Olympics (D):

Managing Health Risks for Some Olympic Venues

Projects for the Olympic Games have many of the same characteristics as other types of projects; specifically, they can be significantly impacted by enterprise environmental factors. However, the enterprise environmental factors may take a different form than most of us are familiar with and may impose more risks. This case study focuses on the enterprise environmental factors that can impact the health and well-being of the Olympic athletes during pre-Olympic practices and the actual competitive events. Health and well-being for the athletes can be looked at in several ways. Since 1970, the threat of terrorism has existed at the Olympic Games and other sport[1]ing events. The threats included attacks during the competition as well as attacks on athletes, officials, crowds of spectators, and tourists. At the Sochi Olympics, the Russian government assigned more than 40,000 security personnel as well as military personnel and equipment to safeguard the Games. At the Rio de Janeiro Olympic Games, there were 83,000 security personnel. The IOC, local OCOGs, and national governments in the host countries are committed to the health and well-being of participants and visitors. But sometimes the health of the participating athletes can be at risk because of the environment in which they must participate rather than due to terrorism. As examples: What are the risks to the athletes due to the Zika virus? What are the risks to the athletes in the aquatic venues if the Olympic waterways were found to be contaminated with bacteria and viruses? These are the risks that will be discussed. THE ZIKA VIRUS

The Zika virus is a mosquito-borne virus that appears to be widespread in Brazil and has been linked to birth defects. Zika has been around for decades, but only recently have issues been raised about its connection to birth malformations and neurological symptoms. There is no vaccine or treatment as yet, so combating the outbreak is heavily focused on eradicating mosquito populations and preventing mosquito bites. This was a concern not only to the officials hosting the Olympic Games in Rio de Janeiro, but to the athletes and visitors to the Games. According to the World Health Organization, pregnant women and women who might get pregnant are at the greatest risk for contracting the virus. But any[1]one can get the virus, become a carrier, and bring the virus back to their homeland. Some countries considered pulling out of the Olympic Games in Rio for this rea[1]son. Ultimately no teams pulled out, but some individual athletes did withdraw out of concerns over Zika.1 The final decision on whether an Olympic athlete should attend was left up to the individual athletes. The United States Olympic Committee hired infectious disease specialists to assist the athletes in determining the risks and in making their own decisions about whether compete in the Games. Rio expected upwards of 500,000 tourists, including 200,000 from North America, as well as 10,000 Olympic athletes and accompanying coaches, trainers and officials. However, if someone is infected and then return to his or her own country that has a much warmer client, the chances of the virus spreading signifi[1]cantly increases.2 The Rio 2016 Games took place in Brazil's winter months of August and September, when the dryer, cooler weather could significantly reduce the pres[1]ence of the mosquitoes that carry the virus. Additionally, the Brazilian Govern[1]ment undertook measures to control mosquitos. There were inspections of each Olympic venue for puddles of stagnant water that could be a breeding ground for mosquitos. Olympic officials also had to contend with the psychological aspect of ath[1]letes' fear of the Zika virus. Athletes were issued mosquito repellant as the pri[1]mary defense against the mosquitoes. They were also encouraged to keep their arms and legs covered as much as possible and not to leave windows or doors open in the sleeping accommodations.

GUANABANA BAY

Guanabana Bay, Rio de Janeiro, and some of the 50 accompany waterways that feed into it were the site for the rowing, sailing, wind surfing, canoeing, and mara[1]thon and triathlon venues at the Summer Olympic Games in 2016. These events were held in water that is severely contaminated with human sewage and teeming with bacteria and viruses. The waterways also have large floating debris, anything from furniture to dead animals. Some of the waterways are also breeding grounds for the mosquito-borne Zika virus. For more than three decades, untreated water from toilets and showers, as well as whatever waste people put down their sinks, has been deposited into the rivers and streams that feed into Guanabana Bay. More than 70 percent of the waste from the 12 million residents of Rio is untreated and flows into these waters. The contamination and waste appears not only in the water but also along the shores of the beaches. Even prior to the beginning of the games, several of the athletes who trained in Guanabana Bay fell ill with diarrhea, fevers, and vomiting as a result of expo[1]sure to the bacteria and viruses in the water. Exposure to fecal matter can lead to hepatitis A, dysentery, cholera, respiratory problems, and other diseases. Although rare, heart and brain disease are also possible. A German athlete who competed in Rio at a pre-Olympic sailing event in preparation for the Games had to be treated at a Berlin hospital for MRSA, a flesh-eating bacteria. The organizers of the Brazilian Olympic Games had promised in their 2009 bid to host the Games that 80 percent of the pollution pumped into the bay would be reduced by the time the Games started. As part of its Olympic project, Brazil promised to build eight treatment facilities to filter out much of the sewage and prevent tons of household trash from flowing into the bay. Only one had been built by the start of the Games. Some believe that Rio's bid to host the Games was part of a plan to force the cleanup of the bay. But now, Brazilian officials say that, at current depollu[1]tion investment rates and even if additional funding were available, at least 10 more years would be required to reduce the pollution levels. The cleanup goal turned into an embarrassing failure. Federal police and prosecutors are investigat[1]ing whether crimes were committed, and there is concern about where billions of dollars in funds have gone that were earmarked to improve sewage services and clean Guanabara Bay since the early 1990s. Brazil has attempted to clean up its waters for decades but has run into prob[1]lems of mismanagement and alleged corruption, which also delayed construction of Olympic facilities. The run-up to the 2016 Games was so troubled, in so many ways, that Olympic officials reportedly met in secret to suggest that the Games be moved to London, according to a report in The Independent.3 Brazilian Olympic officials stated that there was no such "Plan B." For some athletes, the risk was worth taking for the chance to win a gold medal and achieve international fame and recognition. More than 10,000 athletes competed in Rio and almost 1,400 of them came in contact with water polluted with bacteria and viruses. As early as 2014 studies indicated that some of the bacteria found in the bay is a "super bacteria" resistant to most medications. These findings were con[1]firmed by two subsequent studies, one in 2015 and a second just weeks before the Games. The super bacteria can cause hard-to-treat urinary, gastrointestinal, and pulmonary and bloodstream infections along with meningitis. According to the Centers for Disease Control, these bacteria contribute to death in up to half of the patients infected.4 There was also the risk that athletes would not immediately fall ill by coming in contact with the bacteria, but become carriers and bring the resistant bacteria back to their own countries, thus possibly infecting others. The same was true for spectators at Olympics beach venues. Super bacteria showed up in 90 percent of the water samples at Flamengo Beach and in 10 percent of the samples at Copacabana Beach. The most popular beaches for tourists are Ipanema and Leblon, which tested positive for the super bacteria 50 and 60 percent of the time, respectively. The immediate risk to an individual's health because of the super bacteria depends on the state of his or her immune system. These bacteria are opportunistic microbes that can enter the body, lie dormant, and then attack at a later date when a person's immune system is compromised for other reasons.

