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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 9  |  Issue : 4  |  Page : 485-490

Voluntary blood donations in Navi Mumbai, India: Experience in coronavirus disease pandemic


1 Department of Pathology, Dr. D Y Patil Medical College and Hospital, Navi Mumbai, India
2 Department of Pathology, Lokamanya Tilak Municipal Medical College and Hospital, Mumbai, India
3 Department of Orthopedics, Medicity Hospital, Navi Mumbai, Maharashtra, India

Date of Submission15-May-2022
Date of Acceptance20-Oct-2022
Date of Web Publication29-Dec-2022

Correspondence Address:
Dr. Arvind Janardhan Vatkar
Department of Orthopedics, Medicity Hospital, Kharghar, Navi Mumbai 410210, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mgmj.mgmj_70_22

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  Abstract 

Introduction: In India, voluntary blood donation camps (VBDCs) are a key supply of blood and its products. Conducting blood donation drives was challenging in Navi Mumbai due to the widespread lockdown during the coronavirus disease (COVID) outbreak. Study Type: This was a retrospective study. Materials and Methods: To relieve the anxieties and apprehensions of the blood donor population, extensive confidence-building efforts were required. Various safety measures and standard operating procedures were also included, as well as training for VBDC organizers and medical personnel. We studied the blood donations done at our institute on a retrospective basis from blood bank records. Results: Our study showed a 7% increase in outdoor VBDC donations in 2021 over the previous year 2020. However, according to the advice of the local transfusion council, promoting in-house donations raised their number by a stunning 33% in 2021. Conclusion: Even during the COVID pandemic, confidence-building methods and precautions helped restore VBDC’s legitimacy and increase donation numbers by a marginal extent.

Keywords: Blood donation, COVID-19, standard operating procedure, voluntary blood donation camps


How to cite this article:
Shinde SP, Shende AS, Chawla R, Vatkar AJ. Voluntary blood donations in Navi Mumbai, India: Experience in coronavirus disease pandemic. MGM J Med Sci 2022;9:485-90

How to cite this URL:
Shinde SP, Shende AS, Chawla R, Vatkar AJ. Voluntary blood donations in Navi Mumbai, India: Experience in coronavirus disease pandemic. MGM J Med Sci [serial online] 2022 [cited 2023 Feb 7];9:485-90. Available from: http://www.mgmjms.com/text.asp?2022/9/4/485/365980




  Introduction Top


In India, 9 million units of blood were collected versus the demand for 12 million units. Most of this given blood (70%) comes from voluntary blood donors, with the remaining one-thirds coming from family or replacement donations.[1] According to Indian government regulation, a blood bank should save aside 25% of all blood received as a buffer reserve to be used only in an emergency.[1] However, due to a widespread shortage of appropriate blood units, only 20% of India’s 2433 blood banks were able to maintain the buffer stock up to date.[2] A consistent base of regular, voluntary blood donors helps provide an adequate and predictable supply of safe blood.

The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) as a pandemic on March 11, 20203. Following the cues of the rapid spread of the COVID-19 virus, the government of India announced a country-wide lockdown on March 25, 2020.[3] This lockdown was sequentially extended, and later area-wise lockdowns were announced to control local outbreaks. Widespread fear and government instructions compelled the people of India to stay indoors and follow COVID precautions. Many voluntary blood donation camps (VBDCs) were canceled or postponed. This caused severe shortages of blood and its products in hospitals.[4]

The National Blood Transfusion Council and its state counterparts released advisories about blood donation during the pandemic along with precautions and safety measures to organize VBDCs. Our institute managed to carry out VBDCs with the help of these guidelines amidst the widespread COVID pandemic.

Guidelines issued by Maharashtra Blood Transfusion Council (MBTC) issued the following guidelines on March 19, 2020:[5]

  • ➢ To encourage blood donation in-house by appealing to blood donors and VBDC organizers.


  • ➢ To minimize overpopulation in outdoor donation sites, the number of donors would be limited to 100.


  • ➢ Maintain a 1-m separation between persons in VBDC’s clean, sanitary, and well-ventilated premises.


