Immunohematology Laboratory during the Surge of the Covid-19 Pandemic

Immunohematology Laboratory during the S urge of the Covid-19 P andemic.

. In the time of COVID-19, donating blood is more essential than ever.

abstract. What Happens to Blood in a Blood Bank?.

While the donation is being processed, the blood test tubes are sent out for screening. At the American Red Cross, this includes testing for diseases such as hepatitis B, hepatitis C, HIV and West Nile Virus. If any of the tests are positive, the donor will be notified and the blood will not be used. During the testing stage, the blood is also typed for ABO groups and Rh factor. Once the blood is screened and processed, it is stored up to 42 days or until it is needed. A blood bank ensures that hospitals have a safe, reliable blood supply for patients in need. You can help meet supply demands by scheduling your donation today. Your donation may even help save more than one life..

BLOOD TRANSFUSION DURING THE PANDEMIC. Blood transfusions are an essential component of medical care in all fields. With the onset of the COVID-19 pandemic, having enough and safe blood supply to meet patient needs has become a major worry. In many regions of the world, there is a widespread shortfall in blood supply and demand, which has a substantial impact on blood transfusion services. The COVID-19 pandemic harmed the blood donation process by causing a significant drop in blood donors, leading blood banks and donation facilities to establish new regulations to enhance blood supply while safeguarding donors from COVID-19 infection. The blood bank's responsibilities include recruiting donors and testing donated blood. As a result, direct blood donation is the primary source of blood. However, the risk of contracting COVID-19 when transfusing blood becomes a major worry. During the COVID-19 epidemic in many regions of the world, blood transfusion facilities had a particularly difficult time, resulting in a lack of blood services and blood donors ..

During a crisis, society expects people to engage in prosocial behavior that aids in crisis management. In fact, following a crisis, people are more inclined to offer aid. The COVID-19 pandemic, on the other hand, differs in that it is an ongoing disaster that impacts everyone and has the potential to put anyone's health at risk. As a result, we believe the pandemic may have a detrimental impact on our willingness to help, particularly on blood donation intentions. Beyond the crisis, a high degree of willingness to donate blood is required, as additional blood will be required once postponed surgeries resume. As the number of COVID-19 cases increased in our country, transportation was restricted and school restrictions were implemented, resulting in a significant drop in blood donations. But keep in mind that visiting the blood bank is safe, and giving blood is still safe. Only healthy people are eligible to donate blood, and donors are tested upon entry for any signs of illness. There are also physical separation and hygiene precautions in place, including donor screening, wearing gloves, and cleaning down surfaces after each donation..

During this COVID-19 pandemic, blood donation is more crucial than ever, "adds Dr. Le." "At the start of the pandemic, we were confronted with blood drive cancellations due to initial business, school, and travel limitations, which made it difficult to flatten the infection curve." Despite the fact that the postponement of elective procedures reduced some hospital inventory ordering patterns, the demand for blood and platelets remained high due to their therapeutic functions in trauma and cancer therapy. The resumption of elective operations and procedures, which began in early summer 2021, increased demand for blood products. Mitigation methods to prevent or slow the spread of COVID-19, on the other hand, have resulted in a decline in both large and small blood donations as well as continuing cancellations of blood drives at workplaces and schools due to social distancing regulations..

Challenges faced by the blood bank during Covid 19 pandemic.

Challenges faced by the blood bank during Covid 19 pandemic.

 Donor and staff safety In an effort to maintain the inventory, the safety of donors and staffs cannot be jeopardised. Voluntary donors residing at a walk-away distance from the blood bank too might be apprehensive to turn up for donation. The blood collection sites and stations need to undergo thorough disinfection and disposal of medical waste needs be handled more meticulously. Psychological impact of COVID-19 as a disease and the effects due to the nationwide lockdown on donors, acute or long-term, would also require attention. Due to mobility constraints, daily commute of employees is affected. Also, employee absenteeism can be expected due to illness of self/ family or panic especially among those handling infected patient’s sample. As health-care workers who are the front-line warriors are at not only at a higher-risk of contracting the disease but may also experience adverse psychological issues like burnout, anxiety, depression and PTSD (Posttraumatic stress disorder) amongst many..

Consumables logistics and supply The major predicament during this pandemic is not just the illness, but also the disruption in production and service delivery. Most of the reagents used in blood banking are manufactured abroad and due to lack of local producers the service during lockdown period was hampered.  C onvalescent plasma An additional challenge to blood banks is to provide convalescent plasma as part of registered clinical trials . Although the blood demand might decrease due to cancellation of elective surgeries and routine transfusion services, the need for donors to donate convalescent plasma will steadily rise. Not all blood banks are equipped to collect plasma by apheresis technology. And even for blood banks which do perform plateletpheresis, such mass plasmapheresis donations can be quite cumbersome..

STRATEGIES TO COUNTERACT THE CHALLENGES. Alteration of blood donor eligibility criteria and reduction of deferral interval According to some staff of CVMC Blood bank whom we interviewed , the checklist on the symptoms of Covid-19 just like fever, cold diarrhea and other associated mild symptoms is included in the donor’s questionnaire and be deferred for up to 2 weeks if there is. But o n the first months of the pandemic, donors with these symptoms are deferred up to 28 days, according also to the staff. 28 days deferral for those who had recently traveled to other countries (China, Hong Kong, Macau, Iran, Italy, and South Korea ) 8 week deferral instead of 12 weeks deferral Reconsideration for those who were previously permanently deferred (those who lived in England bet 1980-1986).

