This could get bloody: donations drying up
The SANBS has appealed to the public to give blood, saying its SMSes can be used as ‘passes’ in lockdown
Medical specialists say a blood-supply crisis is looming as donations dwindle during the Covid-19 lockdown.
In a letter published in the South African Medical Journal, the doctors say blood should be used sparingly and only given to patients in dire need.
They warn of a possible “dramatic decrease in the number of donations” and a subsequent mismatch in supply and demand.
“The blood products available for our hospitals and clinics will therefore rapidly decrease. This will continue for months,” said specialist anaesthetist Robert Wise, who heads the clinical and critical care units at Pietermaritzburg’s Edendale Hospital and lectures at the University of KwaZulu-Natal (UKZN); Matthew Gibbs, consultant anaesthetist at Cape Town’s Groote Schuur Hospital; and Vernon Louw, who heads the clinical haematology division at the University of Cape Town (UCT).
To avoid a blood shortage during lockdown, the trio recommended these guidelines:
- Blood products are only used when necessary, through diagnosis and management of anaemia.
- Patients should generally only be transfused if alternative measures have failed and they are symptomatic of anaemia, or in cases of emergency.
- Single-unit transfusions should be used as far as possible.
- Health-care workers should be made aware of transfusion threshold data showing that few patients require transfusions if their haemoglobin concentration is greater than 7g/100ml.
- Hospital managers and transfusion committees must be proactive in directing patient blood-management activities in their hospitals.
- The public should be made aware of the problem and make concerted efforts to donate blood out of their normal routine.
- The blood transfusion services should be supported by the department of health and public forums to ensure continued supply of products.
“Addressing these issues will ensure that lives are saved and appropriate care delivered in these difficult times,” said the doctors.
“Failure to address these issues timeously will result in a blood product supply crisis in which patients will suffer with increased mortality.”
Khensani Mahlangu, spokesperson for the SA National Blood Service (SANBS), said even though blood donation was an essential service, the lockdown had caused the cancellation of 800 mobile blood drives and a loss of 20,000 units of blood. However, Mahlangu said it was not yet a crisis.
“We have seen an ebb and flow of blood stock levels since lockdown started and it must be said that our donors have rallied to keep our reserves stable. We are sincerely thankful to our donors for continuing to donate blood during this time.”
The medics said the availability of blood products depended on donations and appropriate use by clinicians.
“A large proportion of donations are made from the elderly, perhaps at greatest risk from Covid-19, and educational institutions, now closed through isolation policies,” they said.
“Data from other countries highlight social distancing and self-isolation as important steps in slowing down transmission of coronavirus. However, these measures will drastically reduce the number of blood donations, unless different collection strategies are employed.”
Less than 1% of the population donates blood, at a rate of just more than 3,500 units a day. More than 30% of donors are under the age of 25.
“The high incidence of HIV, trauma and chronic illness places tremendous demand on an already limited supply, with several areas still having limited access to blood products. All these problems will persist during the Covid-19 pandemic,” said the doctors.
Mahlangu said: “Our blood stocks are stable at the moment and we are monitoring levels. We will inform the public if the situation changes. We must stress that there is a continuous need for blood and for regular blood donors.”
She said SMSes have been sent to donors calling for blood. The messages can be used as a “pass” if donors are stopped on their way to donate.
“We appeal to everyone who is healthy to donate blood today,” said Mahlangu.