  • ➢ To provide enough personal protective equipment (PPE) and sanitizers for personnel, as well as sanitizers for all potential donors.


  • ➢ To add questions in the blood donation screening questionnaire already in practice.


  • ➢ If foreign countries were visited by donors, family, or colleagues in the past 28 days. If cough, cold, or fever was experienced by donors, family, or colleagues in the past 28 days. If so, disallow blood donation.



  Materials and methods Top


On the basis of the guidelines of MBTC as mentioned below, the following measures were taken by our blood bank staff for organizing VBDCs. All these measures were written in the form of standard operating procedures (SOPs) and were printed and distributed among blood bank staff members.

Blood donation screening

Additional questions as mentioned by MBTC in guidelines were written on the standard questionnaire for blood donation and asked potential blood donors for screening.

Education to blood bank staff

  • a. Basic hand hygiene and COVID-19 prevention methods were taught to the staff.


  • b. All of the employees were reminded to take all of the standard precautions while handling blood and blood products.


  • c. PPE donning and doffing instruction as well as the use of the N95 mask was offered.


  • d. Staff at the blood bank were urged to bring their food and avoid dining in the VBDC.


  • e. Staff at the blood bank who had COVID symptoms were instructed to quarantine at home and undergo real-time reverse transcription–polymerase chain reaction (RT-PCR) testing.


Appeal for organizers of voluntary blood donation camps

  • a. The organizers requested that potential blood donors be sent to hospitals rather than VBDCs for donation.


  • b. According to the criteria, the organizers were required to set up the camp with proper ventilation and hand sanitizers, with a maximum of 100 blood donors.


  • c. The medical social worker answered all the organizers’ questions.


Preventive measures in voluntary blood donation camps

  • a. It was necessary to release enough educational materials to organizers and potential blood donors.


  • b. The revised blood donation questionnaire was used to assess potential blood donors.


  • c. There was tight adherence to adequate good ventilation and social separation.


Transport of blood bank staff to the venue of voluntary blood donation camps

  • a. The blood bank ambulance was used with a limited seating capacity, proper social distance, and the usage of an N95 mask while traveling.


  • b. Staff from blood banks were encouraged to go to VBDC locations in personal vehicles whenever feasible.


Equipment responsibility of blood bank staff at the venue of voluntary blood donation camps

  • a. Blood bank employees organized blood collection equipment, donation certificates, and coffee and biscuits for blood donors.


  • b. Blood bank employees set up tables, beds, and mattresses for blood collection.


Precautions by blood bank staff at voluntary blood donation camp venues

  • a. Blood bank employees were required to wear PPE such as N95 masks, hand gloves, operating room gowns, surgical caps, and shoe coverings.


  • b. All potential blood donors were required to wear masks throughout the event.


  • c. Staff members always utilized hand sanitizers. During the entry and departure points of the venue, potential blood donors were given hand sanitizer gel.


  • d. An infrared thermometer with a temperature threshold of 100 degrees Fahrenheit was used to screen everyone in camp.


  • e. After each donor left, the donor seating spaces were cleaned with 1% sodium hypochlorite.


  • f. Alcohol gel was used to sanitize blood bank staff gloves regularly.


  • g. Single-use pens were utilized, and personnel suggested that mobile phones be placed in a plastic pouch that could be cleaned with alcohol gel.


  • h. Gloves, masks, and PPE were placed in a yellow bag and sent to our hospital for proper disposal.


The individual job of blood bank staff

  • a. Medical doctor responsibilities include determining donor fitness, issuing blood donation certificates, issuing leave forms, and treating adverse reactions to blood donation.


  • b. A medical social worker organized all the blood donation equipment from the blood bank.


  • c. A blood technician’s duties included blood collection and storage.


  • d. Finally, when the blood bags arrived at the hospital at the end of the day, the blood bank supervisor separated the blood components and performed blood testing. The medical officer signed off on this testing with stock management.


This work SOP helped to streamline work and help maintain social distancing among blood bank staff. Blood donation information was obtained from our database and analyzed to understand the variations in blood donation patterns (in-house donations and outdoor blood camps) in 2020 (starting of the COVID pandemic) and 2021 (the following year of the peak of the COVID pandemic). Data were taken from the existing records of our blood bank. Ethical approval was taken. For this investigation, no donors were contacted.


