Blood donors and donations in Italy at the time of COVID-19 - Vincenzo de Angelis MD
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Blood donors and donations
in Italy at the time of COVID-19
Vincenzo de Angelis MD
Transfusion Medicine Dept
University Hospital "S. Maria della Misericordia"
Udine - Italy
As to April 18th, the infected people in Italy rose to 175,825 (+3,491 compared to 17th, + 2%), including 44,927 people recovered (+ 2,200 compared to 17 th + 5%) and 23,227 died (+482 compared to 17th + 2%). The currently positive people are therefore 107,771 (+809 compared to 17th + 0.8%). Globally, Lombardy, Veneto and Emilia-Romagna represent ¾ of the cases (Official data from MOH).
https://www.epicentro.iss.it/en/coronavirus/bollettino/Infografica_20aprile%20ENG.pdf
Consequence of SARS-CoV-2 spread 1) The Italian Health System had a high percentage (9-11%) of infected patients being admitted to Intensive Care Units (ICUs) rapidly saturated 2) Government Decrees on limitation measures produced an initial DECREASE in blood donations 3) Hospitals have responded by drastically reducing the non-urgent surgical and medical admittance 4) This was responsible for a DECREASE of blood utilization
(courtesy AVIS Natl. President, dr. GP Briola, Milano)
(courtesy AVIS Natl. President, dr. GP Briola, Milano)
Blood donation is included in the list of “urgent
and essential activities” allowing the people to
leave their houses
Red Blood Cells Production / Distribution in Italy
March 2- April 12
A national media campaign (media, MoH, donors’ Associations…) on the
importance
7 and safety of blood donation, call for donations
6 59032
53539
5
46183 45117
44297
4 39745 40332
36251 37221
34930
32906
3 30673
Reorganization of hospital
2
activity 22871
13793
1
0
2-8-1866 9-15... 16-22... -2291
23-30... 31 mar 5... 6-12...
-7426
-1
-14444
-2 RBC Collected RBC distributed difference
Data from CNS
Consequences - Measures
1) excess in blood inventory, common to many past disasters
2)overcrowding observed in donor centres difficult to guarantee a safe
social distance
Pressure to implement better planning
Moving donors to schedule donations
A more organized flux of people (for donor and staff safety)
A more rational management of the blood inventory .
RBC Collection and Distribution during the
period March 2- April 12 (per Region)
10000 9000
9000 8000
8000
COLLECTION DISTRIBUTION
7000
7000
6000
6000
5000
5000
4000
4000
3000
3000
2000 2000
1000 1000
0 0
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os on igur ard ren lza Giu ene ag sca mbr arc Laz eg ruz pan oli ug lica labr Sici zo ta ia l ia
A rd Ab m P si os on igur ard ren lza Giu ene ag sca mbr arc Laz eg ruz pan oli ug lica labr Sici
d' iem L mb di T i Bo i V. V om To U M M Ca A
d' iem L m b i T B o V. rd Ab m M P i
lle P Lo PA R Sa Ca Ba V om To U M
Sa
s Ca
a d iul i a lle P Lo PA d di iuli R Ca Ba
V PA Fr il V a
PA Fr il i a
Em Em
2 - 8 marzo 2020 9- 15 marzo 2020 16- 22 marzo 2020 2 - 8 marzo 2020 9- 15 marzo 2020 16- 22 marzo 2020
23- 29 marzo 2020 30 marzo- 5 aprile 2020 6 aprile -12 aprile 23- 29 marzo 2020 30 marzo- 5 aprile 2020 6 aprile -12 aprile
Data from CNSEmergency COVID-19 – Emilia Romagna
• 1° week: decrease by 5% blood donations; then call for donations (National and Regional MoH,
Donors’Associations, social media...) increase and also surplus of blood donations.
Recommendations to Blood Centres by Regional Authority (March 13th)
• Plan measures (only scheduled donations) to allow regular/constant access of donors to
the collection sites, and to respect social distancing.
