Indiana Daily Student

A nationwide blood shortage threatens patient care. What can people in Bloomington do?

<p>Phlebotomist Korey Dyerly, right, puts a &quot;blue tag&quot; on blood donated by Antonia Warren on April 2, 2019, during a Red Cross blood drive at Lurie Children&#x27;s Hospital in Chicago. According to an American Red Cross <a href="" target="">statement</a> in June, a rise in trauma cases, organ transplants and elective surgeries depleted the nation’s blood inventory.</p>

Phlebotomist Korey Dyerly, right, puts a "blue tag" on blood donated by Antonia Warren on April 2, 2019, during a Red Cross blood drive at Lurie Children's Hospital in Chicago. According to an American Red Cross statement in June, a rise in trauma cases, organ transplants and elective surgeries depleted the nation’s blood inventory.

The first time Penny Reid ever lied about her age was to donate blood. 

She was a high school student and not quite 17, the minimum age requirement. Decades later, the 56-year-old Monroe County resident is a regular donor. 

Hospitals around the U.S. face a severe blood shortage spurred by a rise in the need for blood and a decrease in donations. As the demand for blood surpasses the supply, some hospitals are forced to reckon with a tighter inventory, and in some cases, delay patient care. 

According to an American Red Cross statement in June, a rise in trauma cases, organ transplants and elective surgeries depleted the nation’s blood inventory. The statement said red blood cell demand from hospitals with trauma centers climbed 10% in 2021 compared to 2019. 

In July, the Red Cross said over 1,000 additional donations were needed each day to meet the needs of hospitals across the country. That number has since gone up. In a September press release, the Red Cross stated it needed to collect 10,000 additional blood products each week over the next month to overcome the shortage. 

How can I donate?

If a person is eligible to donate, they can make an appointment on the Red Cross Website.

According to the Red Cross, blood donations typically last from eight to 10 minutes. After, participants are encouraged to wait  10-15 minutes to rest and eat snacks before leaving the donation site. Whole blood donations usually amount to one pint of blood, which is roughly equivalent to one unit. Each donation is separated into different products--like red blood cells, plasma and platelets-- that can be used to treat different conditions, Lance White, American Red Cross donor recruitment specialist, said.

According to the Red Cross, all blood donors are required to meet Food

Graphic by Abby Carmichael

and Drug Administration eligibility criteria in order to donate blood. Reasons a person may be deferred from donating include: 

  • Feeling sick on donation day.

  • Being on a medication requiring a waiting period following their last dose. 

  • Having low iron.

  • Having traveled to or lived in a malaria-risk country.

People who have contracted or have symptoms of COVID-19 are asked to postpone their donation for two weeks. However, people who have received a COVID-19 vaccine are still eligible to donate. 

The FDA requires men who are sexually active with other men to wait three months from their last sexual activity to donate. The FDA implemented the rule in 1985 to reduce the risk of HIV transmission. To combat the blood shortage in April 2020, the deferral period dropped from 12 to three months. 

Advocates say the rule is discriminatory and rooted in homophobia rather than science, since anyone — including those who are celibate or have sex with members of the opposite sex — can contract HIV. Medical News Today said the three-month waiting period provides adequate time to test blood donations, but the Centers for Disease Control and Prevention reports certain tests can detect HIV in less time.

Every blood donation is tested for HIV regardless of sexual orientation, and the rate of contracting HIV through a blood transfusion is less than one in a million, according to the National Heart, Lung and Blood Institute. 

In 2014, the Williams Institute at UCLA estimated in a study that completely lifting the ban could increase the total annual blood supply 4% and help save over a million lives. 

Why is there a shortage?

The rise in trauma cases and surgical needs is both seasonal and pandemic-related, White said. Summertime typically brings shortages because people who usually donate might be vacationing or traveling. Hospitals also see more accidents and illnesses, causing an increase in demand for blood. 

Donor turnout has reached the lowest point of 2021, decreasing by about 10% since August, the Red Cross said in a recent press release. 

The pandemic has also played a role, White said, because people began to return to routine and in-person activities, leaving them too busy to donate blood or volunteer at drives. 

