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COVID 19 Testing Statement September 2020
COVID 19 Testing Statement September 2020
STATEMENT
29 September 2020
Note
This document has been prepared using collective insights from the IOGP-IPIECA Health Committee,
with consideration of the latest information and positions of international bodies such as the WHO, CDC,
national health bodies, Oil and Gas UK, and others.
The need to urgently address issues in the rapidly moving COVID-19 situation means this document has
not gone through the usual approval/review cycles at IOGP and IPIECA, and will be under regular review
as the situation evolves. This document is intended to provide guidance to harmonize protocols for testing
and quarantine for the oil and gas industry. Many local factors, such as prevalence of the virus, the type
of operation/location, accommodation, and response capability affect the total risk picture. Therefore,
measures to manage the risk to ALARP (As Low As Reasonably Practicable) may differ across different
locations, including the timelines for quarantine.
Users are encouraged to use the document in support of public health advice and any legal frameworks
that may exist from national authorities.
Introduction
As the COVID-19 pandemic evolves, the increased need for testing presents significant challenges.
Limited societal readiness, lack of available testing infrastructure, and the validity of tests used are some
of the principal hurdles to establishing an effective and consistent testing regime. The confusion is further
amplified by the rapid development and deployment of new testing methods and protocols by many labs
and manufacturers, with limited verification of their validity or peer reviewed research.
This document aims to provide clarity on the current types of testing, the opportunities, and limitations
they provide, and a method to assess if testing is appropriate for a specific operational site or
organization. It will be reviewed monthly, or sooner if appropriate. The user is encouraged to verify that
they are in possession of the latest revision before use. A revision history is included on the last page of
this document.
Types of tests
A polymerase chain reaction (PCR) test is an Antigen test, one of two broad types of tests available, each
described in more detail below. The first type of tests are based on detecting part of the genetic material
of the virus (PCR) or proteins associated with the virus (Antigen Tests) and the second type is aimed at
detecting the body’s immune response to the virus (Antibody Tests). These different detection methods
impact how soon after infection the test can become positive and how accurate these results are. Figure
1 shows the different detection methods and timeframes.
Figure 1. Virus detection methods and timeframes
1. Type 1: Testing for the SARS-CoV-2 virus by detecting RNA (PCR) or virus proteins (Antigen Tests)
• PCR tests (to detect SARS-CoV-2-RNA, laboratory based and point of care) are used to
verify whether a suspected case carries the virus and has high specificity for COVID-19,
meaning a positive result is almost certainly positive. PCR can also be done on asymptomatic
people although this comes with some risk of missing cases of (early) infection. These are
the preferred tests for diagnostic purposes in relation to key control measures in our industry.
The key limitations have been societal availability of tests, turnaround times, and the
sampling method. They rely on a nose/throat swab sample that, when done wrong, increases
the number of false negative test results. As such, self- sampling is discouraged. False
negatives are also more common in the first days after exposure to the virus when virus
levels are still below the detection limit or not in the sample even when taken correctly
(common in the first 48-72 hours after the virus enters the body and infection begins, see
Figure 1). A false negative result should be considered if the PCR test is negative while the
patient has symptoms suggestive of COVID-19. A second PCR test can be conducted along
with further diagnostic test to determine if the symptoms are COVID-19 or not.
• Antigen Tests detect the presence of viral proteins (antigens) expressed by the COVID-19
virus in a sample from the respiratory tract of a person. The antigen(s) detected are
expressed only when the virus is actively replicating; therefore, these tests are most suited to
identify acute or early infection. Antigen tests are highly specific, but not as sensitive as RT-
PCR. Overall, in alignment with the World Health Organization (WHO), use of virus antigen
tests is not recommended for diagnosis of SARS-CoV-2 infection.
2. Type 2: Antibody tests to detect IgM and IgG are rapidly becoming available, are easy to use by non-
health professionals, and scalable. Limitations apply to the antibody tests as they may have high
rates of false negative results due to the immune response, only appearing days after someone
already has high levels of virus in their body. Additionally, antibody tests are also unable to
differentiate between active disease and the post disease stage. Variable test quality (specificity and
sensitivity) and a lack of understanding of the extent and duration of immunity (if any) to COVID-19
after having recovered from the illness, makes plans to use these tests to identify those who are
immune to COVID-19 premature.
