Blood shortage in COVID-19: A crisis within a crisis

Abstract

Blood shortage in COVID-19: A crisis within a crisis To the Editor: The coronavirus pandemic has had a devastating impact on healthcare resources in South Africa (SA) and the world at large. [1] Donor blood supplies are not exempt, with national blood banks reporting critical depletions. This is a chronic, multifaceted issue that SA has had to face long before the onset of the pandemic, as fewer than 1% of citizens are active blood donors. [2] Concerns had already been expressed by the South African National Blood Services (SANBS) prior to lockdown, as mentioned in early March 2020 by the SANBS chief marketing officer Silungile Mlambo, who stated that blood stocks were already declining. [3] This deficit has been further exacerbated by the implementation of strict lockdown measures, effectively cutting down daily blood collections by more than 60%. [4] Fortunately, a decrease in demand owing to cancellation of elective surgical procedures, a reduction in occurrence of trauma, and decreases in non-emergency medical treatment provided some compensation. However, compounding factors such as loss of crucial access to corporate blood drives at schools, universities and businesses [5] have upset the balance once more. At the time of writing (21 December 2020) the shortage of blood products was expected to have disastrous implications during the festive season, when incidences of trauma and travel-related accidents generally soar. Our country has a significantly high burden of trauma, [6] so it is of no surprise that this issue has reared its head yet again. The two providers of this essential service, SANBS (which caters for eight of the nine provinces) and the Western Cape Blood Service (WCBS), have both reported shortages of the O blood group, a type of blood that can be universally transfused to all blood groups. [2] At any given time, national blood banks are required to have a minimum blood supply for 5 days. [7] However, at the time of writing, the SANBS reported that its blood reserves were deemed to last the better part of 3.5 days, with a platelet reserve that was expected to last 0.4 days. [2] The healthcare system is almost bursting at the seams owing to the demanding pressures of resource allocation and record-breaking This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Assessment of Transfusion Practices Among Doctors During COVID-19 Pandemic Using Questionnaire-Based Survey

“…As there was none to minimal information on the transfusion requirement of COVID-19 patients, apprehension with regards to changes in the haematological profile, risk profile of COVID-19 patients and reduced number of blood donors, could have led to most doctors (71.8%) believing that shortage of blood components could also affect the transfusion management of COVID-19 patients [ 26 – 29 ].…”

How do I manage a blood product shortage?

“…Blood shortages occurred during the COVID-19 pandemic. 2,3 Blood centers struggled to provide sufficient blood products to their clients promptly and hospital transfusion services struggled to decide how to allocate scarce resources to maximize patient benefit and minimize patient harm. Healthcare workers experienced significant stress from not knowing how to handle the unprecedented extreme shortages caused by multiple factors acting simultaneously.…”

“…The blood supply depends on the availability of donors, blood center collection staff, blood donation supplies, reagents, and instruments. Blood shortages occurred during the COVID‐19 pandemic 2,3 . Blood centers struggled to provide sufficient blood products to their clients promptly and hospital transfusion services struggled to decide how to allocate scarce resources to maximize patient benefit and minimize patient harm.…”

The 4-Year Experience with Implementation and Routine Use of Pathogen Reduction in a Brazilian Hospital

“…While these approaches are used both in endemic and non-endemic countries, there is some evidence that in times of emerging pathogen outbreaks, laboratory tests may not be commercially available, require time to be implemented, and implementation may not be practical in outbreak areas or feasible in resource-constrained environments. The most recent experience with SARS-CoV-2 emergence has shown that, although SARS-CoV-2 may not be transfusion-transmitted, blood continuity can be adversely affected during pandemics [15,16].…”