SAN FRANCISCO — Fears of infection from COVID-19 have prevented people all over the world from donating blood, worsening the global blood shortage.
As schools, churches, and other mainstays of national collection programs have shut down in low- and middle-income countries, so too have blood drives, while restrictions on mobility have made it harder to store and transport already limited stocks.
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According to the World Health Organization, which has a framework to achieve regular, voluntary, unpaid blood donation globally, in 56 countries, more than 50% of blood still comes from family replacement donors, who give blood required by a member of their family or community, or paid donors.
Over the course of the pandemic, donors who supply blood for emergency transfusions have been in high demand; now, as hospitals resume many of the treatments and procedures that were put on pause, the demand for blood products is on the rise.
In response to COVID-19, organizations that were already working on blood donation and delivery are ramping up their efforts to raise awareness, build capacity, and get supplies to patients in need.
Easing concerns and matching donors with banks
The pandemic has accelerated the rollout of Facebook’s Blood Donations feature, which allows people to sign up as blood donors and receive notifications from blood banks seeking donations.
Facebook launched the tool in 2017, initially offering the service in India, then in Pakistan, Bangladesh, Brazil, and as of last year, the United States. Earlier this month, the tech giant extended the service to several additional countries, including Burkina Faso, Côte d’Ivoire, Egypt, Kenya, Senegal, and South Africa.
Kang-Xing Jin, Facebook’s head of health, noted that Facebook onboarded the same number of countries over the last month as it had over the last two years.
“We’ve been getting increased demand from partners throughout the world over the past year,” he told Devex. “Unfortunately, the pandemic has made this more urgent.”
The company has made some changes in response to concerns that arose after the launch of the Blood Donations feature, for example warnings from public health officials in India that the service could fuel a black market for blood.
“The core change we’ve made is making it so requests for blood can only be issued by vetted blood service providers, not individuals,” Jin said.
Now, Facebook is working with blood banks, hospitals, and ministries of health on strategies to ensure that people who sign up as donors actually show up to give blood in times of need.
But a challenge the company and its partners may face moving forward is concern from potential donors about risk of COVID-19 infection.
While respiratory viruses are not transmitted through the transfusion of blood and blood components, precautionary measures should be put in place to ensure the safety of the entire blood donation process, said Osaro Erhabor, a professor on the blood transfusion faculty at the West African Postgraduate College of Medical Laboratory Science in Nigeria.
He also highlighted the importance of raising awareness in order to address the misconceptions people have about the dangers of donating blood during the COVID-19 era.
Building skills and capacity for blood banking
The Global Blood Fund, which supports blood donor centers in low- and middle-income countries, is producing leaflets, posters, videos, and other materials to raise awareness that it is both safe and essential to donate blood even as the threat of COVID-19 remains.
The organization is working in coordination with the Africa Society for Blood Transfusion to localize, translate, and provide these materials free of charge to blood services across Africa.
Previously, Global Blood Fund and the Africa Society for Blood Transfusion would organize training workshops bringing participants from across Africa to a central location to learn about blood donor recruitment and retention. Now that in-person gatherings are no longer possible, they are building a distance-learning program.
Blood banking is a technical business, and the skills to successfully navigate it are often lacking in countries with the worst blood shortages, said Gavin Evans, executive director of the Global Blood Fund.
Before COVID-19, groups from high-income countries would often support voluntary blood donations in low-income countries. “But this is sporadic, expensive and — with coronavirus — currently impossible,” Evans said.
Soon, the Global Blood Fund will deploy a mentoring software platform featuring experts in blood typing, cold chain management, and other essential skills needed to raise the standard of blood donation globally.
Getting blood and other essential products to patients in need
Because blood is perishable, there is a need for consistent donations, as well as a strategy to store, transport, and replenish supplies.
Zipline, the company using drones to deliver blood and other essential medical products in Rwanda and Ghana, is seeing increased interest in its services from other countries, said Israel Bimpe, who works on business development and global health partnerships at Zipline in Rwanda.
He explained how the ability to distribute scarce commodities on demand has become all the more valuable to national health ministries as the pandemic strains the supply of blood and other essential medical supplies.
Zipline encourages ministries of health “to stop thinking about blood supply, medical supply, vaccine supply as three different entities,” he said.
Hospitals are experiencing scarcity on a range of essential products, said Brittany Hume Charm, head of global health at Zipline.
There are fewer units of blood being donated, fewer doses of vaccines and medicines making it into countries due to transport and supply chain interruptions, and limited availability of personal protective equipment and test kits to respond to COVID-19, she said.
Kenya has long struggled with a dysfunctional national blood service. But the coronavirus is making the situation worse.
Zipline is in talks with Kenya and other countries that are interested in storing their stocks centrally and making them available directly to points of care, on demand, with no buffer stock needed, which Charm said is particularly valuable with blood.
As COVID-19 convalescent plasma, or blood from recovered COVID-19 patients, is being investigated as a treatment for COVID-19, demand for this particular blood product is also growing.
Beyond the day-to-day need to ensure that there is a safe and sufficient blood supply to meet clinical needs in low- and middle-income countries, the collection of COVID-19 convalescent plasma poses additional challenges, said Evan Bloch, associate professor of pathology at Johns Hopkins University.
The problem is not just a lack of blood donors, but a lack of testing and reporting to enable the identification of eligible donors of COVID-19 convalescent plasma, he continued.
Bloch explained that pathology and laboratory medicine in many low- and middle-income countries have long been neglected. Now that COVID-19 is raising awareness about the importance of the blood supply and laboratory services, it remains to be seen to what extent the efforts toward convalescent plasma can be used to address the much larger problem relating to the global blood supply, he said.