1. Why do aircraft run into turbulence; how can you be safe during one?

Relevant for GS Prelims & Mains Paper III; Science & Technology

Eight passengers on board a Vistara flight from Mumbai to Kolkata on Monday, June 7, suffered injuries after the Boeing 737-800 encountered severe turbulence during its descent.

While five of the eight passengers suffered only minor injuries, the other three had to be taken to hospital upon landing.

The civil aviation regulator, Directorate General of Civil Aviation (DGCA), has classified the event as an “incident”, which means that it will investigate the causes behind its occurrence.

What happened and when?

The Boeing 737-800 aircraft with 113 passengers on board was on its way from Mumbai to Kolkata on Monday, June 7. Around 15 minutes prior to landing, when the aircraft was at an altitude between 15,000 feet and 20,000 feet, it encountered what has been reported as “severe turbulence”.

Upon landing, the passengers were examined by the airport medical team, which cleared all but eight passengers. Five of these passengers were administered first aid, and the remaining three were admitted to three different hospitals in Kolkata.

One of the passengers, a woman aged 61 years, has a fracture in her right hand; another passenger, aged 77 years, has suffered a spinal tenderness injury.

The third passenger, aged 36 years, received a minor cut on the forehead, and was released after being administered first aid.

What happens when an aircraft encounters turbulence?

As a bare concept, turbulence means disruption of airflow over the wings of an airplane, which causes it to enter an irregular vertical motion.

There are at least seven different kinds of turbulence which an aircraft can face.

Turbulence can be weather-related, in which the plane flies through a thunderstorm or a heavy cloud, or it can be clear air turbulence, which is mainly caused by wind or jet streams.

Other kinds of turbulence include “wake turbulence”, which forms behind an aircraft when it flies through air, creating wingtip vortices.

Are turbulence incidents dangerous?

It depends on the nature and intensity of the turbulence. Aircraft face some form of turbulence on a regular basis, and pilots are trained to deal with these disturbances.

However, there have been several instances of turbulence bringing down modern jetliners. But in these cases, while intense turbulence has been the main cause of an accident, several other contributory factors — such as lack of proper training, poor dissemination of weather- or wind-related information — have played a huge role in the accident.

What will the investigation into the Vistara incident focus on?

As a standard practice, the investigation will try to ascertain why the incident caused severe injuries to the passengers. It will look at factors including weather conditions when the plane encountered turbulence, whether the pilots were caught unprepared, and whether they had asked the cabin to prepare for the upcoming disturbance.

Notably, the passenger charter of rights issued by the Ministry of Civil Aviation in 2019 says that in case of death or bodily injury to a passenger on board a domestic flight, the airline is liable to pay compensation up to Rs 20 lakh.

What must passengers do when an aircraft encounters turbulence?

According to the US Federal Aviation Administration (FAA), “passengers can easily prevent injuries from unexpected turbulence by keeping their seat belt buckled at all times”.

The FAA advises passengers to listen to instructions given by the flight attendants; pay attention to the safety briefing at the beginning of the flight and read the safety briefing card; wear a seat belt at all times; use an approved child safety seat or device if a child is under two; and to adhere to your airline’s carry-on restrictions.

This same advice is often given by pilots and flight attendants on Indian domestic flights. Passengers are routinely instructed to go back to their seats and refrain from using the washroom whenever there is turbulence, and the pilot has switched on the seat belt sign.

How can airlines avoid turbulence?

The FAA recommends that carriers should improve dispatch procedures by keeping communication channels open full-time; include turbulence in weather briefings; promote real-time information-sharing between pilot and despatcher; reinforce the carrier’s turbulence avoidance policy through despatcher training; consider re-routing using automation, atmospheric modelling, and data displays; and use all applicable weather data as well as reporting and forecasting graphics.

It also suggests using operating procedures and training to prevent turbulence injuries, emphasise the importance of flight attendants’ personal safety, promote communication and coordination, and gather data and review the carrier’s history of turbulence encounters and injuries.

Source: The Indian Express

2. India’s revised Covid-19 vaccination policy: All you need to know

Relevant for GS Prelims & Mains Paper II; Polity & Governance

On Monday, Prime Minister Narendra Modi announced that India will shift to centralised procurement of Covid-19 vaccines, after several states had faced difficulties in procuring and managing the funding of vaccines.

