‘Unprecedented’ blood shortage forces hospitals to delay or reschedule surgeries

Donations of blood and platelets decreased during the pandemic.Mike Simons, Tulsa World/Associated Press

Hospitals in Massachusetts and around the country are confronting a severe shortage of the donated blood needed for transfusions, prompting some to delay or reschedule surgeries.

A surge in demand has collided with a slowdown in blood collection — both trends exacerbated by the pandemic and expected to last for weeks or months.

“We haven’t seen anything like this in about 30 or 40 years at least,” said Dr. Vishesh Chhibber, director of transfusion medicine at UMass Memorial Health, where several surgeries scheduled for June 7 had to be postponed for lack of blood.

Although periodic, local blood shortages commonly occur, “This is, I’d say, unprecedented in its scope,” said Dr. Claudia Cohn, chief medical officer for the American Association of Blood Banks.

Normally, a hospital or blood center facing a shortage can get blood shipped in from elsewhere, Cohn said. “Right now, the whole nation is in trouble. No one has that extra supply,” she said.

Kelly Isenor, spokeswoman for the Red Cross of Massachusetts, said that normally the Red Cross nationwide has a five-day supply of all types of blood — meaning that if blood collections suddenly stopped altogether, there would be enough to last five days.

Right now, the supply of the sorely needed type O blood would last only a half-day. “It’s going out faster than it’s coming in,” Isenor said.

Hospital and blood center officials point to multiple factors converging. Hospitals are performing more surgeries to meet pent-up demand after many were postponed during the pandemic. Those patients who put off care “are now presenting with more advanced disease progression, so there’s a greater chance that they need blood transfusions,” Isenor said.

Additionally, she said, “There’s been an atypically high number of traumas and emergency room visits.” Demand from trauma centers for red blood cells was 10 percent higher in 2021 than in 2019, Isenor said.

At the same time, fewer donors are coming out to blood drives and many blood centers remain understaffed and unable to ramp up quickly enough.

Donations typically drop off during the summer as schools close and people go on vacation. But the situation is worse amid the pandemic because blood drives aren’t happening at workplaces, either.

Also, Cohn said, “People are tired from COVID. Life simply is not returning to normal rhythms.”

After months cooped up during the pandemic, Isenor said, “It’s not surprising that giving blood isn’t at the top of the list of what people want to do. But that need is still there, and blood can’t be stockpiled.”

The biggest shortage is in type O blood, which can be safely used in people with any blood type and so is needed for emergencies when there isn’t time to identify the patient’s blood type.

UMass Memorial has been trying to control blood use by ensuring that each transfusion is truly needed, working to reduce the risk of bleeding, and reusing lost blood by washing it in a machine and returning it to the same patient, Chhibber said. He expressed optimism that UMass won’t need to cancel surgeries again.

Mass General Brigham, the state’s largest health system, has not experienced an unusual number of surgeries or traumas, but does see a “worrisome shortage” of blood, said Dr. Tom Sequist, chief patient experience and equity officer.

The hospital system, which collects about 20 percent of the blood it uses and gets the rest from the Red Cross, has started analyzing its options, preparing for the possibility that the shortage could last for months. In the worst-case scenario, the hospitals might limit certain surgeries and reschedule elective procedures, he said.

The Beth Israel Lahey Health hospital group said it has been delaying some elective procedures. The hospitals are also determining a patient’s blood type on admission, so they don’t give the scarce type O if an alternative is available.

Boston Medical Center called the shortage “worse than we’ve experienced in recent years, though no surgeries have been delayed at this point.”

Blood transfusions are needed for certain types of surgery and for when unexpected bleeding occurs during an operation, and also for people who have suffered severe injuries. Additionally, platelets are used in cancer treatment.

With no artificial blood available, the system is built on altruism. “Generally there’s enough good people out there that want to help other people,” said Chhibber, of UMass.

Blood banks are calling for more people to step up and donate — but not all at once, and not just once. It takes a week to process blood, and the products are perishable.

“What we need is a sustained response. We need wave after wave after wave of donations,” said Cohn, of the blood bank association. She urged people who are eligible to donate six times a year.

That’s what 72-year-old Esther Leonelli said she has been doing for decades, pausing only while she was in cancer treatment. Leonelli was among the donors occupying four tables Thursday at the DoubleTree Hotel in Boston, where the Red Cross turned a spare room into a donation center. It was one of about a dozen blood drives the agency holds each day.

“I think it’s important for people who can donate blood to do it, and it doesn’t hurt,” Leonelli said.

Still, at the Red Cross Boston Blood Donation Center on Tremont Street, one of its seven fixed sites in Massachusetts, just four of the 12 donation beds were filled around 4:30 p.m. Thursday.

Sandy Charron, 64, was there donating platelets. A “lifelong donor,” she said she was resuming donations for the first time since the pandemic started. She’d been afraid of COVID-19 infection in an enclosed room, but feels safe now that she has been vaccinated.

Cameron Arnet, 23, has the opposite story. He donated for the first time at the start of the pandemic, thinking, “That’s one thing I can do to help out.”

“Every single time you come in, it’s exponentially getting greater, the impact you have — so it’s just a nice thing to do if you care for people you might not know,” he said.

To find the blood bank nearest you, enter your ZIP code in this locator: aabb.org/giveblood