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New Delhi, Aug 8: The Union Health Secretary Rajesh Bhushan on Friday directed the governments of four states -- Gujarat, Karnataka, Tamil Nadu, and Telangana, to analyse the factors driving the high COVID-19 mortality and devise ways and means to reduce the mortality.

Apart from the higher case mortality, these states account for 17 per cent of India's active cases, high daily new cases, low tests per million, and high confirmation percentage.

In a high-level virtual meeting, Bhushan advised state administrations to adhere to measures suggested by central advisories and guidelines to prevent and reduce mortality due to coronavirus infection.

According to the health ministry, 16 districts in these four states are reporting maximum virus fatalities. It includes -- Ahmedabad and Surat in Gujarat; Belagavi, Bengaluru urban, Kalaburagi and Udupi in Karnataka; Chennai, Kanchipuram, Ranipet, Theni, Thiruvallur, Tiruchirappalli, Tuticorin and Virudhnagar in Tamil Nadu; and Hyderabad and Medchal-Malkajgiri in Telangana respectively.

"The districts were advised to ensure that the advisories, guidelines and clinical treatment protocols issued by the Health Ministry are adopted and effectively implemented to reduce the mortality among COVID-19 patients and other preventable deaths among all sections of the people, particularly those with co-morbidities, pregnant women, the elderly and children," said the health ministry official.

"States were advised to ensure optimum capacity utilization of testing labs, increase tests per million population and reduce confirmation percentage, in addition to ensuring timely availability of ambulances with target zero refusal," the official further said.

"States were also advised to analyze availability and need for projected beds and oxygen, and plan in a timely manner. States and district administration have also been advised to ensure good infection prevention and control practices to control infection in the healthcare workers," said the official.

Principal Secretary (Health) and MD (NHM) from the four States along with district surveillance officers, district collectors, commissioners of the municipal corporation, Chief Medical Officers, and Medical Superintendent of Medical Colleges participated in the meeting.

The Kozhikode International Airport located at Karipur is not safe for the landing of flights in rainy season, according to an air-safety expert, who had warned the aviation ministry and the civil aviation regulator about this in 2011. 

The warning was particularly about the dangers of permitting passenger aircraft to land on runway 10 of the airport during rains and unfavourable wind conditions. 

Nine years later, on August 7, 2020, the warning became a reality when an Air India Express pilots landed in tailwind conditions and the aircraft overshot the tabletop runway to drop off the end and crash.

 “An aircraft landing on runway 10 in tailwind will experience poor braking action due to heavy rubber deposits … All such flights … are endangering the lives of all on board,’’ said Capt Mohan Ranganathan, in a letter sent on June 17, 2011 to then director general of civil aviation Bharat Bhushan and Nasim Zaidi, chairman of a civil aviation safety advisory committee, which was formed after the May 2010 Mangaluru air crash which killed 158 people.

“My warning issued after the Mangaluru crash was ignored. It is a table-top runway with a down slope. The buffer zone at the end of the runway is inadequate,” Capt Ranganathan said. Given the topography, he pointed out, the airport should have a buffer of 240m at the end of the runway, but it only has 90m (which the DGCA had approved). “Moreover, the space on either side of the runway is only 75m instead of the mandatory 100m,” he added.

Capt Ranganathan said there is no guideline for operations on a table-top runway when it is raining. “Runway 10 approach should not be permitted in view of the lack of runway end safety area (RESA) and the terrain beyond the end of the runway. RESA of 240m should be immediately introduced and runway length has to be reduced to make the operations safe,” his letter said.

If an aircraft is unable to stop within the runway, there is no RESA beyond the end. The ILS localiser antenna is housed on a concrete structure and the area beyond is a steep slope. “The Air India Express accident in Mangalore should have alerted AAI to make the runway conditions safe. We have brought up the issue of RESA during the initial Casac-sub group meetings. We had specifically mentioned that the declared distances for both runways have to be reduced in order to comply with ICAO Annex 14 requirement,” Capt Ranganathan said.

He said the condition of the runway strip was known to DGCA teams that have been conducting inspection and safety assessments. “Have they considered the danger involved? Did the DGCA or the airlines lay down any operational restrictions or special procedures?”

The letter also refers to Approach and Landing Accident Reduction (ALAR) training, which is supposed to be mandatory before every monsoon, but airlines don’t follow it, he said. “70% of accidents take place during approach and landing and that is why this training is essential,” he added.

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