Covid weighs on blood donations, surgical interventions at risk

The collection of blood and plasma in Italy still suffers from the Covid-19 effect and, if the trend does not reverse, it is likely that the summer months will be marked by severe shortages. This is the picture that emerges from the consolidated data of 2021 activities and from the preliminary ones of 2022 released by the National Blood Center (Cns) in view of June 14, the date on which World Blood Donor Day occurs. According to the calculations of the Cns, last year the blood and plasma donors in Italy were 1,653,268. It is a figure that thanks to the generosity of the donor people is recovering compared to the previous year, but is still lower than in the pre-Covid period (-1.8% compared to 2019) and, unfortunately, is aging, not renewed since entry of young donors. In essence, a slight downward trend is confirmed which has now lasted for about ten years. Compared to 2012, in fact, the donor population decreased by about 5% and if, in the five pre-Covid years, the figure had been substantially stable, the spread of the Sars-Cov-2 pandemic has hit the blood transfusion system hard. Unfortunately, even the numbers of 2022 do not bode well. After the first two months of the year in which there was a sharp decline in collections, probably attributable to the wave of Omicron variant cases, and after a substantially stable March, the April data showed, in particular for the collection of plasma, a new decline that in all likelihood will lead to an early start of the blood shortages that occur every year in the summer, when high temperatures and holidays push the Italian population to donate less. Despite the many problems – related not only to contagions and suspicious contacts with positives that forced donors to comply with quarantine periods, but also to health personnel usually in charge of donations who were destined for Covid departments or employed in the vaccination campaign – l self-sufficiency as regards the collection of red blood cells has however been achieved and guaranteed. The situation is different with regards to plasma. In fact, once again this year, in order to meet the national need for plasma-derived medicines, we have been forced to resort to the international market. A market marked by the rise in prices due to the difficulties encountered in collection also in the United States, the main player in this area. It should also be emphasized that in 2021, according to the Cns data, “there was no lack of the contribution of the population of donors who confirmed, after more than two years of the pandemic, the generosity and reliability that allowed the transfusion system to hold up even the most unexpected of emergencies. But the numbers once again underline the fact of the progressive aging of the donor population, which is not counterbalanced by an adequate generational turnover “, reads a note. A clear symptom of the problem is the number of so-called new donors, i.e. the people who donated blood for the first time in 2021 or did it more than two years after the last donation, which amounted to 267,949. Always up compared to 2020, but down sharply if we calculate the trend of the last ten years (-9.6% from 2012 to 2021, -6.3% from 2019 to 2021). The lack of blood will have serious consequences, explains Vincenzo De Angelis, director of the National Blood Center. “It is probable that, barring an unpredictable change in trend, in the months of July and August we will encounter difficulties that will not be resolved, as often happens, thanks to the availability of those Regions that have stocks in excess of the demand for blood. and ‘compensate’ the distressed Regions. It will therefore not be a surprise if the available blood will be used to guarantee life-saving therapies for patients suffering from rare diseases, such as thalassemics, while non-urgent surgery will have to be postponed “, says De Angelis. “After two and a half years of the pandemic, the bill is still high. Covid-19, even with its less aggressive variants, has had an enormous impact in these first months of the year and its effects will aggravate the usual shortcomings that occur every summer. We must thank the donors who with their generosity guarantee the functioning of a system based on the criteria of a safe, voluntary, anonymous, periodic and unpaid donation “, concludes De Angelis. The data indicate that blood donors age, in in line with the demographic trend of the country, and the generational change is struggling to establish itself. In the last decade, the young age group aged 18 to 45 has gone from 1,089,510 donors in 2012 (63% of the total) to 866,112 in 2021 (52%): a reduction of 223,398 units. An even more alarming figure – indicates the Cns – again for the age group 18 to 45, is that relating to new donors in 2021, which photographs a decrease of 24% over the decade. Finally, the aging of the population is fully reflected in the data relating to donors over 46, which went from 650,202 to 787,156 in the period 2012-2021.