This marks a change from the previous policy from May 1, when the Centre had asked states to procure 25% of the doses from the open market to vaccinate the 18-44 year age group. Before that (January 16 to April 30), the Centre had procured and allocated vaccine doses to the states for free vaccination of three priority groups — healthcare workers, frontline workers, and persons above the age of 45.

I am above the age of 18. Will I be vaccinated for free?

From June 21, every citizen above the age of 18 will be vaccinated free at vaccination centres run by the Centre or a state government.

In the previous policy starting May 1, a state could administer vaccines free to the 18-44 age group at centres run by the state government. At central government centres, only the three priority groups — healthcare workers, frontline workers, and those above age 45— were vaccinated free. From June 21, both state and central centres will administer vaccines free to all age groups.

What about private vaccination centres?

People of all ages will have to pay for vaccination at private centres. However, private centres can charge only Rs 150 as service charge over and above the price of the vaccine. The maximum price that can be charged by private centres is Rs 780 for Covishield, Rs 1,410 for Covaxin; and is Rs 1,145 for Sputnik V. The total cost of vaccination will be displayed on the CoWIN portal at the time you book your slot.

How many doses will be available free?

The Centre will directly procure 75% of the doses manufactured by vaccine companies, and distribute this among the states, to be administered free. From June 21, states will no longer have any role in procurement. Private hospitals will have exclusive access to the remaining 25%.

How many doses will be provided to which state?

These will be allocated based on three positive metrics — population, disease burden and the progress of vaccination — and one negative metric — wastage of vaccines. A state reporting good vaccination coverage will get a higher number of doses, while a state recording a higher wastage will receive a lower number.

Which groups will be given priority?

Healthcare workers and frontline workers will continue to get top priority at government centres. States will also have to prioritise the vaccination of citizens above 45 since this category accounts for 80% of Covid-related mortality. They will have also have to prioritise the vaccination of those whose second dose has become due, the revised guidelines recommend.

Within the population group of citizens in the 18-44 age group, states may decide their own prioritisation factoring in the vaccine supply schedule.

What about foreign vaccines, once available?

No supply agreements have been finalised by the government yet with Pfizer, Moderna, or Johnson & Johnson. The government is studying the conditions these American manufacturers have set, and any decisions on procurement and availability will be announced only after the final agreements.

Does anything change for private hospitals?

Non-transferable electronic vouchers, approved by the RBI, will be introduced. This would enable people to financially support vaccination of economically weaker sections at private centres. The voucher can be used only for the person to whom it has been issued. It can be downloaded on your mobile; it will be scanned at the vaccination site, and the amount will be credited. It will also be captured on Cowin.

The small private hospitals in my area don’t have vaccination sites. Will this change?

From June 21, the state government will aggregate the demand of private hospitals keeping in view equitable distribution and regional balance. Based on this aggregated demand, the Centre will facilitate supply to private hospitals and their payment through the National Health Authority’s electronic platform. This, indirectly, would enable the smaller and remoter private hospitals to obtain a timely supply of vaccines.

I cannot book an appointment on Cowin. What should I do?

From June 21, all government and private vaccination centres will provide an onsite registration facility. A detailed procedure is to be finalised and published by the states.

Source: The Indian Express

3. The new drug for Alzheimer’s disease

Relevant for GS Prelims & Mains Paper III; Science & Technology

A new drug for treatment of Alzheimer’s disease holds promise, but comes with several caveats. For one thing, it is not a cure, but is aimed at slowing down cognitive decline.

Aducanumab, from the company Biogen, has been approved by the US Food and Drug Administration (FDA) — the first new medication for Alzheimer’s to get FDA approval in nearly two decades.

What is Alzheimer’s disease?

Dementia is an umbrella term for a range of conditions that involve a loss of cognitive functioning. Alzheimer’s dementia is the most common type and involves plaques and tangles forming in the brain. Forgetfulness and memory problems are often early symptoms, but as the illness progresses, patients tend to become confused, may lose their way around familiar places, and have difficulties with planning and completing simple tasks. Dr Rajas Deshpande, neurologist at Lilavati Hospital, Mumbai, said the disease is basically an accelerated ageing of certain neurons in the brain that are concerned with storage and processing of memory.

