At various points during the coronavirus pandemic, North Carolina hospitals have faced shortages of masks, intensive care unit beds, COVID-19 antibody treatments and staff, particularly nurses.
Now it’s blood that has reached a critical level. A decline in donations over the last year, coupled with a return of demand to pre-pandemic levels, has hospital blood banks operating on thin margins.
The blood inventory at Duke University Hospital is about half where it normally is, which means Durham’s Level 1 trauma center has a little more than a day’s supply on hand, said Dr. Nicholas Bandarenko III, medical director for transfusion services.
”If this tightens down harder on us, we will have to operate on less than a day’s supply,” Bandarenko said. “Which means we have to choose who’s getting blood and who is going to have to wait.”
Dr. Lisa Pickett, the hospital’s chief medical officer, said every planned surgery and other procedure that requires blood is being scrutinized to make sure Duke has enough of each patient’s blood type on hand.
“This is the worst I’ve ever seen in my 30-year career,” Pickett said.
Blood donations typically decline around the holidays, as people get busy with family or travel. But this year’s dip is made worse by a drop in donations that goes back months.
Donations to the Red Cross are down 10% during the pandemic, said spokeswoman Cally Edwards. Many businesses, churches and schools have stopped hosting blood drives, to avoid gatherings or because people are working remotely. Blood drives at schools and universities have dropped 62% since the coronavirus arrived, Edwards said.
The Red Cross likes to keep a five-day supply of blood on hand but finds itself with less than a day’s supply of some blood types, including Type O negative, which can be given to patients with any type, Edwards said.
“If something happens to one of our loved ones and they needed urgent, emergency surgery, we would want blood on the shelves for them when they needed it,” she said. “That blood is only available because donors arranged in the days and weeks ahead for that blood to be there for them.”
Demand returned as donations dropped
Blood donations kept up with demand during the first months of the pandemic, in part because people wanted to help in a time of national crisis, said Ellen Kirtner, spokeswoman for The Blood Connection.
“We had a great response at the beginning of the pandemic,” Kirtner said. “People stepped up and were coming out to donate at our center, and people were hosting blood drives.”
At the same time, demand for blood declined in 2020. Hospitals put off many non-urgent procedures to free up staff, beds and equipment for COVID-19 patients, while fewer people got into car accidents while schools and businesses were closed.
Both trends changed in 2021. Demand for blood rebounded, as hospitals resumed normal operations and caught up with delayed procedures. Duke University Hospital used 20% more blood in November than it did the same month a year earlier, Bandarenko said.
At the same time, donations dropped, for reasons the blood collection agencies can’t fully explain. There are fewer blood drives, and three spikes in COVID-19 cases since January 2021 probably kept some from donating. It may also be that the desire to pitch in has worn off as the pandemic has dragged on, Kirtner said.
“We’re not really sure what has caused this decrease in the last 10 months,” she said.
Neither The Blood Connection nor the Red Cross see an uptick in donations on the horizon. The Blood Connection, which provides blood to hospitals in the Carolinas and Georgia, expects to collect 40% less than what its hospitals need in the next 30 days, while the Red Cross reports more than half of its appointments for January in Eastern North Carolina remain open.
Both groups are urging businesses, churches and schools to organize blood drives and for donors who may give occasionally to donate more often.
‘Thankfully nothing bad happened’
Duke University Hospital gets its blood from the Red Cross. Bandarenko said in the past when gunshot or car crash victims needed large amounts of blood, the hospital could order more during the day. Now it gets one allotment per day and no more, he said.
He said Duke ended a recent day with a third of its normal blood supply on hand.
“That was replaced the next morning with our next delivery,” he said. “Thankfully nothing bad happened overnight that night.”
Long term, Bandarenko said the blood shortage will force doctors to find ways to use blood more sparingly and conserve it the way drought-prone areas make the most of their water supplies.
He hopes it will also help the rest of us not take blood, and blood donors, for granted.
“As a society, I don’t think we promote blood donation, and I don’t think people see blood donors as heroes,” he said. “But every blood donation makes a difference in somebody’s life somewhere.”
UNC Rex Hospital is hosting a blood drive on Monday, Jan. 17, in honor of Martin Luther King Jr. Day. The drive will be held outside the hospital in Raleigh from 10 a.m. to 3 p.m., as well as at Rex Wellness Centers in Knightdale and Cary from 10 a.m. to 3 p.m. and in Garner and Wakefield from 2 to 7 p.m. For information or to sign up, go to thebloodconnection.org/rex/
This story was originally published January 13, 2022 12:24 PM.