The COVID-19 pandemic and blood utilisation in South Africa

Authors

  • R Swanevelder Medical Division, South African National Blood Service, Roodepoort, South Africa
  • P-L Wessels Medical Division, South African National Blood Service, Roodepoort, South Africa; Division of Clinical Haematology, University of the Free State, Bloemfontein, South Africa
  • V J Louw Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa https://orcid.org/0000-0002-2885-3342
  • A Swarts Medical Division, South African National Blood Service, Roodepoort, South Africa https://orcid.org/0000-0002-8302-1178
  • M Lennards Operations Division, South African National Blood Service, Roodepoort, South Africa
  • K van den Berg Medical Division, South African National Blood Service, Roodepoort, South Africa; Division of Clinical Haematology, University of the Free State, Bloemfontein, South Africa; Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa https://orcid.org/0000-0001-9805-8013

DOI:

https://doi.org/10.7196/SAMJ.2024.v114i11.2001

Keywords:

COVID-19; blood utilisation; South Africa; blood products;

Abstract

Background. The COVID‐19 pandemic, first reported in December 2019, affected every sector of every country worldwide. Health services were the first to experience the direct impact. Blood services were advised to decrease blood utilisation in anticipation of reduced blood collections. The South African National Blood Services (SANBS) saw a substantial decline in blood demand following the institution of strict national lockdown measures, but the impact of the epidemic and various mitigation strategies remained unknown.

Objective. This retrospective study reviews red blood cell (RBC) utilisation during a 4‐year period from 2019 to 2022 in the South African (SA) population, stratified by public and private healthcare sectors.

Methods. To measure the impact of COVID‐19, blood utilisation pre COVID‐19 was compared with an acute COVID‐19 period and a post‐acute period. Each period covered 450 days. Blood utilisation was evaluated against the background of reported COVID‐19 cases and national lockdown regulations.

Results. With the onset of the COVID‐19 pandemic, overall RBC utilisation dropped by ~17%. The initial decline was more pronounced in the public sector. Overall, utilisation recovered to pre‐COVID‐19 levels in the post‐acute COVID‐19 period, but at different rates in the public and private sectors.

Conclusion. There was a significant change in RBC utilisation during the course of the COVID‐19 pandemic, much more pronounced in the public sector, which services 85% of the SA population. During the post‐acute COVID‐19 period, blood utilisation recovered, but at a much slower rate in the public sector. The COVID‐19 pandemic accentuated the differences in blood utilisation patterns between the public and private healthcare sectors in SA, and each sector’s resilience in adapting to the challenges of the epidemic.

Author Biographies

  • R Swanevelder, Medical Division, South African National Blood Service, Roodepoort, South Africa

    Analytics Specialist

  • P-L Wessels, Medical Division, South African National Blood Service, Roodepoort, South Africa; Division of Clinical Haematology, University of the Free State, Bloemfontein, South Africa

    Patient Blood Management and Transfusion Medicine

  • V J Louw, Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

    Chair and Head Clinical Haematology

  • A Swarts, Medical Division, South African National Blood Service, Roodepoort, South Africa

    Clinical Trial Manager

  • M Lennards, Operations Division, South African National Blood Service, Roodepoort, South Africa

    Senior Manager: Processing and Issuing

  • K van den Berg, Medical Division, South African National Blood Service, Roodepoort, South Africa; Division of Clinical Haematology, University of the Free State, Bloemfontein, South Africa; Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

    Medical Director

References

1. World Health Organization. WHO Director‐General’s statement on IHR Emergency Committee on Novel Coronavirus (2019‐nCoV). Geneva: WHO, 2020.

2. Barriteau CM, Bochey P, Lindholm PF, et al. Blood transfusion utilization in hospitalized COVID‐19 patients. Transfusion. 2020;60(9):1919‐1923. https://doi.org/10.1111/trf.15947

3. Stanworth SJ, New HV, Apelseth TO, et al. Effects of the COVID‐19 pandemic on supply and use of blood for transfusion. Lancet Haematol 2020;7(10):e756‐e764. https://doi.org/10.1016/S2352‐ 3026(20)30186‐1

4. Tolich D, Auron M, McCoy K, et al. Blood management during the COVID‐19 pandemic. Cleve Clin J Med 2020. https://doi.org/10.3949/ccjm.87a.ccc053

5. Velazquez‐Kennedy K, Luna A, Sánchez‐Tornero A, et al. Transfusion support in COVID‐19 patients: Impact on hospital blood component supply during the outbreak. Transfusion 2021;61(2):361‐367. https://doi.org/10.1111/trf.16171

6. Asian Association of Transfusion Medicine. Aide‐memoire COVID‐19. AATF, 2020. https://www. aabb.org/docs/default‐source/default‐document‐library/regulatory/aide‐memoire‐covid‐19‐english. pdf (accessed 22 April 2020).

7. Baron DM, Franchini M, Goobie SM, et al. Patient blood management during the COVID‐19 pandemic: A narrative review. Anaesthesia 2020;75(8):1105‐1113. https://doi.org/10.1111/anae.15095 8. Ngo A, Masel D, Cahill C, et al. Blood banking and transfusion medicine challenges during the

COVID‐19 pandemic. Clin Lab Med 2020;40(4):587‐601. https://doi.org/10.1016/j.cll.2020.08.013

9. SouthAfricanGovernmentNewsAgency.PresidentRamaphosaannouncesanationwidelockdown. SAnews.gov.za, 2020. https://www.sanews.gov.za/south‐africa/president‐ramaphosa‐announces‐

nationwide‐lockdown (accessed 14 October 2024).

