Reflections of the Pandemic in Blood Services

Saim Kerman
Dr., Turkish Red Crescent

Many disciplines work together in natural disasters occurring in the world. While some activities and duties are interrupted during and after the disaster, all structures related to human health continue to work without a break. The COVID-19 crisis has made the health sector the center of all the other industries. In this context, the Turkish Red Crescent General Directorate of Blood Services, which has been operating to meet the blood needs of the country for 66 years, acted in the way the pandemic entailed by working quickly and in coordination.

In addition to being a supporter of the breakthroughs made by a developing country, the Turkish Red Crescent was also present in all areas of humanitarian action that brought many stakeholders together. It was decided to establish a blood aid organization to support the health systems on the suggestion of the then Chairman, Nihat Reşat Belger at the Red Crescent Congress in 1953 out of consideration of TRC’s solid institutional structure. In line with the studies initiated following this decision and the opinions of the experts sent to the UK and the US on blood transfusion, TRC started blood banking services at two blood centers that opened simultaneously in 1957. Today, it has transformed into a large organization that can meet the blood component needs of 1,142 hospitals thanks to eighteen regional blood centers, 69 blood donation centers, four central laboratories, and 4,006 expert personnel. It has become a significant part of the treatment process thanks to its effective blood stocks management carried out not only for routine blood needs but also for unexpected situations such as natural disasters and acts of terrorism in various regions of the country.

The efforts were directed at returning life to normal by providing people of the regions affected by natural and human-related disasters within a certain period. However, as of 2020, the COVID-19 pandemic broke the routines of preventive and curative medicine. Despite being up to date on the studies regarding the rapid spread of the outbreak and its treatment, the reflex of Türkiye’s health system on this issue could be monitored after the first case in Turkey in March 2020.

Upon the first statement made by the Ministry of Health, the Red Crescent Crisis Board convened and discussed the measures and actions to be taken in all fields of activity of the organization. The preventive measures listed in the document titled “Measures to be Taken at Blood Centers,” prepared in line with the recommendations of the COVID-19 Scientific Advisory Board, were quickly implemented. The necessary arrangements were urgently initiated in the blood service units and blood donation areas to meet the ongoing need for blood during the pandemic. The number of beds in the donation halls has been reduced, and protective clothing for the personnel and masks for our donors have been made mandatory.

Convalescent plasma, to be obtained from the blood of individuals who have recovered from COVID-19 disease, has taken its place in practice in many countries, upon the recommendation of the US Food and Drug Administration (FDA). As for Turkey, The Ministry of Health has decided to include convalescent plasma therapy in COVID-19 treatment as of 1 April 2020 and authorized us in this regard. We opened 12 Convalescent Plasma Donation Centers in cities with a high case rate announced by the Ministry. We formed teams to work at these centers and communicate with recovered patients. We improved the information management systems we use for blood donor recruitment regarding obtaining convalescent plasma components and all process steps. We prepared informative documents containing workflows for all personnel who will take part in the process.

The press and social media heavily covered the working conditions and the ongoing need for blood. At these difficult times, our blood donors did not withdraw their support for the patients since people who have compulsory blood appointments were exempted from lockdown restrictions. In this context, the Online Blood Appointment System software has been brought into service immediately to ensure safe transportation in case of lockdown and to reduce the waiting times of our donors who want to donate whole blood, plateletpheresis, and convalescent plasma. Our donor and donor candidates were able to make an appointment on the date, day, and time they wanted at the nearest blood donation point via the official website or call center. One of the contributions of the pandemic to our institutional structure, the Online Blood Appointment System, has been integrated into the blood donation app, expanding the access preferences to be used by our donors. They were able to arrive at the blood donation areas by showing the text message, which they got after they made an appointment, to the security forces, even during the lockdown hours. When the need for the convalescent plasma components used in the course of the severe COVID-19 was increasing, we increased the number of people and regions to interact with by searching for recovered patients in coordination with the teams working at the Provincial Directorates of Health upon the assignment of the Ministry of Health. The application to record the interactions throughout the country was made available to the personnel assigned in the Provincial Directorates of Health, and these records could be monitored from a single point. The number of Convalescent Plasma Donation Centers was raised to 42 to provide more opportunities for donor candidates who were contacted and agreed to donate convalescent plasma. 661 hospitals used convalescent plasma components, and 120,174 units reached patients.

In conclusion, although the number of blood donations decreased by 14% in 2020, the rate of meeting the country’s blood needs did not change due to the postponement of elective surgeries by the Ministry, the use of an online appointment system in case of lockdown, and the use of components in the existing TRC stocks. During this unexpected and unpredictable pandemic, we succeeded thanks to the agile governance of our blood services, the outstanding efforts of our teams, and the dedication of our biggest supporters, our blood donors.

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