Blood donation much needed now
Why are we short of blood during the COVID-19 pandemic? Let me tell you a story in the hope of finding an answer.
Last week, while Pune was seeing a sudden surge of COVID-19 cases, the ICU team at Ruby Hall Clinic was in the midst of another crisis. It’s hard to imagine in this day and age that being pregnant and giving birth can result in life-threatening complications. But this can still hold true. A 28-year-old woman from Parner taluka who had just delivered twins was rushed into our hospital in a state of shock. Post her c-section delivery, she had lost too much blood and was in a critical condition. The pregnant lady had reached our ICU in a state of shock due to post partum hemorrhage and severe liver failure leading to coagulopathy (non clotting of blood leading to severe hemorrhage , with low platelets and severe anaemia). It is a life threatening condition needing massive blood and blood component transfusion. Immediately, we knew she was fighting for life.
She was in need of a sizeable number of various blood components — red cell concentrate units, platelets, apheresis platelets and plasma. Since we were already in the midst of blood shortage, we counselled her family members and explained the condition to them. The family immediately rushed back to their nearby village and organised a voluntary blood donation drive by gathering the villagers. And the result? 84 strong voluntary donors ended up donating their blood.
This brings us back to the question — why are we short of blood during the COVID-19 pandemic? In India, blood donations have drastically reduced due to the implementation of social distancing, cancellation of various blood drives and low donor turnout due to fears associated with catching infection from public places. Moreover, blood has a shelf life. While the donations have dried up, stock is expiring daily and hospitals are dipping into their reserves. The blood platelets have a shelf life of only seven days. In absence of a continuous supply, the reserves are bound to dip.
But does this mean we cannot come together in times of need? Historic experience with outbreaks of such epidemics suggest that there will be significant impact on blood availability due to reduced blood donation. It’s important to stress that we as doctors know the supply of blood is limited and when an emergency is called for, we stick to exactly how much blood a patient needs. Every day, we do everything in our power to deliver optimal care, including giving the right amount of blood to the right patients who need this lifesaving therapy. Yet the dwindling blood supply is making our jobs harder.
The extreme shortage of blood in the past few months is is now affecting those who are in urgent need of blood and blood components, like those with thalassaemia and severe anaemia, instances of severe blood loss, road traffic accidents, antepartum and postpartum haemorrhage, and patients needing urgent surgeries. As this became a major cause of concern, the Ministry of Health and Family Welfare (MoHFW) issued guidelines for safe donation of blood during the ongoing pandemic.
What do the numbers say?
The WHO estimates that blood donation by 1% of the population is generally the minimum to meet a nation’s most basic need for blood. In India’s case, as per the data of 2016–17, there was a shortage of 1.9 million units (or 15%) vis-à-vis the WHO norm. Most countries with low rates of blood donation are largely dependent on blood provided by the families or friends of patients who require transfusion. The experts believe that as per the WHO standards, India is already far behind.
While blood shortage and inconsistency remain a larger issue for India to deal with, the situation has become particularly worrisome owing to COVID-19.
Why is donation so crucial?
We’re going to need a massive turnout from people who have not donated or have not donated for a long time to come out and donate. And this is not something we’re appealing for just for one day, one week or one month. It’s going to persist throughout this whole pandemic. Patients are still going to need cancer treatment. Patients are still going to need emergency open-heart surgery. Premature babies are still going to be born, and we really want to still give them that chance at life.
As doctors, we don’t want to make the decision whether the blood should go to the premature baby or the grandfather who needs dialysis or an adolescent transfusion patient or a father in a car accident.
Are you at risk of COVID-19 infection if you donate blood?
People need to remember that blood collection drives are not mass gatherings and individuals are not at risk of contracting COVID-19 through the blood donation process or via a blood transfusion. In fact, at Ruby Hall Clinic, we are requesting blood donors to come in only on an appointment basis. While walk-in donors are welcome and accepted, in respect for donors’ time and to help abide by social distancing standards, donors are being encouraged to take a prior appointment.
When should you not donate blood?
As per the National Blood Transfusion Council (NBTC), blood cannot be donated upto 28 days post-COVID recovery or discharge from a treating facility or within 28 days of home isolation. Moreover if you show any mild, pre-symptomatic, moderate, and severe COVID-19 symptoms do not opt for blood donation for 28 days.
Are blood donors screened for COVID-19?
Everyone entering Ruby Hall Clinic is screened for fever, symptoms and exposure to the COVID-19 virus. At registration they again are asked about COVID-19 exposure, and shortly prior to donation, the donor room nurses do another screening for fever and symptoms. Members of the staff are masked, wear safety coats and, except for the screening and blood draw itself, a minimum 6-foot distance between people is always maintained.
The way forward
At Ruby Hall Clinic, we’re working with the state and national authorities to spread the word about the need for donors, and encourage local health systems to do the same with their area blood banks. So what can you personally do? The answer is simple: Donate. From personal experience I can say this proudly — when my son was visiting India four months ago, he himself was part of a blood donation drive despite the on-going pandemic. Both as a doctor and a mother, it left me with nothing but admiration.
The current situation may be even more dire given the looming uncertainty surrounding the pandemic’s trajectory during this surge. Blood donation is the greatest act of kindness and at a time where the world is facing one of the biggest health crisis, it is fundamental to donate blood and ensure safer donation drives. Remember, people still need blood for reasons that don’t have anything to do with the coronavirus.
On the 13th and 14th of April 2021, Ruby Hall Clinic along with Jankalyan Blood Bank is organising a voluntary blood donation drive for this very purpose. With many people cooped up inside and wondering what to do or how to help, donating blood is a great contribution. In times such as these, we tend to forget how easy it can be to help another human being, and a small act of kindness on your part can make a big humanitarian contribution in these trying times.
I’ll end this blog leaving you with some food for thought — if you’re a blood donor, you’re a hero to someone, somewhere, who received your gracious gift of life. So, it is therefore my sincere appeal to you all to please come out and donate blood. Make the most of the moment and seize the opportunity to help us doctors save someone’s life.
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