According to World Health Organization (WHO) estimates for 2017, dementia affects approximately 50 million people worldwide, a number that is projected to grow to 82 million by 2030. In India, it is estimated that 5.3 million people (1 in 27) above the age of 60 have dementia in 2020, according to the Dementia in India 2020 report published by the Alzheimer’s and Related Disorders Society of India. This is projected to rise to 7.6 million by 2030.

How does the new drug work?

The hallmark of Alzheimer’s disease is the accumulation of the debris caused by the breakdown of neurons in the brain, leading to plaque formation. The drug aducanumab, with brand name Aduhelm, is a monoclonal antibody that is designed to reduce the presence of amyloid beta, a protein that forms plaques in the brain.

Aduhelm (aducanumab) aims at altering the course of the disease by slowing the deterioration of brain function.

“The process of regaining memory has not been proven. What has been shown is that it reduces plaque formation,” Dr Deshpande said.

How expensive is it?

The company has said the average wholesale cost would be $56,000 (over Rs 40 lakh) per year. Experts, however, said it would not be before a year or two before the drug is available in India. “There are some hyped medicines and it could be possible that when tried on the ground they may not be useful. Still, we are in a desperate situation and hope the drug is useful,” Dr Deshpande said.

The drug is to be given as a monthly intravenous infusion. In clinical trials, some patients given the highest dose of the drug experienced brain swelling and had to be monitored. Headache is also a reported side effect of the drug.

How promising is it?

Since there is no treatment so far, the drug that can slow down the process holds much promise and is a ray of hope, said Dr Amit Dias, Assistant Professor, Department of Preventive Medicine, Goa Medical College, and a member of Alzheimer’s and Related Society of India. “The drugs we have so far only attempted to improve the function by acting at the level of neurotransmitters,” Dr Dias said.

Most doctors agree that the pathophysiology of Alzheimer’s disease has not been completely understood yet. Since this is a neuro-degenerative process, there is need for solid proof that something really works to halt it. Hence the process of drug discovery has been slow.

How much is known about its efficacy?

The drug was tested in patients at the earliest stages of Alzheimer’s before the disease had a major impact in their ability to care for themselves. It was not tested in people who had progressed to moderate dementia – a state in which the patients lose the ability to care for and feed themselves.

Despite not enough evidence, the drug was approved by the FDA under narrow clinical circumstances. The FDA has asked Biogen to conduct a new trial. It is for people with early-stage Alzheimer’s who have had a PET scan confirming the presence of beta-amyloid in their brain.

“It is a novel drug that is designed to slow the progression of Alzheimer’s and not a cure. Still, trial results are not convincing,” said Dr Manoj Hunnur, Mumbai-based neurologist.

“The development of this drug has been going on for several years with several trials having been conducted and a marginal benefit has been shown in terms of reducing the amyloid load in the early stages of the disease. It is to be noted that these trials were conducted on patients who were in the early stages of the disease,” a researcher from the Centre for Brain Research, Indian Institute of Science, Bengaluru told The Indian Express.

“No studies on this drug have been done in India. Considering the fact that the research on use of antibodies as a potential treatment for Alzheimer’s has been going on for nearly two decades, there are benefits and drawbacks. It remains to be seen how this drug performs in the phase 4 clinical trials that have been proposed.”

How is Alzheimer’s currently managed in India?

While there is slow but growing recognition that dementia is a major public health problem, doctors say there are low acceptance levels among families. “A lot of time is spent refuting the problem and taking multiple opinions till such time that the patient worsens and then is taken to the neurologist,” said Dr Deshpande.

Sometimes there is no sympathy about the patient not being able to remember anything and their condition is attributed to mental weakness or depression. Once diagnosed after ruling out treatable causes of memory loss, there are usually four types of medications, including blood thinners for vascular blockages, and memory enhancing medicines (which do not increase memory power) to increase conduction between neurons.

Some patients do not tolerate some drugs due to side effects, and these have to be given cautiously as a low dose. There are other medicines that may cause a change in pulse rate and have to be given carefully, Dr Deshpande said.

Source: The Indian Express