Hospital transfusion service operations during the SARS‐CoV‐2 pandemic: Lessons learned from the AABB hospital survey in preparation for the next infectious disease outbreak

Abstract

Background The SARS‐CoV‐2 pandemic disrupted hospital operations, affected the blood supply, and challenged the health care system to develop new therapeutic options, including convalescent plasma (CCP). The aim of this study is to describe and analyze blood supply fluctuations and the use of convalescent plasma in 2020. Methods AABB distributed a weekly and biweekly questionnaire through email to hospital‐based members (HBM). Results The survey was sent to 887 HBM with 479 unique respondents, most of the hospitals served pediatric and adult patients, and all states of the country participated, except Idaho and Vermont. Fifty four percent of HBM reported increased wastage in the early phase of the pandemic (May), which decreased to 4% by the end of June and throughout the rest of the year. The majority of HBM reported receiving alerts from their blood suppliers reporting blood shortages throughout the year. During March and April, only 12% of HBM were performing elective surgical procedures. The top reasons to delay procedures were: bed availability (28%); COVID‐19 caseload (23%; and blood availability (19%). By mid‐April, 42% HBM had transfused CCP and reported >24 h delay in getting the units; the vast majority obtained CCP using the Expanded Access Protocol, and later, the Emergency Use Authorization. HBM consistently prioritized the most severe patients to receive CCP, but the proportion of severely ill recipients fell from 52% to 37% between May and October, with an increase from 5% to 21% of HBM providing CCP transfusion early in the course of the disease. Discussion Blood utilization and availability fluctuated during the pandemic. The fluctuations appeared to be related to the number of COVID‐19 in the community. The use and regulatory landscape of CCP rapidly evolved over the first 8 months of the pandemic.

Using automation to manage donor engagement and fine-tune supply and demand during the first year of the COVID-19 pandemic

“…2 presents a closer look at daily apheresis collections from March 1 to June 30, 2020. Plasma and RBC collections were suspended for a two-week period (end of March to mid-April 2020) due to canceled elective surgeries resulting in an industry surplus [2] , [3] . The blood center’s goal during this period was to maintain donor engagement, especially for frequent apheresis platelets donors.…”

“…Blood collection and blood usage were significantly disrupted by the COVID-19 pandemic [1] , [2] , [3] , [4] . Blood product demand became unpredictable, especially in the first months following the March 2020 lock down [1] , [2] , [3] , [4] .…”

“…Blood collection and blood usage were significantly disrupted by the COVID-19 pandemic [1] , [2] , [3] , [4] . Blood product demand became unpredictable, especially in the first months following the March 2020 lock down [1] , [2] , [3] , [4] . In the early months of the pandemic, blood drives were canceled, donors stopped presenting, and hospitals reduced elective surgeries [3] .…”

“…Blood product demand became unpredictable, especially in the first months following the March 2020 lock down [1] , [2] , [3] , [4] . In the early months of the pandemic, blood drives were canceled, donors stopped presenting, and hospitals reduced elective surgeries [3] . Blood centers were also challenged during the COVID-19 pandemic to collect COVID-19 convalescent plasma (CCP).…”

Passive order auditing associated with reductions in red blood cell utilization: National blood shortage experience

“…1,2 In the United States, the aging blood donor population, limited resources for blood donor recruitment and retention, and consolidation of blood collection centers have reduced blood product inventory and resiliency. 2,3 Decreased blood collection during the Coronavirus Disease 2019 (COVID-19) pandemic has resulted in the most critical blood shortage in the United States in the last two decades [2][3][4][5][6][7] and challenged blood suppliers worldwide. 1,[8][9][10] In a 2020 survey, 472 of 861 (54.8%) of responding AABB-accredited hospitals reported receiving alerts from blood suppliers of challenges filling blood orders.…”