review the experiences of companies tackling the SARS outbreak in remote settings. In the absence of a vaccine, robust diagnostic tests and specific treatment, this medical issue appeared initially to have no medical, but only operational answers. Options chosen in terms of staff management, treatment abilities and evacuation capacities will be discussed. In conclusion, the importance of appropriate communication and accurate information will be analysed to help corporations make appropriate decisions in such challenging circumstances.

Introduction

The severe acute respiratory syndrome (SARS) is described as the first epidemic of the XXI century. SARS hit the world in November 2002 when the first cases of atypical pneumonia were reported from the Guangdong province, South China. The disease rapidly spread to Hong Kong, Vietnam and Singapore, and then reached other hemisphere and continents. In such a short notice, nobody was prepared to tackle it. When it came to the attention of Public Health authorities, and to the hands of companies decision makers as they had at that time very little knowledge of the disease.

The agent itself was unknown, the dissemination was puzzling, transmission was unclear and the reservoir was unidentified. Epidemiologically, the incubation period was vague, thought to be of some days, and some rumours existed of ‘superspreaders’, able to contaminate a large number of other people. Clinically, the diagnosis was differential with other pulmonary infectious diseases, and no diagnostic means were available.

It is under these circumstances that companies running remote sites had to take decisions, and to implement SARS management policies. For the first time companies' management understood that national employees were not ‘the risk’ (i.e. African employees with viral hemorrhagic fever) but the non-nationals were (Filipinos, Canadians), bringing an uncontrollable disease in an unprepared environment.

Remoteness of offshore operations was not comparable, depending of their geographic location. For instance, the situation was indeed not comparable between those rigs located in the SARS transmission area, where everybody could have possibly been infected (i.e. offshore Vietnam), and those out of this area (i.e. offshore Africa), where contamination would have come from a rotator.

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