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COVID-19 and the impact on blood availability and transfusion practices in low- and middle-income countries
Linda S Barnes1,2,3, Arwa Z Al-Riyami4, Tina S Ipe5
1Biotherapies, AABB, Bethesda, Maryland, USA.
Insights
The COVID-19 pandemic severely impacted blood supply in low- and middle-income countries, leading to significant declines. Adaptations included enhanced collaboration, donor outreach, and the implementation of COVID-19 convalescent plasma programs.
Area of Science:
- Public Health
- Hematology
- Infectious Diseases
Background:
- The COVID-19 pandemic exacerbated pre-existing blood supply deficits in low- and middle-income countries (LMICs).
- Global disruptions significantly affected blood availability, posing critical challenges to healthcare systems.
- This study investigates pandemic-related impacts and adaptive strategies in LMIC blood transfusion services.
Purpose of the Study:
- To characterize the challenges faced by LMIC blood supply systems during the COVID-19 pandemic.
- To identify and analyze adaptations implemented by blood transfusion services in LMICs.
- To explore the role and barriers of COVID-19 convalescent plasma (CCP) programs.
Main Methods:
- A cross-sectional survey was conducted among LMIC blood transfusion practitioners.
- The survey included 31 questions on blood availability, challenges, and adaptations, administered in English, French, or Spanish.
- Mixed methods analysis was employed to interpret the collected data from October to December 2020.
Main Results:
- 77.4% of respondents reported a decline in blood availability (10-50%) due to public fear, stay-at-home orders, logistics, and canceled blood drives.
- Adaptive measures included increased institutional collaboration, modified donor eligibility, enhanced promotion via social media, and replacement donations.
- 48.4% of respondents reported CCP donation, with 19.4% utilizing CCP transfusions, facing challenges in recruiting recovered donors.
Conclusions:
- LMIC blood systems faced severe challenges during the COVID-19 pandemic, with significant reductions in blood availability.
- Adaptive strategies, including inter-institutional collaboration, targeted outreach, and CCP initiatives, were crucial for mitigating supply shortages.
- Further research is needed to optimize CCP program implementation and address donor recruitment barriers in LMICs.
Background/Case Studies:
The coronavirus disease 2019 (COVID-19) pandemic disrupted the global blood supply. Low- and middle-income countries (LMICs) already experienced blood supply deficits that preceded the pandemic. We sought to characterize the challenges experienced during the pandemic, and adaptations, such as COVID-19 convalescent plasma (CCP).
Study Design/Methods:
A cross-sectional survey explored blood availability, challenges, and adaptations. The survey contained 31 questions, e-mailed in English, French, or Spanish, to selected LMIC blood transfusion practitioners. Data acquisition occurred between October 28 and December 28, 2020. A mixed methods analysis followed.
Results/Findings:
A total of 31 responses from 111 invitations represented 26 LMIC countries. Languages included English (22, 71%), Spanish (7, 22.6%), and French (2, 6.4%). Most respondents (29/31, 93.5%) collected blood; 58% also transfused blood (18/31). The supply of blood came from hospital-based blood donations (61%, 11/18); blood suppliers (17%, 3/18); and both sources (22%, 4/18). Collectively, 77.4% (24/31) of respondents experienced a decline in blood availability, ranging from 10% to 50%. Contributing factors included public fear of COVID-19 (21/24); stay-at-home measures (18/24); logistics (14/24); and canceled blood drives (16/24). Adaptations included increased collaboration within and between institutions (17/27), donor eligibility changes (21/31); social media or phone promotion (22/39); and replacement donation (3/27). Fifteen of 31 responses reported CCP donation (48.4%); CCP transfusion occurred in 6 (19.4%). The primary barrier was engaging recovered patients for donation (7/15).
Conclusion:
Our survey describes challenges experienced by LMIC blood systems during the COVID-19 pandemic. While the decline in blood supplies was severe, adaptive measures included collaboration, outreach, and CCP programs.
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