Keeping Our Hospital Partners Informed During Novel Coronavirus (COVID-19) Pandemic
Thursday, March 19
Dear Transfusion Service Partner,
Every day the American Red Cross works to protect patient care through an adequate and available blood supply. However, amid the nation’s powerful response to the novel coronavirus (COVID-19) pandemic, blood providers are challenged to replace both eligible donors and the needed facilities to operate productive blood drives. Red Cross has had more than 4,600 blood drives canceled, resulting in 143,600 fewer units. Consequently, the Red Cross has launched a nationwide media appeal to generate public awareness of the critical need for continued blood donations throughout the pandemic and that blood is essential to health care. Donating blood is safe and necessary. Please encourage the continuation of blood drives and donations in your hospital and community.
As we work to build new blood supplies, we are also aggressive in securing those products already on the shelf. We appreciate your rapid response to our request for proactive conservation to safeguard limited inventories. Through our combined efforts, the rate of decline of the red blood cell supply has slowed. However, we have yet to realize the full impact of the pandemic response and government ordered quarantines. Our inventory projections indicate red blood cells will be severely constrained by next week. We must remain vigilant.
With red blood cell supplies expected to worsen quickly, we are discontinuing stock rotations and auto-return/replenish ordering. We recommend hospitals retain products in-house through expiration as our ability to restock with longer dated products will be greatly diminished. Place new orders only as inventory is used or expired.
Several hospitals and health systems around the country have already chosen to cancel elective surgeries. If you have not done so, we strongly recommend hospitals postpone or cancel elective surgical procedures at this time.
Due to constrained supplies on antigen negative red blood cells, Red Cross is taking added measures to meet special needs. Antigen negative units will be released for patient need only. Stock antigen negative orders will be discontinued for the foreseeable future. Antigen screened orders should be placed via Connect and include the required patient information. Consider reducing the use of antigen negative units by at least 30%. Some approaches already implemented by hospitals treating many sickle cell patients include:
- Limit use of CEK negative units to sickle cell patients who are alloimmunized to at least one clinically significant alloantibody.
- Reschedule sickle cell patients based on (actual or anticipated) pre-procedure HbS (<30% for stroke and <40% for non-stroke). Alternatively, consider modified exchange procedures in lieu of full exchange procedures. Alternatively, consider a simple transfusion in lieu of an exchange transfusion.
- Use CEK prophylactically only for females of childbearing potential.
Fortunately, platelet collections have largely withstood the effects of coronavirus. Collected at Red Cross fixed sites with an established donor base, they have not been affected by the drive cancellations and donor loss impacting red blood cells. Currently, we have a strong and stable supply of platelets and are filling orders as scheduled.
To best enable our teams to efficiently and appropriately triage these limited supplies, all product orders, including STAT orders, HLA orders and IRL orders must be placed online via CONNECT.
Increased coordination and communication with your hospital is vital to Red Cross’s ability to manage this unprecedented event. We appreciate your continued diligence in educating hospital staff on the severity of the situation, the need for restrictive blood product use and the ongoing need for blood donations.
Pampee P. Young, M.D., Ph.D.
Chief Medical Officer
American Red Cross