PCR Tests:
1. RT-PCR (Real Time – Polymerase Chain Reaction) tests are the best diagnostic method in
symptomatic people, particularly in the early phase of a SARs-CoV-2infection, but still have limited
availability in some countries and should be directed to those who need it most. As such, prioritized
testing specific to our industry becomes a moral issue when not strictly indicated on medical grounds.
It therefore needs to be aligned with priorities and guidance set by local health authorities. In some
areas, oil and gas workers are clearly identified as critical societal workers and will be prioritized. In
others, this is not the case.
2. PCR testing can be used to shorten quarantine times prior to starting work from 14 days to a week in
some countries. It is most accurate (having the lowest rate of false negative results) when sampled by
a health professional after 5-7 days of quarantine. This ensures that all societal exposures prior to
quarantine are captured and reduces the risk of false negative tests due to sampling errors when the
virus levels are still low in the first days after infection. When results come back negative from the lab,
this single test can be used to end quarantine early, although some quarantine time (7 days) will
remain necessary1.
3. PCR testing is a valuable tool to test close contacts of confirmed cases in the workplace.
4. People with COVID-19 symptoms should be tested as per relevant national health guidance.
5. A key priority for the use of such tests in our industry remains to keep offshore or remote installations
COVID-19 free. Therefore, the operators of such installations need to ensure and facilitate a
coordinated testing/quarantine approach for all personnel wishing to travel to such installations.
6. If an inconclusive test result is obtained, it should be considered positive. Personnel which are
asymptomatic for 10 days following a positive test can be considered non-infectious. Timing of the
test may vary depending on exact travel history and there may be cases or situations which
necessitates several tests during the quarantine period.
Antigen tests
1. Antigen tests are highly specific, but not as sensitive as RT-PCR tests. This means there is a higher
chance of false negatives. The data reviewed on antigen tests for other respiratory diseases, such as
influenza, does not give a high level of confidence in their sensitivity. Currently, the US FDA has
approved one antigen-based test for SARS-CoV-2, however test specificity and sensitivity are not
published and have only been determined on a small number of clinical samples.
2. Antigen test performance also depends on factors such as the time from onset of illness, the
concentration of virus in the specimen, the quality of the specimen collected from a person and how it
is processed, and the precise formulation of the reagents in the test kits.
3. Overall, in alignment with World Health Organization practice, use of virus antigen tests is not
recommended for diagnosis of SARS-CoV-2 infection.
1
Per guidance issued by OGUK: The positive predictive value (PPV) of a positive PCR test for an offshore worker isolating at
home with symptoms is 93%: in other words, the test confirms they are very likely to have COVID-19, and they should continue
isolation for 7 days. For the same worker, a negative test has a negative predictive value (NPV) of 76% (in other words, 24% of
negative tests are false negative results), which is not considered sufficient to confidently return the worker offshore. The worker
Antibody tests
1. Antibody (IgM and IgG) tests are rapidly evolving and readily available. Accuracy of the different
products on the market remains debatable and the current World Health Organization advice is that
they are only useful in large population prevalence surveys. The tests do not have the required
accuracy for screening workers or controlling outbreaks, due to the high rate of false negatives and
variable quality of the different brands of tests. While the quality of testing kits is improving, the
fundamental aspect of antibody testing is an assessment of the body’s immune response to the virus.
Tests will therefore always have higher levels of false negative results in the days following infection,
as the body’s immune response will still be low.
2. The use of antibody tests is not recommended for identifying potential immunity to SARS-CoV-2. The
evidence on acquired immunity post SARS-CoV-2 infection is still inconclusive. A level of immunity
following infection is likely to protect people to some extent, but how much and for how long is yet to
be accurately determined. Recent reports on a number of cases of reinfection with the SARS-CoV-2
virus in individuals who had had COVID-19 months before and had cleared the virus provide further
evidence that the extent and duration of immunity after a COVID infection remains unclear.
3. Antibody tests can be used for mapping of controlled larger populations that can include several
companies/facilities in the same work area but should not be used for diagnostic purposes. The
results may give insights into previous disease prevalence within a single company, location or
population and may also provide valuable information for national and international health bodies.
Quarantine is a critical tool to manage the risk of COVID-19 spread at a worksite. It separates a person or
group of people reasonably believed to have been exposed to a communicable disease (COVID-19) but
not yet symptomatic, from others who have not been exposed. The aim is prevention of the possible
spread of the communicable disease. Even with testing, appropriate quarantine measures will remain
necessary.