TESTING THE WATER

Two questions must be answered concerning the testing of the water:

1. What pathogens should be tested for, bacteria or viruses, or possibly both?

2. Where in the bay should the testing take place?

Pathogens are infectious agents such as bacteria, viruses, or parasites that can cause disease in their hosts. The Rio OCOG followed the World Health Organiza[1]tion's "Safe Recreational Water Environments" guidelines and conducted a regular testing program of microbial water quality. Although the test results showed com[1]pliance with the guidelines, the argument was that testing focused on the levels of bacteria rather than viruses, which pose the greater health risks. Water testing can show safe levels of fecal bacteria and at the same time show dangerous viruses. An investigation conducted by the Associated Press (AP) found that the water in several locations was infested with disease-causing viruses that were as much as 1.7 million times the levels that would be considered hazardous at beaches in Southern California and cause them to be closed to the public.6 Another AP analysis of a decade's worth of government data on Guanabara Bay and other waterways showed that sewage pollution indicators consistently spiked far above acceptable limits, even under Brazilian laws, which are far more lenient on pol[1]lution than laws in the United States or Europe.7 With pollution levels this high, exposure is almost unavoidable and the chance of infection is high. Since the majority of the waste enters the waterways close to the shore, it was believed that as you get farther offshore into the deep waters of the bay, the risks from the pathogens would dissipate. However, the number of viruses found over a kilometer from the shore in Guanabana Bay, at locations where sailors would com[1]pete at high speeds and get utterly drenched, were equal to those found along shore[1]lines closer to the sewage sources. Some testing showed pathogen levels that were over 16 times the amount permitted under Brazilian law.8 These results indicated that it would be safer if the competition took place deeper in the lagoon or bay. "Kristina Mena, a U.S. expert in risk assessment for waterborne viruses, examined the AP data and estimated that international athletes at all water venues had a 99 percent chance of infection if they ingested just three teaspoons of wateralthough whether a person would fall ill depended on immunity and other factors."9 The International Sailing Federation reported that just over 7 percent of the sailors who competed in a mid-August Olympic warm-up event in Guanabana Bay fell ill, but the federation had not conducted a full count of how many athletes got sick in the two weeks following the practice sessions, the approximate incuba[1]tion period for many of the pathogens in the water.10 Some athletes who competed in aquatic events took precautions by wearing special clothing or even masks. Austrian sailor David Hussl said he and his teammates took such precautions, washing their faces immediately with bottled water when they were splashed by waves and showering the minute they return to shore. And yet Hussl said he had fallen ill several times.11 CONCLUSIONS Many of the athletes felt that it was unfair that they had worked so hard for years and made sacrifices for their country only to have their destiny based on vari[1]ables that might change the Games' outcome. Despite the risks, most athletes were still expected to compete in this environment for the chance of winning Olympic gold. They accepted the risks, took precautions where appropriate, and resigned themselves to competing in potentially dangerous water. It may be years after the Games are over before we know the true health issues caused by exposure to the contaminated waterways.

QUESTIONS (Answer these questions using the PMI Code of ethics to answer)

1. If you are the project manager for organizing these events, can the health risks be quantified? 2. What could a project manager do to possibly mitigate the health risks?

3. What are the chances that the Rio OCOG might recommend that these events be removed from the Games because of the health risks?

4. Would the International Olympic Committee remove the events from the Rio Olympics?

5. If you had been an Olympic athlete, and this were your only chance to compete, would you have accepted the health risks?

6. What could the OCOG have done to help mitigate the risks?

7. What can athletes do to mitigate the risks?

8. From a project management perspective, was holding these events despite these health risks a moral or ethical violation of the PMI Code of Conduct and Profes[1]sional Responsibility?

Many of these questions are hypothetical and should be used as the basis for classroom discussion. Without knowing the final outcome of the health risks that appeared in the literature prior to the start of the Games, we can only speculate what might have happened. There can be more than one correct answer to some of these questions based upon the assumptions you have made.