Irish blood donations held up well during Covid but supply likely to come under pressure

Ireland’s blood donation service suffered its share of pandemic setbacks. It lost many of the venues it uses for mobile clinics; city centre donor pools dried up as workers stayed home; and now it is struggling to recruit the nurses it relies upon.

But despite the mass disruption inflicted by Covid, blood donations persisted. Comparing 2019 with the height of the pandemic in 2021, they fell by just 6 per cent, a maintenance level the Irish Blood Transfusion Service (IBTS) puts down to the loyalty of its donor base.

However, challenges are mounting, with hospital demand for products high and only expected to grow as they catch up on delayed procedures.

“Blood supply is always a challenge,” says operations director Paul McKinney, whose job involves a daily monitoring of stocks, both here and in the UK, where blood is sometimes sourced.

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At the beginning of this week, levels appeared healthy — O negative, the so-called universal blood type, had a six-day supply, four days more than the minimum requirement. Other types ranged from nine days to just two for A positive.

Once overall stocks dip below that critical two-day supply level, an amber alert can be triggered — a drastic move that cuts blood use, potentially leading to the cancellation of medical procedures.

Ireland narrowly avoided one in April, when 350 units were imported from the NHS in England, a reciprocal arrangement that further safeguards the system. Hospitals simultaneously reduced their own stores in order to allow the national stockpile to recover.

“I do believe that hospitals now are trying to catch up [on procedures] and I believe that demand for our products is going to be very high over the next couple of years,” says McKinney. “You just have to see the waiting lists and you can see what’s coming down the tracks.”

Lost venues

One way to secure supply is to take clinics on the road. But over the course of the pandemic, and the mass disruption it brought to businesses, many venues were lost. This aspect of the service is down about 20-30 per cent.

“A lot of hotels closed; obviously they weren’t doing business. They shut their doors so that put us under a fair amount of pressure because obviously our mobile clinics go over to different regions and different areas. Because donors can only donate once every three months, we move around,” says McKinney.

Some of the hotels were deemed too small as social-distancing requirements were put in place. Others were used as vaccination centres and, more recently, to shelter Ukrainian refugees, which left the locations unavailable to blood clinics.

“As tourism is attempting to try and recover, and with so many weddings cancelled or postponed, people put them off, so the hotels are very busy and they’re obviously trying to catch up on lost revenues,” says McKinney of the ongoing battle to get them back.

“And a lot of the rooms that we would have used for the collections in hotels are function rooms and are obviously being used to try and catch up on the wedding backlog.”

In 2019 there were 130,850 donations from 80,284 donors. The pandemic saw the introduction of safety measures, and those happy to keep donating were sent text messages of appointments to show gardaí at checkpoints.

But there was a necessary cessation of marketing aimed at attracting first-time donors, who must spend longer amounts of time in the enclosed areas of clinics. Older donors were discouraged for medical reasons.

Staffing problems

Despite it all, people continued to give blood. In 2021, 127,614 units were donated, a decline of just 5.8 per cent on the last full pre-pandemic year. It came from 72,791 donors, a reduction of just 9 per cent.

However, even when public engagement remains healthy, the service needs staff and that has also proved a challenge.

“We’re no different to anybody else: we do have a recruitment and retention challenge and nurses are like hens’ teeth,” says McKinney. The service needs an increase of a quarter, from 60 to 80, although Ireland’s situation is no different from the UK, he says.

Most of the Covid-related measures have now disappeared from the service. “On World Blood Donor day the message is that donating blood is an act of solidarity,” McKinney says. “Over the last two and a half years [donors] really have helped the IBTS keep the show on the road and help the hospitals get through a very challenging time.”