Blood shortages have area on edge of ‘disaster’
Banks in South Texas have struggled with supply in pandemic; sites for drives became unavailable and donors feared COVID-19
SAN ANTONIO — Ryan and Brandi Morkovsky never expected to be worrying about their daughter’s blood type.
In January, their 2-year-old daughter, Amy, was diagnosed with early-stage acute lymphoblastic leukemia after a mysterious rash appeared on her arms and legs. Over 11 days in the hospital, Amy began chemotherapy and underwent spinal taps and bone marrow biopsies.
On top of the stress of having a sick child during a pandemic, Amy’s parents learned of an unforeseen complication that could disrupt her care: ongoing blood shortages. Already, Amy, now 3, has needed a handful of transfusions. She is O-negative, so she can receive blood only from like donors, who make up 7 percent of the population.
Her treatments have not been delayed yet, but critically low blood inventories have posed a looming threat from the moment she was diagnosed, her father said.
“It’s really frightening for a parent of a child who needs blood relatively frequently to know that this shortage is happening,” he said.
Throughout the COVID-19 crisis, blood banks in Texas and across the country have consistently struggled to maintain adequate supplies of blood products, which are an essential part of medicine.
Appeals for blood donations tend to be more frequent during the holidays and periods of high need in the wake of mass casualty events and disasters. But over the past year, the South Texas Blood and Tissue Center — which supplies blood to more than 100 hospitals and clinics in 48 counties — has called for the public’s help almost continuously.
The organization has never contended with anything as prolonged and disruptive to blood collection as the pandemic. And it cannot fully count on other blood banks for help because they are in the same position.
Even as overall donations increased last year, they did not keep pace with rising demand from area hospitals, which are treating a growing and aging population. During the first few months of this year, blood orders have been 20 to 35 percent higher than the previous two years, with the return of patients whose medical care was delayed by COVID.
South Texas Blood and Tissue also had to rebuild the blood supply after the February freeze triggered a blood shortage emergency.
As of Monday, the center had a 1.5-day supply — far short of the week’s worth it needs to respond to all requests for blood — and less than a day’s inventory of Type O blood, which is used in emergencies.
“We’re really at the brink of a disaster if we don’t have donors able to step up and help us replenish the blood inventory,” said Adrienne Mendoza, the center’s vice president of blood operations.
During the pandemic, that reliance on altruism has proved insufficient, as the public’s opportunity and willingness to give were upended.
The most reliable sites for blood drives — high schools, college campuses and businesses — became unavailable as institutions transitioned to remote learning and working. Donors were also fearful that they might catch the virus if they ventured out to give blood. As a result, the number of new donors plummeted.
To scrape by, South Texas Blood and Tissue leaned heavily on existing donors, who returned to the center’s donation locations more frequently to help compensate for those losses.
Red blood cells, plasma and platelets are not used just for patients who are actively bleeding. Patients like Amy are often given blood products, as are people with conditions such as sickle cell anemia, those undergoing surgery and women giving birth.
When there are blood shortages, patients like Amy are affected first, as people in more critical condition are prioritized, said Dr. Leslie Greebon, director of transfusion medicine services at University Health.
The pandemic has fundamentally changed Greebon’s work. When the inventory becomes exhausted, it’s Greebon who makes the call on who needs blood the most. Her days are now spent reviewing every request to determine whether it could be postponed or an alternative product used.
“It’s not inconsequential to the patient,” Greebon said. “It brings delays and uncertainties if they’re actually going to get what they need.”
With so many pleas for blood donations over the past year, Greebon worries that the public is becoming inured to the urgency.
“We tend to have less and less response the more and more we ask for it,” she said.