COVID-19 Pandemic Exacerbates Challenges With US Blood Supply

By Lisa Rapaport

April 13, 2021

(Reuters Health) - The COVID-19 pandemic has led to a blood supply shortage in the U.S. mainly due to halted blood drives and stay-at-home orders, and not due to increased transfusion needs to treat coronavirus patients, according to an essay published in the American Journal of Public Health.

The authors explore pressure points in the U.S. blood supply that preceded the pandemic, challenges that unfolded during the pandemic, and the potentially catastrophic impact on blood supplies that would occur of the virus were capable of transmission through blood.

"There is good scientific evidence that the COVID virus is not transmitted by blood transfusion - this means that we lucked out this time," said lead author, William Riley of Arizona State University in Phoenix.

"If COVID had been a blood transmissible virus we would have had an incredible crisis on our hands," Riley said by email. "We dodged a bullet this time, however, there will be a future pandemic of this scale which has the potential to be transmitted by blood."

Since the pandemic began, the U.S. blood supply has reached critically low levels, with only a 1-day inventory in some cases, Riley and colleagues write.

Prior to the pandemic, they estimate that roughly 37% of the U.S. population was ineligible to donate blood due to exclusion factors and that only about 3.9% of people eligible to donate blood did so.

If COVID-19 infection was added as an exclusion factor, they estimate that the pool of eligible blood donors would drop by 19% based just on exclusion factors.

While blood donations dropped during the pandemic for other reasons, so did transfusions as medical clinics closed and many elective procedures were canceled or postponed, the authors note.

"Blood donations decreased dramatically during the COVID-19 pandemic due to a variety of factors including societal closures, stay at home orders, cancellation of blood drives and widespread illness," said Dr. Christina Barriteau, medical director of the blood bank at in the division of pediatric hematology and oncology at the Ann & Robert H. Lurie Children's Hospital of Chicago and an assistant professor of pediatrics at Northwestern University Feinberg School of Medicine.

"While blood donation at many blood centers continued with adequate social distancing measures; cancellation of blood drives at schools and other large-scale events caused a decrease in blood donations," Dr. Barriteau, who wasn't involved in the essay, said by email.

Respiratory viruses in general are not known to be transmitted by blood transfusion, said Dr. Rita Reik, chief medical officer for America's Blood Centers in Washington, D.C., who was not involved in the essay. Current blood donor screening also requires the donor to be feeling well and healthy on the day of donation and to pass a mini-physical to rule out fever and other signs of infection, Dr. Reik said by email.

"From a public health perspective, blood centers do not accept persons acutely ill with any sort of infection as blood donors," Dr. Reik said. People who have recovered from COVID-19 infections, however, may donate and be a source of convalescent plasma that may be used to treat those with current infections.

As stay-at-home orders lift, blood donation needs to be promoted and encouraged, Dr. Reik said.

"The take-home message for clinicians and the public is that we rely upon their support to identify and recruit donors daily," Dr. Reik said. "It is the blood products that are on the shelf that save lives in a disaster, and this always requires adequately stocked shelves."

SOURCE: American Journal of Public Health, online March 18, 2021.