Pre-deployment screening of all personnel prior to departure to an offshore or remote site is accepted as
good practice. This may involve up to 14 days of quarantine and a SARS-CoV-2 testing regimen. Within
the 14-day period, those who are infected will likely show clinical symptoms necessitating further testing
and isolation2. For those who remain asymptomatic, some will still have carried the virus; however, if they
remain asymptomatic for the entire quarantine period, they are unlikely to be able to infect others after the
quarantine ends. Personnel in extremely clinically vulnerable and moderately clinical vulnerable groups
should have an individual occupational health risk assessment before returning to the workplace.
At the start of the quarantine period a questionnaire can be conducted to assess the baseline risk of
infection. The questions should determine:
1) the individual’s travel history to high COVID-19 prevalence areas over the past two weeks
2) whether they have had contact with confirmed COVID-19 cases
3) whether they have any symptoms associated with COVID-19
Answering ‘yes’ to any of these three questions can be the basis for postponing access to the worksite or
initiate for-cause SARS-CoV-2 testing. When all questions are answered with ‘no’, PCR testing near the
start of the quarantine period (day 5-8) may be used to reduce the required quarantine time to the point
2
For further information on testing during isolation periods, see Figure 2 in Lauer SA et al, “The Incubation Period
of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application”,
Annals of Internal Medicine 172 (9), May 2020.
where a negative test result comes back. Testing towards the end of the quarantine period may be used
for increased assurance of personnel being COVID-19 free.
For those who have tested positive for the virus or those who developed symptoms while in quarantine,
the duration of quarantine (in isolation) may need to be extended. For people that remain asymptomatic
after testing positive, isolation for up to 10 days following the test is recommended. After this period, the
person is unlikely to pose any risk of infection to others and according to United States Centers for
Disease Control and Prevention (CDC) guidance, there is no need for retesting after this period. For
those developing symptoms, they should isolate until 48 hours after they have become completely
symptom free, or as per medical advice.
IOGP-IPIECA position
1. We view RT-PCR testing provides a considerable level of certainty and is the preferred testing tool
currently available for diagnostic purposes. This testing method should be considered for use in those
situations where there is a legal requirement to do so, where critical functions for safety or business
continuity that cannot be done remotely are performed, and where the consequences of having
COVID-19 cases on site for people and operations are higher (e.g., offshore, remote and site
accommodation). A key consideration remains the availability of PCR testing for low risk groups,
without taking testing resources away from societies at large. It needs to be aligned with priorities set
by national health authorities.
2. Using a screening questionnaire at the start of a 7-day quarantine, in combination with a RT-PCR test
(one time) done on days 5-7 of quarantine, provides a good certainty of determining the COVID-free
status of a worker prior to entering a worksite that is COVID free.
3. We do not support general diagnostic antibody testing for (remote) locations/installations unless for
mapping of controlled larger populations as referred to above.
4. We would like to see a “harmonized” approach to testing for COVID-19 across the oil and gas
industry, but recognize constraints set at the national health authority levels. We will therefore
continue to monitor the development of testing methods/protocols and offer updates to this guidance
as and when needed.
Key testing considerations and quarantine protocols
Table 1. Summary of key testing considerations and quarantine protocols
A Screening questionnaire Easy to administer and low Personnel may not provide truthful
cost responses to questions
Use of a self-administered
questionnaire to identify Quick turnaround time aids Personnel may be unaware of
vulnerable people, those that are decision making. having been in contact with a
ill, and those that may have been confirmed or suspected case
exposed to confirmed or
suspected cases
B Real-Time Polymerase Chain Most reliable and accurate Requires a laboratory test
Reaction Test (RT-PCR test) test. Highly specific (>99.9%)
if lab-based equipment (multi-
Commercial turnaround time of two
channel) and test kits using 3
days, excluding sample shipping in
genome fragments are used
many locations
Testing costs
C Rapid Screening Test Relatively cheap and rapid High likelihood of missing a true
(immunoassay) for COVID 19 test that can be done onsite positive - since these tests produce
antigen or antibody false negative results, infectious
personnel may develop the
condition offshore
E Quarantine for 7 days + rapid Relatively cheap and rapid High rate of false positives as well
screening test (immunoassay) test that can be done onsite as false negatives
Revision History