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The COVID-19 pandemic and blood utilisation in South Africa
R Swanevelder1, P-L Wessels2, V J Louw3
1Medical Division, South African National Blood Service, Roodepoort, South Africa.
Insights
The COVID-19 pandemic significantly reduced red blood cell (RBC) use, especially in South Africa's public sector. While blood utilization recovered post-pandemic, the public sector
Area of Science:
- Hematology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic profoundly impacted global health services, including blood collection and utilization.
- South African National Blood Services (SANBS) observed a significant drop in blood demand due to national lockdown measures.
- The precise impact of the pandemic and mitigation strategies on blood utilization remained unclear.
Purpose of the Study:
- To retrospectively analyze red blood cell (RBC) utilization in South Africa from 2019 to 2022.
- To compare RBC utilization across public and private healthcare sectors before, during, and after the acute phase of the COVID-19 pandemic.
- To understand the pandemic's effect on blood supply chain dynamics and sector-specific resilience.
Main Methods:
- A retrospective study design was employed, analyzing RBC utilization data over a 4-year period (2019-2022).
- Data was stratified by public and private healthcare sectors within South Africa.
- Blood utilization trends were evaluated against reported COVID-19 case numbers and national lockdown regulations, comparing pre-COVID, acute COVID, and post-acute periods (each 450 days).
Main Results:
- Overall RBC utilization decreased by approximately 17% during the COVID-19 pandemic.
- The initial decline in blood utilization was more substantial within the public healthcare sector.
- While utilization recovered to pre-COVID levels in the post-acute phase, recovery rates differed significantly between public and private sectors.
Conclusions:
- The COVID-19 pandemic caused significant shifts in RBC utilization, disproportionately affecting the public sector, which serves the majority of the South African population.
- Blood utilization recovery in the post-acute period was slower in the public sector compared to the private sector.
- The pandemic highlighted and exacerbated pre-existing disparities in blood utilization patterns between South Africa's public and private healthcare systems, underscoring sector-specific adaptive capacities.
Background:
The COVID-19 pandemic, first reported in December 2019, affected every sector of every country worldwide. Health services were the first to experience the direct impact. Blood services were advised to decrease blood utilisation in anticipation of reduced blood collections. The South African National Blood Services (SANBS) saw a substantial decline in blood demand following the institution of strict national lockdown measures, but the impact of the epidemic and various mitigation strategies remained unknown.
Objective:
This retrospective study reviews red blood cell (RBC) utilisation during a 4-year period from 2019 to 2022 in the South African (SA) population, stratified by public and private healthcare sectors.
Methods:
To measure the impact of COVID-19, blood utilisation pre COVID-19 was compared with an acute COVID-19 period and a post-acute period. Each period covered 450 days. Blood utilisation was evaluated against the background of reported COVID-19 cases and national lockdown regulations.
Results:
With the onset of the COVID-19 pandemic, overall RBC utilisation dropped by ~17%. The initial decline was more pronounced in the public sector. Overall, utilisation recovered to pre-COVID-19 levels in the post-acute COVID-19 period, but at different rates in the public and private sectors.
Conclusion:
There was a significant change in RBC utilisation during the course of the COVID-19 pandemic, much more pronounced in the public sector, which services 85% of the SA population. During the post-acute COVID-19 period, blood utilisation recovered, but at a much slower rate in the public sector. The COVID-19 pandemic accentuated the differences in blood utilisation patterns between the public and private healthcare sectors in SA, and each sector's resilience in adapting to the challenges of the epidemic.
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