The Effect of the COVID-19 Pandemic on the Global Blood Supply
Mass lockdowns and other curtailment strategies during the early phases of the COVID-19 outbreak, including suspension of voluntary blood donation camps [1], has put a major strain on the global blood supply. Blood drives scheduled in the spring and summer—the time of year that traditionally sees the largest uptake of blood donation—have been canceled as a result of new social distancing guidance. Challenges will continue to present themselves as the virus leads to uncertain patterns of demand for blood components and loss of critical staff due to illness or fear thereof.
The number of donations in hospital-based or separate blood transfusion services has sharply declined since the outbreak, jeopardizing inventory. Closely monitoring supply and demand is necessary to ensure the availability of sufficient blood supply to support major trauma and other conditions. Platelet donations require particularly close attention due to their short shelf life [3]. Though many patients with COVID-19 do not require transfusion [3], diminishing blood supply raises concerns for those with conditions necessitating regular transfusions, such as cancer, leukemia, and sickle cell diseases.
Another primary concern surrounding blood donation is product safety. Though there is no evidence of SARS-CoV-2 transmission by transfusion to date, detectable RNA has been found in the blood of some infected people, even if symptoms are light. Traces of RNA, however, do not necessarily represent infectious viral particles, and low concentrations suggest the potential of false positive results [3]. Additional studies are needed to determine the presence of the virus in blood donors as well as the consequences on blood transfusion. Strict deferral periods must be applied for those with confirmed or suspected exposure to the virus and those who have recently visited high risk regions; furthermore, appointments should be encouraged over walk-ins.
The decreasing availability of personnel due to quarantine measures, illness, and/or fear of the virus will continue to present another major hurdle for blood collection. Concerns about exposure to ill donors or the need to self-isolate due to other instances of potential exposure could lead to substantial reductions in blood-collection staff. With blood supply shortages in some areas across the U.S. already being observed, plans for staff replacement will increasingly be put into effect, such as the training of non-essential personnel for blood collection and processing [2]. Furthermore, staff should be encouraged to self-report illness or potential exposure and be given supportive policies for sick leave.
Safety concerns have also risen in laboratories for blood transfusion during the COVID-19 pandemic. These may be alleviated through partial or full automation of tests and additional equipment with anti-aerosol or disinfection function, in addition to proactive measures such as temporarily isolating blood for 14 days after collection [2]. Delaying the release of donor blood for clinical use has already been enforced in areas seriously affected by COVID-19 [2].
COVID-19 has put donor blood in critical supply and noninfected patients at risk. Transitioning to a state of normalcy depends on the duration of the pandemic and related behavioral changes, which will likely remain in effect well beyond original estimates [1].
References
[1] Apelseth, Torunn O et al. “Effects of the COVID-19 Pandemic on Supply and Use of Blood for Transfusion.” The Lancet Haematology, 2020, doi:10.1016/S2352-3026(20)30186-1.
[2] Cai, Xiaohong et al. “Blood Transfusion During the COVID-19 Outbreak.” Blood Transfus, vol. 18(2), 2020, 79-82, doi:10.2450/2020.0076-20.
[3] Raturi, Dr. Manish & Kusum, Anuradha. “The Blood Supply Management Amid the COVID-19 Outbreak.” Transfusion Clinique et Biologique, 2020, doi:10.1016/j.tracli.2020.04.002.