COVID 19: Impact of Social Distancing on Blood Transfusions worldwide

The hidden cause of death is not COVID19, its the lack of blood.

Introduction:

Its the 25th of April 2020, people have been under lockdown in most parts of the world as a measure to fight the novel 'Corona Virus' what we will be calling moving forward as COVID19 like normal human beings. We are here, we are amidst the impact of a tiny virus that has changed the course of history. The world has never united for a cause at this level. Even the flat earthers, climate change deniers and the anti-vaxxers have started taking things seriously. Social distancing will become a part of our culture as a lesson of this pandemic. Things are never going to be the same. I mean heck, Crude oil was showing a historic negative yesterday. things are getting crazier day in. Social media is receiving more engagement as a result of people staying home. Gamers are busy living the gamer life even harder expecting a world war 3 zombie apocalypse. Tik Tok stars are rising out of nowhere. Educators have gone full scale online. Schools still collecting fees though. And the best of the best, the world has realised that most of the tasks you were forced to do out of a company floor could have easily been done from home or remotely even in your pyjamas. Remote work is here to stay. Politics is getting ugly, countries are blaming each other and not willing to accept responsibility. Some countries have contained the situation really well by focussing on drills to practice better healthcare. There is hope. But not when Trump is out here asking to inject disinfectant as a measure to attain immunity over the virus. People are out of jobs here. Companies are unable to hire. Economies are collapsing. This sounds like an Apocalypse.

In short, it's a once in a lifetime event. We must seek within ourselves to see how this event is going to shape and affect us instead of making silly excuses and using this as a handicap. That is some low life attitude that does not belong amongst the already existing negativity that the world has.

Correlation between lockdowns and unavailability of blood

But Luke, What does all of this have to do with blood and why is there such a big "introduction to covid19" that you're getting us to read.?

--Social distancing has been imposed in many countries. But complete lockdowns are also being practised worldwide in countries that have a high population density. As a direct impact of this, the blood ecosystem is about to face adverse effects. How adverse are we talking about? I mean more deaths due to lack of blood flowing in the ecosystem than coronavirus

The inventory of Blood banks all over the world is dependant on human donors who usually donate in groups or individually. But due to social distancing and the fear of stepping out, the number of donors has reduced drastically almost to negligible values.

Let us look at the top 10 facts the WHO has presented us about blood transfusion: (source https://www.who.int/bloodsafety/FactFile2009.pdf)

Fact 1

Blood transfusion saves lives and improves health, but millions of patients requiring transfusion do not have timely access to safe blood. Every country needs to ensure that blood supplies are sufficient and free from HIV, hepatitis viruses and other chronic infections that can be transmitted through unsafe transfusion. 

Fact 2:

In developed countries, transfusion is most commonly used to support invasive medical procedures and surgeries like open-heart surgery and organ transplant. In developing nations it is used more often in pregnancy-related complications and severe childhood anaemia. As the demand for blood is increasing, blood shortages are common. More blood donors are needed to replace those that are lost every year due to ill health, retirement and relocation

Fact 3:

In developing and transitional countries, many people die because safe blood is not available, even in some urban health-care facilities. In the southern African region, up to 20% of maternal deaths and 15% of child deaths are attributable to severe anaemia due to malaria. The management of these cases often requires a safe and timely blood transfusion.

Fact 4:

More than 536 000 women die every year during pregnancy or childbirth, 99% of them in developing countries. Haemorrhage leading to blood loss is the main cause of maternal deaths worldwide, accounting for up to 44% of maternal deaths in some areas of subSaharan Africa. 

Fact 5:

More than 5 million people die from violence and injury every year. Road traffic crashes are the leading cause of death among young people between 10 to 24 years according to the WHO report, Youth and Road Safety. Nearly 400 000 young people under the age of 25 are killed in road traffic crashes every year. Millions more are injured or disabled... Safe blood transfusion is an essential part of emergency trauma care systems to minimize death and disability of injured patients. 

