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Objectives To estimate SARS‐CoV‐2‐specific antibody seroprevalence after the first epidemic wave of coronavirus disease 2019 (COVID‐19) in Sydney. Setting, participants People of any age who had provided blood for testing at selected diagnostic pathology services (general pathology); pregnant women aged 20–39 years who had received routine antenatal screening; and Australian Red Cross Lifeblood plasmapheresis donors aged 20–69 years. Design Cross‐sectional study; testing of de‐identified residual blood specimens collected during 20 April – 2 June 2020. Main outcome measure Estimated proportions of people seropositive for anti‐SARS‐CoV‐2‐specific IgG, adjusted for test sensitivity and specificity. Results Thirty‐eight of 5339 specimens were IgG‐positive (general pathology, 19 of 3231; antenatal screening, 7 of 560; plasmapheresis donors, 12 of 1548); there were no clear patterns by age group, sex, or location of residence. Adjusted estimated seroprevalence among people who had had general pathology blood tests (all ages) was 0.15% (95% credible interval [CrI], 0.04–0.41%), and 0.29% (95% CrI, 0.04–0.75%) for plasmapheresis donors (20–69 years). Among 20–39‐year‐old people, the age group common to all three collection groups, adjusted estimated seroprevalence was 0.24% (95% CrI, 0.04–0.80%) for the general pathology group, 0.79% (95% CrI, 0.04–1.88%) for the antenatal screening group, and 0.69% (95% CrI, 0.04–1.59%) for plasmapheresis donors. Conclusions Estimated SARS‐CoV‐2 seroprevalence was below 1%, indicating that community transmission was low during the first COVID‐19 epidemic wave in Sydney. These findings suggest that early control of the spread of COVID‐19 was successful, but efforts to reduce further transmission remain important.

The data appear broadly representative of the current transfusion and inventory management practices surrounding the use of group O D- RBC units. Strategies to reduce O D RBC demand include reevaluation of inventory holdings particularly at smaller centers, increasing the panel of phenotyped RBC units across all ABO groups, more regular rotation of units between hospitals to minimize time expiry, and continuing education for promoting transfusion of ABO-identical RBC units.

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ustralian Red Cross Lifeblood is the national supplier of fresh blood and blood products to the Australian community, produced from voluntary, non-remunerated blood donations. In Australia, as elsewhere, overall demand for red blood cells (RBCs) has declined over the past ten years, but the demand for universal RBC units -ie, from group O RhD-negative (RhD-) donors -has increased. 1,2 To ensure an adequate supply of O RhD-RBC units, Lifeblood dedicates resources to recruiting and retaining O RhD-donors.The only available data on ABO RhD blood group prevalence in Australia are based on information for first-time blood donors during 1993-94. 3 The demographic characteristics of Australia have changed substantially in the meantime, the population having increased by 7.5 million people to 2019, 4 including three million migrants, predominantly from South East Asia, India, and China. 5 Understanding migration patterns is important for blood collection planning, as the distribution of ABO RhD blood groups differs between ethnic groups. 6,7 As recent national data on ABO RhD blood group prevalence in Australia are not available, it is unknown whether supply for high demand blood and blood products can be sustained.The most recent information on ABO RhD blood group prevalence was collected in the Northern Territory and Western Australia to support clinical care for Indigenous Australians. 8,9 However, data for these two jurisdictions cannot be generalised to all parts of Australia. National data are needed to provide accurate information for planning the supply of blood and blood products, to reduce clinical waste, and to ensure blood collection patterns match community demand.We aimed to determine the distribution of ABO RhD blood groups in Australia. We analysed Lifeblood information for blood donors, but these data are biased by disproportionally high collection from certain donors to meet clinical demand for specific blood groups, such as group O RhD-for RBC units and group AB blood for plasma. We therefore also assessed blood group data provided by national pathology agencies. MethodsWe undertook our study during 1 January -31 December 2019. The Lifeblood national transfusion scientific team contacted 41 pathology agencies (representing 324 health providers approved by the National Blood Authority to receive blood and blood products from Lifeblood) by email, using internal communications distribution lists. The pathology agencies covered all approved health providers in metropolitan, regional, and rural areas in all eight states and territories of Australia.Participating agencies provided ABO RhD blood group data for all patients during 2019 for whom pathology analysis included blood typing. We did not collect information about the blood typing methods and equipment used by individual services. Patient age, sex assigned at birth, and residential postcode could also be supplied, but these details were optional. We specifically requested that duplicate results for patients be removed, but we could not check dupli...