How the Covid-19 pandemic adversely affected voluntary blood donation

Saving lives could be the ultimate humanitarian gift. The practice of blood donation is one of the most remarkable approaches to save lives. Every year, blood and blood product transfusions save millions of lives, including in emergencies.

Blood transfusion is an essential service provided by healthcare systems, and people who donate their blood make a significant contribution to the health and survival of others. Voluntary blood donors are the foundation of a safe, sustainable blood supply of a country.

Without a system based on regular voluntary blood donation, no country can provide sufficient blood for all patients who requires a blood transfusion.

But there is a significant gap in blood availability between low and high-income countries. According to the WHO, in high-income countries, the median rate of blood donation is 31.5 donations per 1000 persons. This compared to 15.9 donations per 1000 individuals in upper-middle-income countries, 6.8 in lower-middle-income countries, and 5 in low-income countries.

In many countries, demand for blood exceeds supply, and blood services have difficulty meeting demand while also assuring the blood's quality and safety. A sufficient supply can only be ensured through regular volunteer blood donations.

According to compiled information from governmental and private blood transfusion institutions, Bangladesh has an annual demand of more than 8000,000 bags of blood, and volunteer donors help meet 35% of the demand. Over 600,000 units of blood were collected in 2016 against an estimated demand of 800,000 units.

With the fastest growth of health care facilities, the demand for a safe blood supply is increasing to meet the country's primary health care needs. Bangladesh has yet to fulfil the need for an adequate supply of safe blood.

However, one of the most difficult challenges ahead of us is to keep volunteer donors' morale up and motivation strong enough to continue donating blood even throughout the Covid-19 pandemic crisis.

But some rumours, misleading information, and concerns are affecting blood donors during the pandemic.

Furthermore, because of government interventions such as stay-home policy, mass lockdown, and restriction towards public gatherings and using public transportations during the Covid-19 epidemic, the establishment of voluntary blood donation drives has been challenged.

According to WHO estimates, the Covid-19 pandemic reduced blood supply by 20% to 30% in all six regions of Bangladesh, and donor attendance has fallen in those regions.

The majority of blood donors are university or medical students. Those students organise numerous volunteer blood donation groups, clubs, and other organisations. As a result of the widespread shutdown of educational institutions, the voluntary blood donation drive has been challenged.

Similarly, there has been a general public reluctance to donate blood to hospitals out of fear of contracting the virus. Additionally, there have been certain misunderstandings concerning blood donation during the pandemic, though Covid-19 spreading by blood transfusion is not known to be transmitted by blood in general.

These factors have resulted in a considerable decrease in the number of blood drives and blood bank storage. The drop in voluntary blood donating has been seen in several nations worldwide.

Such restrictions and the fear of transmitting Covid-19 make it difficult for both blood donors and receivers. According to several reports, patients with thalassemia or anaemia struggling to manage donors. These patients have to get a regular blood transfusion to lead a healthy regular life. Covid-19 uncertainty, followed by lockdown, may have a severe influence on thalassaemic patients. Here, between 10% and 12% of the 160 million population are carriers of thalassemia.

However, voluntary donors are considered the safest donors since they are motivated by compassion and a desire to assist others, and a feeling of moral obligation or social responsibility. Blood collection services consider specialised advertising that focuses on donors' humanitarian motivations during times of pandemic crisis. They should continue to reassure donors about the safety procedures in place at their facilities.

According to studies, one of the most effective ways for donor recruitment is through the influence of active blood donors. Additionally, it appears as though the majority of donors were not motivated during the pandemic by Covid-19 antibody testing, which should be addressed in association with free health check-ups as a means of encouraging safe blood donations.

Also, Blood donation guidelines should be followed for safe blood donation considering the covid 19 pandemics.

Who is eligible to give blood, and who is not?

1. There is no waiting period or restriction for qualified blood donors who are vaccinated against Covid-19 with an inactivated or RNA-based vaccine.
2. Blood donors who got a live attenuated Covid-19 vaccination or who are unsure of the sort of Covid-19 vaccination they got must wait 14 days before donating.
3. Mild, moderate, and severe Covid-19 patients must be excluded from blood donation for 28 days following release from a treatment centre or 28 days following the end of home isolation.
4. Plasma could be donated if an individual has previously received plasma for a covid treatment purpose.
5. If a person has previously received monoclonal antibody therapy, then he/she must wait for three months before donating plasma

Some of the safety measures and precautions that blood donation organisers and donors need to consider:

1. Blood donation centres and organisers should educate employees and donors about these precautions and provide facilities such as running water, hand sanitisers, personal protective equipment, face masks, and colour-coded trash cans.
2. Donors must take general precautions such as social distancing, mask use, and adequate hand sanitisation before donating blood.
3. If a person has had a fever or sore throat in the last 1/2 weeks or is currently on antibiotics, he or she must disclose this information before contemplating blood donation.

Ashrafur Rahaman Mahadi is an MBBS (final year) student at the Central Medical College, Cumilla