Blood banks across the country have taken a significant hit as more Americans are working from home and are not willing to risk breaking social distancing guidelines to donate blood. Blood’s limited shelf life puts a further strain on the national blood supply.
“In the initial weeks of the COVID-19 pandemic, the U.S. blood banking system found itself facing twin challenges: More patients were being hospitalized and were potentially in need of blood transfusions, while donations dwindled as a result of the implementation of social distancing and the cancellation of blood drives. The threat to the national blood supply prompted the [Food and Drug Administration] to issue new blood donation guidelines in April 2020, lifting certain longstanding restrictions on who can donate blood – and when.
The agency reduced the deferral period from 12 months since last exposure to 3 months since last exposure for male donors who have had sex with another man (MSM), female donors who have had sex with an MSM, those with recent tattoos or piercings, and those who have traveled to malaria-endemic areas. The agency had been considering these changes before the pandemic, but the timeline of implementation was accelerated by COVID-19.” 1
Changes in the FDA blood donation guidelines were already being developed prior to COVID-19 based on evidence that blood donated by these individuals is safe. COVID-19 simply accelerated the updated regulations because of the need to allow every healthy and willing person to donate.
“Donation restrictions for MSM and their female contacts began during the HIV/AIDS epidemic of the 1980s. When a 1983 study suggested that AIDS was caused by a [blood-borne] pathogen, concerns rose worldwide that this unidentified, potentially lethal pathogen could have contaminated the nation’s blood bank supplies. At the time, HIV/AIDS was more prevalent among gay men than the general population, so the FDA issued a blanket, lifetime ban against MSM blood donations.
Despite advances in HIV testing and blood screening procedures over the following decades, the ban remained in place. The policy drew increasing criticism for excluding donors based solely on sexual orientation.
It wasn’t until December 2015 that the FDA revised the policy, shortening the lifetime ban to a deferral period of 12 months – meaning MSM donors must wait at least 1 year after their last sexual encounter with a man before donating blood.” 2
Jodi Sheedy, Senior Director of Integrated Communications at the American Red Cross noted that “Throughout this pandemic, the Red Cross has seen thousands of blood drive cancellations across the country due to coronavirus concerns, resulting in hundreds of thousands of fewer blood donations. As community organizations, businesses, and schools restrict access to facilities once open to local events and members of the public, Red Cross blood drives at these locations also continue to be canceled.”3
Several times since the COVID-19 pandemic began, significant portions of the U.S. have operated with less than one day’s supply of type O blood units on hand.
It appears that the drop in donations during the pandemic is affecting more groups than others. In September, which is Sickle Cell Awareness Month, the American Red Cross declared an urgent need for blood donations from Black donors after seeing a “significant decrease” in their numbers in the first half of 2020. For example, in 2019, more than 15,000 Black donors gave blood at educational institutions across the country; this year, in part due to in-person school closures, that number has dropped to 2,700.
“Sickle cell patients can require multiple blood transfusions to alleviate this throughout their lifetime to help treat their disease, and Black and diverse blood donors are essential in helping [these] patients recover from crisis and prevent more serious complications like acute anemia, tissue and organ damage, and strokes,” Yvette Miller, MD, Executive Medical Director for the American Red Cross’s Donor & Client Support Center, said in the release.4
The FDA’s new guidelines now has the U.S. mirroring the deferral period established for MSM donations in the U.K. Dawn Ward, MD, Medical Director of the UCLA Blood & Platelet Center and Assistant Clinical Professor in the Department of Pathology and Laboratory Medicine at UCLA’s David Geffen School of Medicine said “We’ve had many questions from donors, specifically in regard to the MSM policy and how they felt that it was somewhat discriminatory,” she said. “Having that decrease in the deferral from 12 months to 3 months is a move in the right direction.” Still, she acknowledged that a 3-month deferral is “not 100% percent to where donors would like it.”
1, 2, 3 What will the FDA’s newly loosened blood donation restrictions mean for donors, blood banks, and the safety of the national blood supply? Accessed Jan 23, 2021 from https://www.ashclinicalnews.org/spotlight/feature-articles/rewriting-rules-blood-donation/
4 Red Cross Has Urgent Need for More Black Blood Donors to Help Sickle Cell Patients. Accessed Jan 22, 2021 from https://www.redcross.org/about-us/news-and-events/press-release/2020/red-cross-has-urgent-need-for-more-black-blood-donors-to-help-sickle-cell-patients.html
5 Revised Recommendations for Reducing the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products. Accessed Jan 20, 2021 from https://www.fda.gov/media/92490/download