Vol 15, Issue 6, 2022 Online - 2455-3891 Print - 0974-2441 BLOOD TRANSFUSION SERVICES IN COVID: SCALING THE UNSCALABLE MOHIT CHOWDHRY*, ANKITA SHARMA, SOMA AGRAWAL, MANOJ MISHRA Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India. Email: mohit_c@apollohospitalsdelhi.com Received: 22 February 2022, Revised and Accepted: 31 March 2022 ABSTRACT Objective: The present manuscript discusses our journey of providing safe BTS during this ongoing COVID-19 pandemic. Methods: It was a single-center, retrospective type of study conducted over a period of 1 year (January 2020–December 2020) in the department of transfusion medicine. The number of donations (replacement and voluntary) was compared during the pre-COVID months with that during the COVID outbreak. The measures included but were not limited to various aspects of staff management, environmental factors, guidelines implementation, and innovative assertions for implementing COVID-19 appropriate behavior. Gradually, provisions were also made for the collection of the COVID convalescent plasma from the recovered donors as a part of the management guidelines issue by the Indian Council of Medical Research. Results: COVID-19 pandemic has had a drastic negative impact on the blood donation but it has also highlighted the potential and the ability of the BTS to withstand such testing times. Conclusion: COVID-19 has left a profound impact on the blood transfusion services. It has highlighted the importance of having a coping strategy in place to withstand such times without compromising the health and the needs of the patients. Keywords: Blood transfusion services, COVID-19, Blood supply management, Blood demand, Blood donation. INTRODUCTION On December 2019, the first case of a respiratory illness caused by an unknown virus was detected in Wuhan, Hubei Province, China [1]. The virus spreads rapidly across the globe affecting many people. These patients reported symptoms of pneumonia. In late December, the World Health Organization (WHO) identified this pathogen as a new strain of coronavirus and it was named by International Committee on Taxonomy of viruses as SARS-CoV-2 and the associated disease was coined as coronavirus disease 2019 or COVID [2]. On January 5, 2020, the WHO declared the COVID-19 outbreak a public health emergency of international concern and later a pandemic on March 11, 2020 [3]. The disease has had a devastating impact on the world, killing millions of people globally, and affecting lives and livelihood of innumerable people [4]. India too could not escape the wrath of this deadly virus, and on March 24, 2020, nationwide lockdown was announced as a preventive measure to curb the spread of COVID-19 [5]. This pandemic has had a very profound impact on the health-care services including blood donation and blood supply. Safe blood and blood components are an indispensable human product and their supply relies solely on blood donation which was reduced substantially during the COVID times. Many blood centers in India and abroad have struggled with the blood transfusion services (BTSs) during this COVID pandemic. It has been a testing time for both hospital staff and the patients alike. Each pandemic comes with its own challenges which need to be managed meticulously through proper planning and actions. These measures should be in accordance with the existing policies of the blood center and should abide by the guidelines laid down by the concerned governmental agencies. Although during this time, numerous challenges and obstacles were presented to the health-care fraternity, it also showed many silver linings in the form of undeterred commitment of the health care workers (HCW). They not only had to look after the patients but also would “take the battle home” where they had to isolate themselves from their own families. Similarly, the BTSs were presented with such unique challenges. The global pandemics in the past have greatly enhanced the knowledge, attitude, and practice with respect to the preparedness of health-care services including the BTS [6]. Maintaining a continuous, uninterrupted supply of blood and blood components plays a lifesaving role in many situations [7]. Blood transfusion is almost a routine medical procedure in repleting blood losses due to surgery, trauma, chemotherapy, hematology, etc. The latter two being the major consumers of packed red cells, closely followed by bone marrow transplant (BMT) and solid organ transplant units [8]. We discuss our journey of providing safe BTS during this ongoing COVID-19 pandemic. METHODS Study design The retrospective study performed from January 2020 to December 2020 was divided into two phases. The initial 3 months being the pre- COVID phase and the last 9 months belonging to the COVID phase. All the parameters and activities related to BTS were taken into account, namely, whole blood donation, component preparation, and issue, various apheresis procedures, namely, preparation of single donor platelets (SDPs), plasma on cell separator, therapeutic plasma exchanges, peripheral blood stem cell harvest, and preparation of COVID convalescent plasma (CCP). The COVID period spanning over a period of 9 months witnessed a total of 9770 WB donation, preparation of 9745 blood components, and 1380 apheresis procedures. There was also a gradual rise in demand of CCP and the period from April 2020 to December 2020 witnessed preparation of around 439 CCP. There was also a steep decline in the number of voluntary whole blood donors from around 1288 in the pre- COVID period to almost 471 during the COVID time, a massive reduction to almost one-third of the original figures. RESULTS Challenges and measures The COVID-19 pandemic has affected both the demand and the supply of blood with the latter facing a major blow due to the widespread fear and anxiety among the voluntary and replacement blood donors [9]. The © 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/ licenses/by/4.0/) DOI: http://dx.doi.org/10.22159/ajpcr.2022v15i6.44498. Journal homepage: https://innovareacademics.in/journals/index.php/ajpcr Research Article