America’s Blood Supply Dries Up as Rare National Crisis Unfolds

Hospitals in some American cities are rationing type O blood, the type used in the most life-threatening emergencies, after the American Red Cross confirmed the country has less than a single day’s supply on hand. It is only the second time in the organization’s history that it has declared a full national blood crisis. The shortfall traces back to a donation slump that set in weeks before summer trauma season began and has only worsened since the emergency was first announced on July 13.“Since announcing the emergency blood and platelet shortage on July 13, thousands of people have stepped up to help. Unfortunately, donations are still not keeping pace with hospital demand, and the situation has escalated,” the media relations lead for the American Red Cross, Daniel Parra, tells The New York Sun.Donations, Mr. Parra says, have fallen to a four-year summer low, “worsening this summer’s emergency shortage.” The crisis, he adds, “is especially dire for type O blood,” with the Red Cross “now limiting distributions of type O blood to hospitals, and the supply of type O positive blood has now fallen below a one-day supply.”How did the country’s blood supply, built on a system of voluntary and repeat donors, come apart so quickly in the span of a single summer?The Type O SqueezeType O blood carries outsized weight in American medicine. O positive can go into roughly 80 percent of patients and accounts for about 60 percent of everything the Red Cross distributes nationwide, while O negative, the universal donor type, is what paramedics reach for when there is no time to run a match. Blood banks that typically keep a five-day cushion have watched that buffer evaporate.The national supply fell by roughly 25 percent in a single month this summer even as hospitals pulled nearly 3,500 more units a week than expected from the system, according to Red Cross figures. A single car accident victim can require as many as 100 units of blood.At Johns Hopkins Hospital in Baltimore, that volatility shows up patient by patient.“Occasionally, blood component usage can be unpredictable such that one patient with acutely high transfusion needs, for example in the setting of major trauma or multiple organ transplants, can have a major impact on inventory for the entire hospital,” the blood bank medical director at the Johns Hopkins University School of Medicine, Dr. Elizabeth Crowe, tells the Sun.Hopkins has leaned on an internal contingency plan and tighter coordination across its affiliated hospitals to hold the line.“We have an emergency blood inventory plan in place to help us navigate these types of shortages,” Dr. Crowe continues. “We have been more coordinated as a health system with our local Hopkins (JHHS) affiliates to ensure that each hospital has the blood they need for patient care and to minimize any potential for waste.”Pinpointing exactly why this summer tipped into crisis territory, beyond the usual seasonal dip, is not straightforward, Dr. Crowe underscores.“There is a seasonality to blood inventory shortages, which we tend to expect during the summer and around the winter holidays. It is difficult to pinpoint the exact reason that the situation has risen to the current crisis levels this year as compared with prior years,” she says. “Our system relies on volunteer donors who take time out of their lives to help others. The importance of this cannot be understated.”When Elective Surgery WaitsThe practical fallout of a type O shortfall reaches straight into the operating room. Hospitals begin by conserving supply for the most urgent cases, according to a hospital industry representative who has been fielding questions on the shortage.“When Type O blood runs low, hospitals take steps to conserve supplies for the most urgent care,” the vice president of media relations and strategy for the American Hospital Association, Colleen Wilber Kincaid, tells the Sun. As a very last resort, she notes, hospitals may delay elective procedures. Before that, however, facilities prioritize supplies strictly for life-threatening emergencies like trauma, and speed up testing to use specific matched blood instead of universal O whenever possible.The Red Cross describes a similar chain of decisions playing out at the bedside.“There is always the chance that a physician could postpone an elective surgery if the necessary blood products aren’t readily available. In a worst-case scenario, a physician may have to forgo performing a more serious procedure for a patient because of a shortage of blood,” Mr. Parra explains, stressing that the organization is “doing everything we can to minimize any impact of this shortage on hospital patients.”That caution extends to the clinical side, where an academic medicine physician says his team is treating the shortage as familiar, if unwelcome, territory.“Blood shortages, when they occur, require increased coordination and careful management of resources to prioritize patient safety, and our teams are experienced in managing these situations,” a distinguished professor of medicine at Rutgers Biomedical Health Sciences, Dr. Jeffrey Carson, tells the Sun.He also highlights that his health system is “closely monitoring the current blood supply situation and working with our blood supplier partners to ensure our patients continue to receive the care they need.”Blood sitting in reserve, Dr. Carson explains, “saves lives,” and he is urging donations because “every donation helps ensure that patients — whether facing scheduled surgeries, emergencies, or ongoing treatment — have access to the blood products they need, when they need them.”Missing The School PipelineThe Red Cross has pointed to the loss of high school and college blood drives, which typically supply a meaningful share of the nation’s donations, as a major driver of the summer slump. The reason is largely one of calendar: once classes let out, the gymnasiums, cafeterias and campus quads that normally host mobile donation units sit empty for months, taking a captive and habitual donor pool out of circulation right as summer trauma cases climb.This summer, the usual seasonal dip has been compounded by conditions the Red Cross says kept even willing donors away: stretches of extreme heat, poor air quality and a wave of foodborne illness pushed donations to their lowest summer point in four years.Mr. Parra confirms the scale of that divergence.“Blood donations from blood drives held at education institutions make up about 20 percent of the blood supply,” he says. “Many of these institutions are not able to host summer blood drives, which adds to the seasonal strain on the blood supply.”At Hopkins, those campus and mobile drives lower the barrier to giving in ways that fixed donation centers cannot always match.“The mobile drives at schools or on campuses certainly decrease the activation energy to donate,” Dr. Crowe says. “We host on-site mobile drives with the American Red Cross at our hospital and have a very willing donor base.”There is no substitute waiting in the wings for now, she cautions.“We have no feasible alternatives to blood components, though this is an active area of research and should be supported,” Dr. Crowe explains. “For now, we rely on altruistic volunteer donors. It’s our responsibility to ensure that their donation is used appropriately for patient care.”Doctors interviewed for this story described what will happen if the shortage continues: Elective surgeries will get pushed back first. If that isn’t enough, physicians will delay more serious procedures too.The Red Cross has cast the fix as incremental rather than out of reach. Because blood cannot be stockpiled, Mr. Parra says, “factors such as fewer donations amid consistent hospital demand can have an impact on the blood supply.” The organization is working “to educate blood drive sponsors, current donors and those who have never given blood, or who maybe haven’t given blood in some time, that the need for blood is constant and hospital patients are continuously in need of lifesaving transfusions.”“If more people committed to donating blood on an ongoing basis, it could help end blood shortages,” Mr. Parra points out.As of early September, the Red Cross says, the crisis has not been resolved. Local chapters are continuing to run donor appeals, with the organization maintaining that just three additional donors at each remaining blood drive could stabilize the supply.

America’s Blood Supply Dries Up as Rare National Crisis Unfolds

America’s Blood Supply Dries Up as Rare National Crisis Unfolds

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