CHEARS

With the majority of population set to get vaccinated in the coming months, researchers believe India will face a shortage of blood supply. Citizens from the age groups 18-44 who incidentally are the most eligible group of blood donors might not be able to donate blood after their vaccination. As a result the blood collection agencies are urging people to donate blood before getting their vaccination.In the past year, the blood banks has seen a decline in donations. The possible reasons associated with this factor could be the hesitancy of the public and donor' unwillingness owing to the fear of contacting the infection, or the loosening and tightening lockdown restrictions. Another significant fear observed amongst the population was the fear of reduced immunity after a donation. According to a study conducted in Kolkata, the drop in blood donation in the past year itself was 51.2%. With already such perilous conditions, loss of potential donors may eventually lead the blood banks into crisis. The shelf life of a bag of blood after donation is 42 days for red blood cells and 7 days for platelets. With a 4 to 6 week time gap between vaccines, a vaccinated person can't donate blood for more than 2 months. Though the majority of hospitals have paused all elective surgeries, the trauma accident, emergency cases and deliveries still need a blood supply.

The pandemic has produced a heated debate regarding the safety of blood donations in some countries. While the lockdown reduces the amount of health care activity, unavoidable patient care still needs to be continued. Though the state and national government have taken adequate measures to increase the blood inventory through public appeals to donate blood and by ensuring voluntary donors that blood donation is regarded as a permitted activity during lockdown, a significant decline in pattern of donation is still observed. It was observed that hospital employees form a vital voluntary donor base in any pandemic because they are easily available, furthermore, they have experience of blood donation and are very much aware of the blood crisis. The blood donation centres follow the strict guidelines implemented by the government for social distancing, masking, hand hygiene, and cough etiquette adequately and judiciously. Another challenge faced by such institutions is the inadequate staffing which has become a challenge faced in the COVID period. With most of the staff in hospitals engaged in COVID related duties, there are less staff for emergencies. Another issue faced is the provision of hospital transportation facility in the lockdown period and arrangement of accommodation and food for staff in the hospital premises.

We have clearly established the need for the hour, but then the question arises apart from the obvious help to the patients, how the donors are benefitted. A study on psychological effects of quarantine suggests that COVID has led to mental stress and a feeling of anxiety in the general community. With the increased restrictions on socialization , a necessity, yet have led the public into a sense of desolation, the duration of pandemic which is now over for more than a year has pushed people into negative mind space. Donating blood is a socially meaningful act and an opportunity to build a sense of self as part of a network of selfless citizens . Donating during a time when the need is critical and immediate can provide an opportunity to connect to a wider community .It provides the cooped up citizens with a sense of purpose. Now, along with the demand for blood donation from non COVID-19 infected, non -vaccinated people there is similar call for plasma donors. This treatment has become widespread on social media platforms and thus the population is going crazy over it. It is believed that plasma donation from a previously infected person contains antibodies and thus can save the lives of critical patients at the right time. Researchers disagree with this they believe that more than Remdesivir and plasma treatments , steroids and antiplatelets have proven to be more lifesaving. The convalescent plasma treatment wave is yet to pass. In the meantime, recovered COVID patient are going in waves to donate their plasma. Though not as effective it provides a sense of relief to the relatives as well as the patients. It is said that a patient is eligible to donate plasma after 14 days of resolution of treatment or the alleviation of symptoms.

What can the people and government do to prevent the blood supply crisis? An individual can donate their blood before taking a vaccine if possible. Though everyone in the given age group wouldn’t be able to get vaccinated within the next two months but a huge chunk of able donors might and some may even get affected by the virus hence preventing them from donating. According to the guidelines issued by the National Blood Transfusion Council, a donor has to wait for 28 days after getting vaccinated to donate their blood. Blood donation has become a pillar for modern medicine.

The good news is that people have become more aware to this threat. Hence the youth groups, NGOs, Hospitals and blood bank have pre-emptively put out word and called for able donors. The responsibility lies with the general public to realise the need and help the healthcare system. Without receiving proper amounts of blood the chances for survival for patients becomes close to nil. A proper transfusion at the appropriate time is must. Due to the already limiting nature and strict guidelines of criteria for donation the able candidates are limited and selective. India is a country where a huge amount of its population is undernourished. Especially in women anaemia is very common. Apart from this, if a person has any comorbidities or an issue with his blood work he becomes ineligible. The COVID-19 pandemic has introduced severe stressors into the supply chain and has contributed to the public health emergency and threatening population health. However, this acute blood shortage will reflect deeper issues for public health emergency preparedness as well as the structure of the blood collection system. There is no known end date for the COVID-19 pandemic and no guarantee that COVID-19 will be the last epidemic or pandemicthe world will see. It is hence a priority for the people to prevent another crisis by living in co-operation and donate blood.

References:

•  Second Interim, National Guidance to Blood Transfusion Services in India in light of Covid-19 Pandemic. Available from: https://www.mohfw.gov.in/pdf/2nd NBTC Guidance in Light of COVID19 Pandemic.pdf. 

• https://www.medscape.com/viewarticle/949396_5