• Plan activities aimed at ensuring collection of blood also in forthcoming weeks (shortage
expected on April/May after the huge collection of March)
• Safety measures (common, see later)
• Appropriate use of blood (PBM, restrictive transfusion triggers, early recall of untransfused
units after surgery – not later than 12 hr)
• First time retested donor common practice in Emilia Romagna: Donors’ Association asked to plan
the recruitment of candidate donors in the next months
(courtesy Blood Coordinating Authority, dr. V. Randi, Bologna)Emergency COVID-19 – Lombardia
(the most affected Italian Region: half of the deaths recorded here)
Collection: weekly decrease by 20% (February 24 to March 15), decrease by 14% in the following weeks (after call
for donation) from March 16 to 22 and huge decrease (40% ) from March 23 on
Distribution: progressive decrease from February 22 on (higher decrease > 30%, average 25 %); now up-turn (last
week) in distribution (to be confirmed)
Emergency inventory of the region (II + III level emergency) in normal conditions: 500 units; doubled from
February 25th to March 6th and stable till march 16; then increased (unwilling) up to 6 times, stable on these high
levels till the first week of April, then progressively decreasing and coming to normal levels now.
ACTIONS
Plan blood collection sessions and Schedule donations; share the inventories among regional Blood Centers
(=computerized regional unique inventory)
Decrease, in the short term, regional blood collection program by 30 % as compared to the plan pre-COVID-19.
(courtesy Blood Coordinating Authority, dr. R. Chianese, Milan)Emergency COVID-19 - Veneto
The first Italian region (together with Lombardia) where the SARS-CoV-2 spread has been recorded (February 22).
Dramatic decrease in blood donations and then rapid increase due to a big pressure on public opinion (by national and
Regional MoH, Civil Protection, Blood Donor Associations, National Health Institute…). Increase of blood distribution
during last week (increased hospital activity) and expected shortage in the forthcoming months, when hospitals will rise
activities at a regular level
ACTIONS
• Daily monitoring of collection/distribution in the region by the regional blood coordinating authority and information to
all Transfusion Depts (to share the inventories among regional Blood Centers)
• Fixed amount of donors allowed by each session of blood collection, reservations required; planning reduction of
activity in some collection sites on weekends (measures to prevent the spread of the infection)
• All these measures reduced the elimination of outdated units to a minimum; the situation requires a reorganization
of the relationships between transfusion facilities and donor associations for a better dynamism and a faster
adaptation of collection programmes.
Weeks March 2- March 9- March 16- March 22- March 30 April 6 -
8 15 22 29 Apr 5 12
RBC 4299 4769 5716 3673 3222 2842
Collected
RBC 4369 4000 3628 3812 3980 4478
Distributed
(courtesy Blood Coordinating Authority, dr. G. Roveroni, Padova)Emergency COVID-19 - Piemonte
1) Shortage at the beginning (March 3 to 9), due to restrictions in people’s movement; in some
instances Health Authorities did not allow blood sessions on mobile units
2) Then call for donations (National and Regional MoH, Donors’Associations, social media...)
increase and also surplus of blood donations, also due to drastic reduction of hospital elective
activities (surgical and medical)
3) Now situation back to normal, as a consequence of regular organization of planned donor
sessions with scheduled donations
4) A maintenance of regional self-sufficiency and a regular supply of blood to other regions
(Sardinia) is expected in the next weeks/months.
(courtesy Blood Coordinating Authority, dr. F. Ripa, Torino)Post Donation Information: How to deal with Post Donation +ve Onset of close Total Informations / swabs symptoms contact PDI Region * (February 22- April 12) Veneto 10 69 20 99 Friuli-VG 4 10 8 22 Emilia 9 104 35 148 Romagna Lombardia 23 286 58 367 Piemonte 3 9 23 35 Total 49 478 144 671 *following ECDC definition
GENERAL RECOMMENDATIONS TO PREVENT
SARS-COV-2 DIFFUSION1. Schedule donations and do “triage” when
scheduling
2. Limit the number of donors in waiting
rooms
3. Sanitize hands of donors before donation
4. Surgical mask to donors
5. Distancing of chairs and beds
6. Surgical mask, protective visor to staff
7. Contact limited in time (close contact
staff/donor < 15 ‘)
8. Staff change gloves after every donation
(also before SARS-CoV-2)
9. If possible, put a screen in Front-office
conditions (open environments)
10. Sanitize rooms/mobile units after use
SPECIFIC RECOMMENDATIONS
FOR BLOOD SESSIONSYou can also read