Patients who delayed care during the pandemic are also going to hospitals in worse condition, according to the Red Cross. 

White said it has been decades since this kind of a crisis. During this year’s shortage, less than half a day’s supply of type O-negative blood, which can be given to patients of any blood type and is the most frequently used, was available.

“Imagine you have an emergency and you need to go to the E.R., and you get to an E.R. and you need a blood transfusion and they tell you, ‘We don’t have your blood type,’” White said. “It could potentially be that it’s just a very big inconvenience. It could potentially be life or death.” 

However, blood is perishable and cannot be stockpiled, which is one of the reasons people are urged to give regularly, White said.

IU Health has a minimum number of units it lets the supply drop to before ordering more from the Red Cross, Rhonda Grimm, IU Health Hospital Laboratory-Blood Bank Supervisor, said, and they have hit those minimums — or gone below in the case of the universal O-negative type. 

The Red Cross usually sends the full ordered amount if the blood is meant for a specific patient, Grimm said. For orders meant to replenish the overall supply, hospitals typically receive about half of what they order. During a shortage, the blood supply must be spread out carefully to all the Indiana hospitals in need. IU Health is monitoring how much blood each facility has, Grimm said, and if a hospital needs blood, it knows where to send it to in the system.

How much is needed?

At IU Health Bloomington Hospital, Grimm said the hospital typically keeps around 150 units of blood on the shelf at all times, but that number has dropped to about 100 in the past few months. 

Approximately 36,000 units of red blood cells are needed each day in the U.S., according to the Red Cross. One unit can save up to three lives. About 38% of the population is eligible to give blood yearly, the Red Cross estimates, but only 3% roll up their sleeves to donate.

Grimm said IU Health Bloomington has not canceled any surgeries or denied transfusions, but she is reminding physicians to use blood as judiciously as possible. Physicians are waiting until symptoms of conditions like anemia are more severe to give transfusions. 

Although the shortage at IU Health was worse earlier this summer, Grimm said she is starting to see the situation dip again. However, she said she expects the flow of blood donations to always vary. 

Because smaller shortages typically happen around the holidays, White said it’s going to be a long road back to sustainable levels after a shortage this severe. He said another critical point will likely come around Thanksgiving and Christmastime, since those are typically shortage times anyway.

Graphic by Abby Carmichael

“We have a small window of time from now to then to build back up somewhat,” White said. “At that point, if we aren’t able to do that, things could take a bad turn.”

White said Indiana does a good job of collecting blood compared to other states. He said the state is an “exporter region,” meaning it can send surplus blood to other states after meeting local need. White estimates Monroe County is one of the top counties in the Midwest when it comes to collecting blood. 

From July 2020 through June 2021, Hyacinth Rucker, American Red Cross of Greater Indianapolis Regional Communications Manager, said in an email, the Indiana region of the Red Cross collected 118,538 units of red blood cells and 20,460 platelet products. 

Jennifer Hasel is a Blood Emergency Readiness Corps member and project and operations development manager at the Oklahoma Blood Institute. BERC is a group of blood centers that collect an emergency supply of blood for major events like mass shootings. 

Hasel said the goal is to be prepared and avoid shortages like these by making sure blood is already readily available. 

“The bottom line is, if a tragedy happens and the blood’s not there, it’s too late,” Hasel said. “People could line up outside the door, but if the blood’s not on the shelf, ready to be transfused and already tested, then those people are not gonna make it without it.”

Reid gives blood about five times per year. Even during the COVID-19 shutdown, she said she still regularly donated.

“When there’s a big disaster, everybody rushes out to give blood as a way to contribute to that sense of community loss,” she said. “I wish that people could take that energy and use it all the time. We’re always facing a sense of community loss and community trauma in one way or another.”

She said everyone who can should make the effort to donate blood even if they might be nervous about the idea, because blood drives are everywhere.

“It’s really easy to make it a part of your life forever,” she said. “It’s just a really, really solid and straightforward and easy thing to do that saves lives, and there’s no reason to not at least check it out.”

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