  Results Top


Blood donation statistics and the effect of the pandemic on our blood bank

Our tertiary care hospital is served by our blood bank. Blood transfusions are also available to thalassemia patients undergoing treatment at our facility. We designed the SOPs for blood donation in March 2020 to alleviate an acute shortage of blood and its products. Despite our best efforts, the number of blood donations managed by our blood bank fell in the year 2020. However, after the COVID limits were loosened in 2021, blood donation rates began to rise again. Data from our blood bank records from 2020 and 2021 back up this claim, as shown in [Table 1].
Table 1: Showing the number of blood donations for the years 2020–2021 showing types of blood donation (voluntary and replacement blood donations) and sources of blood donation (in-house vs. outdoor camps)

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Donors of various types

Blood donors can be divided into two categories: voluntary and replacement donors. People who approach us at our hospital or our outdoor camps are called voluntary donors. These voluntary donors are given donation certificates/donor cards, which they can exchange for blood units at our blood bank for anyone in need of a transfusion. Replacement donors are persons who donate blood to our blood bank to replace the units of blood that were transfused to their family or friends while they were receiving treatment at our hospital. [Figure 1] shows a progressive increase in the number of replacement donors in 2021 by 33% compared with 2020. On the contrary, voluntary donors decreased in 2021 by 11% compared with 2020. This can be related to a reduction in the number of blood donations in outdoor camps compared with in-house donations. Replacement donors may also be more frequent because of increasing patient admission rates during the COVID epidemic.
Figure 1: Chart showing replacement blood donations increasing over the years compared with voluntary donations

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The overall number of blood units donated decreased steadily from February 2020 (639 contributions) to July 2019 (160 donations). Later, in October 2020, donations climbed and stayed consistent at an average of 400 donations until the end of 2021.

Blood units sources

Blood donation may be classified into two categories: in-house donations (at our hospital and related facilities) and in-camp donations.

According to the MBTC, the number of in-house hospital blood donations steadily grew because of our advice to promote them. [Figure 2] shows that most VBDC (in-camp) donations were made in February 2021. However, they plummeted to zero in September 2021. They gradually rose till the end of 2021. In contrast, in-house donations gradually grew from August to September 2021. The rate of in-house blood donation increased by 11% in 2021 over 2020, compared with only 9% growth in VBDCs over the same period as shown in [Table 1].
Figure 2: Chart showing a gradual increase in in-house blood donation numbers over 2 years

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[Figure 1] shows the largest rise in total VBDC donations in the first three months of 2019, followed by a gradual fall. This corresponds with India’s proclamation of lockdown following the COVID epidemic.


  Discussion Top


Despite the COVID epidemic, our efforts resulted in an increase of 7% in outdoor VBDC donations in 2021 over the previous year. However, according to Maharashtra state transfusion council recommendations, increasing in-house contributions raised their number by a whopping 33% by 2021.

Gupta et al.[6] collected 2487 blood units in 2019, with 2039 (81.99%) collected in VBDCs. In our study, the proportion of in-house donations was around 60% both in 2020 and 2021. [Figure 3] gives a brief glimpse of a comparison of blood donation parameters in our study and Gupta et al. This suggests that the average proportion of VBDC donations is more in our blood bank (59%) compared with blood banks studied by Gupta et al.[6] (17%).
Figure 3: Blood donation parameters of our study vs. Gupta et al. from January 2020 to June 2020

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The multicenter study done in Saudi Arabia showed no changes in blood donation numbers. Some facilities were negatively impacted, whereas others saw an increase in blood product supply during the pandemic. Overall, there was no significant variation between 2020 and 2019 among the examined centers. This might be attributed to the better blood supply and transfusion management.[4],[7]

According to officials of the Region of the Eastern Mediterranean of 16 regional blood centers, public concern has contributed to a 26%–50% drop in donations. Half of the centers activated their SARS-CoV-2 preparedness procedures. All centers established donor deferral criteria, although steps to limit the risk of donor and staff exposure varied.[8]

In China’s Zhejiang Province, the number of whole blood donors fell by 67%, whereas the success rate of donation recruiting fell by 60% when comparing numbers for 2019 and 2020. Most responders were concerned about the “possibility of contracting COVID-19 during blood donation.”

