Blood and organ donations shrink amid coronavirus fears

The U.S. Surgeon General yesterday pleaded with Americans to keep donating blood, as the nation’s supplies are already running low amid fears stoked by the coronavirus pandemic.

“You'll be helping your country and your community during this crisis. And you might even save a life,” Surgeon General Jerome Adams said in a press conference on Thursday.

Medical experts say that blood drives and donations have already dropped off significantly. In the last few days, more than 4,000 scheduled blood drives have been cancelled, in part due to closings at the schools and workplaces where these drives are usually held.

That equates to 130,00 fewer blood donations, says Kate Fry, CEO of America’s Blood Centers, a nonprofit whose member organizations collect a majority of the nation’s blood supply. She adds that some blood banks around the country are already running low, and the materials have a short shelf life: 42 days for red blood cells and five days for platelets, the cell fragments in blood that form clots to help prevent bleeding.

The epidemic is also changing the organ donation and transplant landscape. Transplantations for urgent conditions are continuing as usual, but some less critical operations are being put on hold.

While potential donors may fear for their own safety or that of others during a pandemic, health experts say there’s no reason at this time to believe COVID-19 could be spread by blood or in the normal course of organ transplantation. All the experts consulted for this story say that the risk of becoming infected during a blood donation is minimal, and that the organizations involved are doing everything possible to reduce the chance of transmission.

“If you are feeling well, please donate blood,” says Sridhar Basavaraju, director of the Office of Blood, Organ, and Other Tissue Safety at the U.S. Centers for Disease Control and Prevention.

Blood needed

The call to keep donating is backed by past research on coronaviruses. With SARS and MERS, about half of tested patients showed some level of the viruses’ genetic material—in this case RNA—in their blood, says Michael Busch, professor of laboratory medicine at the University of California, San Francisco, and director of Vitalant Research Institute. One early study found viral RNA in one percent of blood samples collected from coronavirus patients in China. But the mere detection of these RNA strands is not the same as finding a live virus.

Busch says that to his knowledge, nobody has cultured any live coronavirus from blood samples, meaning the viral particles circulating in the blood may not be infectious. He adds no respiratory virus has been shown to be transmitted via the blood, including the new coronavirus, officially known as SARS-CoV-2.

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Research from South Korea, which has been submitted but not yet peer reviewed for publication, looked at a small group of patients who received transfusions from individuals with the new coronavirus. The donors came down with symptoms shortly after giving blood and alerted physicians. Strikingly, those patients who got blood from donors who later became sick did not themselves become infected, says Busch, who helped edit the paper.

To minimize the risk of transmission while donating, the Red Cross has instituted new measures to keep volunteers and donors a safe distance apart, fully sanitize everything that comes into human contact, and make sure everybody involved is healthy. Volunteers and patients have their temperatures taken on site, and are asked a battery of questions, including details about travel, health status, and prior contact with sick people.

Of course if you are not feeling well, wait to donate, says Prabhakar Borge, a divisional chief medical officer of the American Red Cross. But not forever. The Red Cross is asking donors to wait 28 days before donating if they have had contact with anyone known to be infected with new coronavirus, or if they have symptoms themselves, such as a fever and a cough.

But the need for blood is acute—and doctors fear it could get worse. “We really are in uncharted waters here,” Fry says. You can sign up or find a place to donate via America’s Blood Centers or the American Red Cross.

Organ donations

For now, critical transplant surgeries—which are necessary for saving lives—are continuing mostly unchanged, says Will Chapman, surgical director of the Transplant Center at Washington University School of Medicine and Barnes-Jewish Hospital. This includes transplants from people who opted to donate their organs, such as the heart, liver, kidney, or lungs, before dying.

If the recently deceased was suspected to have had the new coronavirus, however, the “organs wouldn’t be used,” Chapman says. That’s being done out of an abundance of caution. The novel coronavirus hasn’t been shown to appear in any of these organs—besides of course the lungs, the upper respiratory tract, and sometimes within lymph nodes. Active research is ongoing to better understand exactly if the new coronavirus spreads elsewhere in the body, Busch adds.

That said, some hospitals around the country are delaying non-critical surgeries, for example, kidney transplants for people whose condition can be managed with dialysis. And many patients with a non-urgent transplant scheduled or expected are being asked to wait for a few months, for their own safety, but also to make room in hospitals as coronavirus cases are expected to grow.

For example, a liver cancer patient who needs a new organ, but whose disease is currently well-controlled with medication, is probably better off waiting a couple months for the situation to calm down, Chapman says. That’s because people with new organs take immunosuppressant drugs to ensure the body accepts the organ, which would make them more vulnerable to severe consequences of the coronavirus.

Risk of exposure to the virus is also higher in a hospital setting compared to, say, sheltering in place. Some organ donors, like those giving their kidneys, will also be asked to wait to give for all the same reasons. But for giving blood, there’s no reason to delay.

“We’re doing everything we can,” Busch says, “to assure people that donating blood is safe, and it’s critical.”