Adaptations of transfusion systems to the COVID‐19 pandemic in British Columbia, Canada: Early experiences of a large tertiary care center and survey of provincial activities

Abstract

Background In March 2020, a state of emergency was declared to facilitate organized responses to the coronavirus disease 2019 (COVID‐19) pandemic in British Columbia, Canada. Emergency blood management committees (EBMCs) were formed regionally and provincially to coordinate transfusion service activities and responses to possible national blood shortages. Study Design and Methods We describe the responses of transfusion services to COVID‐19 in regional health authorities in British Columbia through a collaborative survey, contingency planning meeting minutes, and policy documents, including early trends observed in blood product usage. Results Early strategic response policies were developed locally in collaboration with members of the provincial EBMC and focused on three key areas: utilization management strategies, stakeholder engagement (collaboration with frequent users of the transfusion service, advance notification of potential inventory shortage plans, and development of blood triage guidance documents), and laboratory staffing and infection control procedures. Reductions in transfusion volumes were observed beginning in mid‐March 2020 for red blood cells and platelets relative to the prepandemic baseline (27% and 26% from the preceding year, respectively). There was a slow gradual return toward baseline beginning one month later; no product shortage issues were experienced. Conclusion Provincial collaborative efforts facilitated the development of initiatives focused on minimizing potential COVID‐19–related disruptions in transfusion services in British Columbia. While there have been no supply issues to date, the framework developed early in the pandemic should facilitate timely responses to possible disruptions in future waves of infection.

Blood shortages planning in Canada: The National Emergency Blood Management Committee experience during the first 6 months of the COVID‐19 pandemic

“…British Columbia has also recently published their experiences on actions taken as a result of NEBMC recommendations. 19 Activation of the Plan in the context of the COVID-19 pandemic has highlighted gaps in its design and execution and provides an opportunity to address these going forward. Firstly, while the concepts regarding decreased ability to collect blood in a pandemic were considered in the development of the Plan, the extent of a subsequent reduction of clinical services and trauma presentations decreasing RBC demand was not appreciated and ultimately led to an excess in RBC outdates, which does not appear to have been reported elsewhere.…”

Impacts of COVID‐19 and elective surgery cancellations on platelet supply and utilization in the Canadian Province of British Columbia

“…In addition to shutting down surgeries, various provincial efforts were made across different HAs to preserve blood products. Led primarily by HA‐1 physicians, these initiatives included clinical advisories and education to encourage appropriate blood utilization, screening platelet orders for appropriateness and improving inventory management to reduce wastage [15]. Of note, platelet utilization remained significantly less in BC during the renewal phase, when elective surgeries resumed.…”

Hospital red blood cell and platelet supply and utilization from March to December of the first year of the COVID‐19 pandemic: The BEST collaborative study

“…3,6 Investigators around the world, in Canada, Italy, Asia, Africa, and the Middle East, reported decreases in blood donations and blood products produced. [6][7][8][9][10][11][12][13][14][15] In the United States (US), in March 2020, the American Red Cross alone canceled more than 4600 blood drives, reducing the available blood supply by 143,600 units. 16 At the same time, in the spring of 2020, elective surgical procedures in many countries were canceled.…”

“…16 At the same time, in the spring of 2020, elective surgical procedures in many countries were canceled. 3,[12][13][14]17 Non-urgent procedures, and in some instances, solid organ transplants and autologous stem cell transplants were postponed. 4,18 Many hospitals also transitioned to mainly caring for COVID-19 patients who were found to require few transfusions, even when critically ill. 3,[18][19][20][21] Published studies to date have reported on blood supply and utilization during the first few weeks to months of the pandemic in one region of the world.…”

“…4,18 Many hospitals also transitioned to mainly caring for COVID-19 patients who were found to require few transfusions, even when critically ill. 3,[18][19][20][21] Published studies to date have reported on blood supply and utilization during the first few weeks to months of the pandemic in one region of the world. 3,6,[7][8][9][10][11][12][13][14][15] Although it has been suggested that the initial reduced blood supply during the pandemic was counterbalanced by decreased clinical activity and thus blood use, few studies have tested this hypothesis. 4,[12][13][14][15]20 We conducted a retrospective study of 13 institutions in 4 countries aimed at characterizing the impact of the COVID-19 pandemic on hospital blood supply and utilization from March through December of the pandemic in 2020.…”