The overall supply of red blood cells decreased by 65%.[9] This is the first research to describe the impact of blood donor statistics at an Indian tertiary health care center’s blood bank over 2 years. It also mentions how blood donation suffered during the early months of the epidemic when India was put on lockdown. However, the figures in this research only cover one region in Navi Mumbai. Blood donation patterns may differ in other rural and urban areas of India affected by periodic local lockdowns.


  Conclusion Top


Blood donation campaigns in India were severely hampered by the COVID pandemic-induced shutdown. Blood banks throughout India took steps to reduce the impact. Our analysis found a 16% decline in volunteer blood donors in 2021, with a promising 7% gain in VBDC contributions, presumably because of our efforts and initiatives to improve it. A more comprehensive Pan-India examination of multiple blood bank facilities will indicate the total impact of the COVID epidemic and health organizations’ efforts to reduce blood shortage.

Ethical policy and institutional review board statement

Approval from the Institutional Ethics Committee for Biomedical and Health Research (IECBH) of Dr. D Y Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India has been obtained to undertake the research study on “Voluntary Blood Donations in Navi Mumbai: Experience in Coronavirus Disease Pandemic” vide their letter no. DYP/IECBH/2022/142 dated September 29, 2022.

Ethical review board clearance was taken from Dr. D Y Patil Medical College, Nerul, Navi Mumbai.

Financial support and sponsorship

Not applicable.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Indian Red Cross Society. National Voluntary Blood Donation Day- Message of The Secretary General [Internet]. Available from: https://www.indianredcross.org/sg-message-27-sep-2013.html. [Last accessed on 9 May 2022].  Back to cited text no. 1
    
2.
Sharma A, Harish JS, Kumar D, Thaman RG The experience of organizing blood donation camp through student initiative. J Pharm Bioallied Sci 2021;13:1488-95.  Back to cited text no. 2
    
3.
Cucinotta D, Vanelli M WHO declares COVID-19 a pandemic. Acta Biomed 2020;91:157-60.  Back to cited text no. 3
    
4.
Gupta AM, Ojha S, Nagaraju P, Poojary M, Sh S, Sathyan V, et al. Impact of the novel coronavirus disease and lockdown on the packed red blood cells inventory management: An experience from a tertiary care oncology center in western India. Hematol Transfus Cell Ther 2021;43:126-32.  Back to cited text no. 4
    
5.
Orders/Circulars/Guidelines/Manuals [Internet]. Available from: http://mahasbtc.org/index.php/guidelines-manuals/. [Last accessed on 24 Sep 2022].  Back to cited text no. 5
    
6.
Gupta AM, Ojha S, Poojary M, S H S, Nagaraju P, Dhokle R Organization of the outdoor blood donation drives amid novel coronavirus pandemic and national lockdown: An experience from a tertiary care oncology institution in India. Transfus Apher Sci 2020;59:102878.  Back to cited text no. 6
    
7.
Hakami NY, Al-Sulami AJ, Alhazmi WA, Qadah TH, Bawazir WM, Hamadi AY, et al. Impact of Covid-19 on blood donation and supply: A multicenter cross-sectional study from Saudi Arabia. Biomed Res Int 2022;2022:1474426.  Back to cited text no. 7
    
8.
Al-Riyami AZ, Abdella YE, Badawi MA, Panchatcharam SM, Ghaleb Y, Maghsudlu M, et al. The impact of Covid-19 pandemic on blood supplies and transfusion services in the eastern Mediterranean region. Transfus Clin Biol 2021;28:16-24.  Back to cited text no. 8
    
9.
Wang Y, Han W, Pan L, Wang C, Liu Y, Hu W, et al. Impact of Covid-19 on blood centres in Zhejiang province china. Vox Sang 2020;115: 502-6.  Back to cited text no. 9
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
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