Replacement family donation Intensifying donor recruitment Promotion through social media and radio broadcast Donor recruitment through mobilizing donors from healthcare workers Conducting blood donation drives in military settings Staff and donor safety through observance of preventive measures  Appointment system Change in shift of staff Minimize wastage of blood  Extending shelf-life of blood components (e.g. platelet concentrate) Splitting platelets into two (2) doses Redistribution of blood to centers that are in need Pathogen inactivation Active inventory management Cancellation of elective surgeries and non-urgent procedures.

Donor education and awareness played an important role in donor recruitment during the pandemic period. Effective communication with blood donors and blood donation drive organizers on donor eligibility and the deferral period, especially regarding COVID-19 through various platforms, including social media, such as WhatsApp and Facebook, proved beneficial at our center in lessening the deferral rate during the post-lockdown phase of the pandemic year. This coping strategy was extensively used as a powerful tool for creating public awareness, the effectiveness of which was well appreciated during the pandemic crisis by the blood centers across the globe. The common deferral reasons identified in a previous study conducted at our center include the hemoglobin-based deferral followed by high blood pressure. However, in the pandemic year post-lockdown phase, a minimal proportion (5.4%) of the deferral was due to the COVID-19 risk. This is probably due to the inclusion of regular blood donors, rather than first-time donors, who are well informed on the blood donation eligibility criteria and, thus, opted for self-deferral..

Permanent/ indefinite • HIV (+), Kaposi’s sarcoma • Risky sexual behavior (sexual workers, multiple partners) • Syphilis, Gonorrhea, Genital herpes • HBsAg (+), anti-HBc (+), History of hepatitis after 11th birthday • Hemophilia, von Willebrand’s disease, receiving clotting factors • Sickle cell anemia, Thalassemia, Polycythemia, Leukemia, Lymphoma • History of Cancer (except basal/squamous cell cancer, carcinoma in situ of the cervix, and papillary thyroid carcinoma that has been surgically removed) • History of Babesiosis, Chagas disease • Family history of Creutzfeldt-Jakob disease • Recipient of human dura mater grafts, pituitary-derived growth hormone (CJD) • Colitis / Irritable bowel syndrome • Chronic alcoholism • Have taken the drug TEGISON for treatment of Psoriasis.

3 years • History of Malaria (after becoming asymptomatic) • Have taken the drug SORIATANE for treatment of Psoriasis 1 year • After Hepatitis B immune globulin administration • Close contact with someone with symptomatic viral hepatitis • Tattoo, skin piercing, accidental needle sticks • Recipient of blood transfusion, organ/tissue transplant • Rape victims • Received rabies vaccine / immunoglobulin • Abortion/Miscarriage with Dilatation and Curettage • Immigrant or refugee coming from an area endemic for Malaria • Incarceration in a jail for more than 72 hours in the previous 12 months 8 weeks • After vaccination with MMR (Measles, Mumps, Rubella).

4 weeks - Vaccinations BCG, Chickenpox vaccination, Measles, Mumps, Oral Polio Typhoid, yellow fever, AH1N1, HPV, smallpox vaccinia, including Cov-19 vaccine -After cessation of the drug Proscar, Accutane, Propecia 6 months After cessation of the drug Avodart for prostate gland enlargement 3 months Recent whole blood donation 1 month Dengue Fever 3 days Aspirin intake in the past 36 hrs 48 hours Whole blood donation deferred after Apheresis (plasma, platelets, granulocytes).

Additional Deferrals in relation to Covid-19. The blood establishment’s responsible physician must evaluate prospective donors and determine eligibility (21 CFR 630.5). The donor must be in good health and meet all donor eligibility criteria on the day of donation (21 CFR 630.10). The responsible physician may wish to consider the following: individuals diagnosed with COVID-19 or who are suspected of having COVID-19, and who had symptomatic disease, refrain from donating blood for at least 10 days after complete resolution of symptoms, individuals who had a positive diagnostic test for SARS-CoV-2 (e.g., nasopharyngeal swab), but never developed symptoms, refrain from donating at least 10 days after the date of the positive test result.

individuals who are tested and found positive for SARS-CoV-2 antibodies, but who did not have prior diagnostic testing and never developed symptoms, can donate without a waiting period and without performing a diagnostic test (e.g., nasopharyngeal swab), individuals who received a nonreplicating, inactivated, or mRNA-based COVID-19 vaccine can donate blood without a waiting period, individuals who received a live-attenuated viral COVID-19 vaccine, refrain from donating blood for a short waiting period (e.g., 14 days) after receipt of the vaccine, individuals who are uncertain about which COVID-19 vaccine was administered, refrain from donating for a short waiting period (e.g., 14 days) if it is possible that the individual received a live-attenuated viral vaccine. (https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/updated-information-blood-establishments-regarding-covid-19-pandemic-and-blood-donation?utm_medium=email&utm_source=govdelivery).

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Here are Some Photos Taken From Blood Bank During our Duty.

Here are Some Photos Taken From Blood Bank During our Duty.