Fact 6:

Donated blood should always be screened for HIV, hepatitis B, hepatitis C and syphilis prior to transfusion, but in 31 countries (out of 133 countries reporting in 2006) not all donated blood is tested for one or more of these infections. Testing is not reliable in many countries because of staff shortages, poor quality test kits, irregular supplies, or lack of basic laboratory quality. It is also not affordable or cost-effective in most developing and transitional countries

Fact 7:

More than 81 million units of blood are collected globally every year. Less 45% of these are donated in developing and transitional countries where more than 80% of the world’s population lives. The average blood donation rate is three times higher in transitional countries and 11 times higher in developed countries than in developing countries. 

Fact 8:

Adequate stocks of safe blood can only be assured through a regular donation by voluntary unpaid blood donors because the prevalence of bloodborne infections is lowest among these donors. It is higher among donors who give blood only as a replacement when it is required for a family and among those who give blood for money or other forms of payment. 

Fact 9:

More and more countries are moving towards voluntary donation. Three new countries achieved 100% voluntary unpaid blood donation in 2006. But 38 countries were collecting less than 25% of their blood from voluntary unpaid blood donors. Family/replacement donors and paid donors still remain a significant source of blood in many countries. 

Fact 10:

Often transfusions are prescribed when simpler, less expensive treatments might be equally effective. This exposes some patients to the needless risk of infections or severe transfusion reactions due to incompatibility of blood groups. Safe clinical transfusion practices are fundamental for transfusion to be truly life-saving with minimal risk. 

What does this mean:

Let me try explaining the implications of the lockdown using the following blocks

If the number of donors reduces worldwide, it's going to lead to a global shortage of blood. It's fair to point out that blood transfusions are more localised. But to keep in mind, that even local groups of blood donors have stopped contributing. This correlates to a direct deficit in the supply of blood within the blood banks who act as aggregators between Blood Recipients and Donors. Obviously, the demand is not going to decrease, there is already a deficit before the virus entered our lives now on top of that we have to deal with its domino Effect

Implications

Due to a shortage of blood, immediate requirements such as surgeries, pregnancies, chemotherapy, thalassemia cannot be fulfilled easily thus, leading to an increasing number of deaths due to unavailability of blood.

The total number of deaths will rise throughout the lockdown period due to blood shortage

What can be done:

We need to organise a system to streamline the donations of blood so that the demand for blood supplies can be maintained to a large extent and not face a complete meltdown. If you are a healthy person, you can voluntarily donate blood every 90 days. I encourage everyone to do so. Be brave. Step out, and Save a life. This is one of the noblest things to do. You're literally saving a life. I would suggest you read more about how to donate to the region you live in before getting excited. I'll hit up an article on how this can be done. Many healthcare units are practising 'Convalescent Plasma Donations'. Here is a link to more on CPD https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html

What am I doing about this:

Way before the COVID19 hit the scenes, 3 years back, I had to start from scratch, conducting research on the ground, surveys with medical professionals on their pain points, case studies on requirements of patients, understanding the processes in and out and studying the dreadful 'Policies and Guidelines' trying to find out why there is a dire need to use technology to do the impossible. We've been working to bridge the gap between the Donors, Recipients, Blood Banks and Hospitals. Our team is developing an integrated system that aims at reducing the time taken to acquire blood using ML. We are very far from launch. But with the pandemic, we have realigned our priorities and are focussed to quickly delivering a world-class solution to a world-class problem-Blood

Conclusion:

The death rates due to non-availabilty of blood has been a never-ending problem. It is elevated further by the impact of COVID19, social distancing, lockdowns. People are going to be dying in the millions. This article is no way is a request to come out of lockdowns but a recommendation for you to be aware of blood transfusions and how you can contribute to saving lives throughout the pandemic.

#Covid19

#Blood

#DonateBlood

#SaveLives