10. Shander A, Goobie SM, Warner MA, et al. Essential role of patient blood management in a pandemic:

A call for action. Anesth Analg 2020;131(1):74‐85. https://doi.org/10.1213/ane.0000000000004844 11. Wise RBD, Gibbs M, Govender K. South African Society of Anaesthesiologists perioperative patient

blood management guidelines. South African Society of Anaesthesiologists, 2020.

12. Alexander M. South Africa Gateway 2018. Infographic. South Africa’s rural and urban population from 1960 to 2016. https://southafrica‐info.com/infographics/infographic‐south‐africas‐rural‐urban‐

population‐1960‐2016/ (accessed 25 June 2024).

13. Bolton L, van den Berg K, Swanevelder R, Pulliam JRC. Characterising differences in red blood cell

usage patterns between healthcare sectors in South Africa: 2014‐2019. Blood Transfusion 2022(July‐

August):4. https://doi.org/10.2450/2021.0209‐21

14. Bolton L, Swanevelder R, Pulliam JRC. Mind the gap: Patterns of red blood cell product usage in South

Africa, 2014 ‐ 2019. S Afr Med J 2021;111(10):985‐990.

15. Statistics South Africa. General Household Survey 2022. Pretoria: Stats SA, 2022.

16. Jukić I, Hećimović A, Vuk T. Blood donation during natural disasters – experience with COVID‐19

and earthquakes in Croatia. Croatian Med J 2021;62(2):196‐197.

17. Yazer MH, Shaz B, Seheult JN, et al. Trends in platelet distributions from 2008 to 2017: A survey of

twelve national and regional blood collectors. Vox Sang 2020;115(8):703‐711. https://doi.org/10.1111/

vox.12917

18. Gupta AM, Ojha S, Poojary M, et al. Organisation 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(5):102878. https://doi.org/10.1016/j.transci.2020.102878

19. Moraliyage H, de Silva D, Ranasinghe W, et al. Cancer in lockdown: Impact of the COVID‐19 pandemic on patients with cancer. Oncologist 2021;26(2):e342‐e344. https://doi.org/10.1002/ onco.13604

20. Dinmohamed AG, Cellamare M, Visser O, et al. The impact of the temporary suspension of national cancer screening programmes due to the COVID‐19 epidemic on the diagnosis of breast and colorectal cancer in the Netherlands. J Hematol Oncol 2020;13(1):147. https://doi.org/10.1186/s13045‐020‐ 00984‐1

21. Burger RNL, Rensburg R, Smith A, van Schalkwyk C. Examining the unintended health consequences of the COVID‐19 pandemic in South Africa. National Income Dynamics Study (NIDS), 2020. https://cramsurvey.org/wp‐content/uploads/2020/07/Burger‐examining‐the‐unintended‐health‐ consequences.pdf (accessed 14 October 2024).

22. Pattinson R, Fawcus S, Gebhardt S, Soma‐Pillay P, Niit R, Moodley J. The impact of COVID‐19 on use of maternal and reproductive health services and maternal and perinatal mortality. S Afr Health Rev 2022;24. https://doi.org/10.61473/001c.75291

23. Ndlovu N, Gray A, Busan J, Muretihi L. Health and related indicators 2021. South African Health Review 2022;24:106‐119. https://doi.org/10.61473/001c.75480.

24. Evans D, Girdwood S, Long L. Private sector data related to the HIV care and treatment burden by geographic area. HE2RO Policy Brief. Health Economics and Epidemiology Research Office, 2019. https://www.heroza.org/?p=3864 (accessed 14 October 2024).

25. Zuma K, Simbayi L, Zungu N, et al. The HIV epidemic in South Africa: Key findings from 2017 national population‐based survey. Int J Environ Res Public Health 2022;19(13):8125. https://doi. org/10.3390/ijerph19138125

26. NtusiN,SonderupM.HIV/AIDSinfluencesbloodandbloodproductuseatGrooteSchuurHospital, Cape Town. S Afr Med J 2011;101(7):463‐466.

27. Wong EB, Olivier S, Gunda R, et al. Convergence of infectious and non‐communicable disease epidemics in rural South Africa: A cross‐sectional, population‐based multimorbidity study. Lancet Glob Health 2021;9(7):e967‐e976. https://doi.org/10.1016/S2214‐109X(21)00176‐5

28. Kracalik I, Mowla S, Katz L, et al.Impact of the early coronavirus disease 2019 pandemic on blood utilisation in the United States: A time‐series analysis of data reported to the National Healthcare Safety Network Hemovigilance Module. Transfusion 2021;61(Suppl 2):S36‐S43. https://doi. org/10.1111/trf.16451

Downloads

Published

2024-11-04

Issue

Section

Research

Categories

How to Cite

1.
Swanevelder R, Wessels P-L, Swarts A, Lennards M, van den Berg K. The COVID-19 pandemic and blood utilisation in South Africa. S Afr Med J [Internet]. 2024 Nov. 4 [cited 2025 Jan. 19];114(11):e2001. Available from: https://samajournals.co.za/index.php/samj/article/view/2001

Similar Articles

1-10 of 374

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)