Paris Olympics and Paralympics: Insights from nationwide coordination in preparedness, supply chain management and blood inventory

Abstract

The Paris 2024 Olympic Games posed a unique challenge due to their scale, associated risks and the need for robust healthcare preparedness. This review outlines the forecasting and anticipatory measures taken by the Etablissement français du sang (EFS) to ensure a resilient blood supply chain throughout the event. A steering committee was formed 2 years in advance to coordinate risk assessments, operational planning and institutional collaboration. The EFS aimed to maintain daily reserves of 90,000 red blood cell (RBC) units, anticipating a 25% shortfall in the Île‐de‐France region, which was to be balanced by increased contributions from other regions. To support operations, logistical strategies involved the prepositioning of supplies, securing transport routes and reinforcing both trauma centres and Olympic venues. Staffing was also adapted, with changes to work schedules, an extended summer leave period and provisions for remote work at EFS headquarters. In anticipation of seasonal infectious risks, nucleic acid testing (NAT) was implemented for West Nile virus (WNV) and dengue (DENV) in high‐risk areas. Cybersecurity measures were also reinforced through strengthened information technology infrastructure and integration with the national cyber crisis response system. These proactive measures proved effective: blood stocks remained stable, only a few arboviral infections were detected and no major cyber incidents occurred. The Paris 2024 experience emphasizes the importance of early, coordinated and cross‐sectoral planning in safeguarding national blood supplies during mass events. The centralized structure of the EFS, along with its integration into public health systems and past experience with major events, enabled uninterrupted and resilient service delivery.

Highlights.

• The Paris 2024 Olympic Games highlighted the importance of early, coordinated and multi‐sectoral planning in safeguarding the national blood supply during mass gatherings.

• Proactive measures, including an early governance framework, rigorous risk modelling and nationwide coordination, proved essential.

• Etablissement français du sang's (EFS's) centralized structure and comprehensive approach, covering every step from donor collection to patient transfusion, enabled the effective maintenance of transfusion safety and logistics.

INTRODUCTION

The organization of large‐scale events attracting significant numbers of participants and spectators presents numerous safety and public health challenges. Blood transfusion and blood supply is one of them, while ensuring the continuity of blood product supply remains essential. This involves assessing and anticipating needs both in normal circumstances and during emergency situations involving a massive influx of victims.

Proper planning and modelling of the entire chain, from blood donor to patient, in such exceptional contexts is a critical factor in guaranteeing the quality and continuity of care anywhere in the country, at any time.

The Olympic Games have unfortunately already been the scene of several terrorist attacks, such as in 1972 in Munich or, more recently, in 1996 in Atlanta, which left 2 people dead and 111 injured. Attacks had also been carried out in the weeks leading up to the 2014 Sochi Olympics, resulting in around 30 deaths. Some studies described the management of casualties from the bombing in the United States, but none of them gave details on blood supply or usage [1, 2].

The Etablissement français du sang (EFS), France's national blood service responsible for blood collection, processing and the majority of distribution, had to prepare for all potential scenarios. Although France has extensive experience hosting large‐scale cultural and sporting events, the stakes surrounding the Olympic Games were significantly higher.

This article provides a structured overview of the preparations undertaken by EFS and the lessons learned to ensure uninterrupted transfusion services during such a major international event.

CONTEXT

The EFS

The EFS is a public institution created in 2000 under the supervision of the French Ministry of Health. It is the sole civilian public blood transfusion service in France, responsible for ensuring national self‐sufficiency in blood products while maintaining the highest standards of safety and quality. Its core mission is to guarantee a safe and sufficient supply of blood products nationwide; organize and adapt transfusion activities in line with technological, medical and scientific advancements; and promote blood donation based on the ethical principles of voluntary and unpaid contributions. The EFS may be required to work closely with the Armed Forces Blood Transfusion Center, which is responsible for providing blood transfusion support to the armed forces during overseas operations or on national territory, particularly in crisis situations.

EFS oversees the collection, processing, testing and distribution/issuing of labile blood products, including red blood cells (RBCs), platelets and plasma, across mainland France and its overseas territories. Its operations are supported by 13 regional establishments, 18 preparation sites (including 3 overseas) and 7 blood testing laboratories (including 3 overseas).

Each year, EFS collects nearly 2.7 million donations from 1.5 million donors. It supplies blood products to around 1500 public and private healthcare institutions, either directly through its 143 issuing sites or indirectly via hospital blood banks. Additionally, EFS provides specialized transfusion advice to healthcare professionals. Beyond transfusion activities, EFS plays a significant role in donor medicine, transfusion medicine and transplant medicine. It manages 130 specialized biomedical laboratories, including cell therapy units, tissue banks, healthcare centres and research teams.

Major events in France and lessons learned from the past

France has long experience in hosting major events that attract large audiences. In 2016, the UEFA Euro football championship brought 2.5 million spectators to France, including 1 million international visitors from 110 countries, across 12 stadiums. In 2023, the Rugby World Cup welcomed 2.3 million spectators, among them 600,000 from abroad, in nine stadiums. Beyond such exceptional occasions, France also hosts large‐scale sporting and cultural events every year, such as the Tour de France; the Fêtes de Bayonne, which attracts around 1 million visitors over 5 days; the Fêtes de Dax, drawing between 500,000 and 800,000 visitors over 5 days; and numerous music festivals.

Moreover, France has had to face numerous terrorist attacks in recent years, events that created massive and urgent blood requirements. Since 2012, terrorist attacks have killed 274 people in France, with the attacks of 13 November 2015 and 14 July 2016 alone claiming 258 lives and leaving 1087 people injured.

From past experiences, whether during major sporting events or in response to terrorist attacks, several valuable lessons have been learned [3].

Stock levels have been reassessed based on the use of blood products in relation to the flow of casualties admitted after the Paris attacks, as well as on the hospitalization capacity defined for each facility, in order to ensure an immediate response to any mass‐casualty situation, regardless of location or timing. Particular attention has been paid to maintaining sufficient reserves of fresh frozen plasma. Stocks are adjusted according to the number of casualties likely to be treated, the expected evolution of blood needs in light of hospital capacity during a crisis, the resupply capability and the need to limit product expiration. These adjustments are reviewed periodically, particularly for facilities located in cities expected to host major events. The capacity to produce pooled platelet concentrates (PCs) was also surged through a broader use of ‘Top and bottom’ blood bags, and the logistics schemes designed to help replenish blood stocks in the event of a crisis. Additionally, the use of lyophilized plasma was authorized for civilian purposes in 2016, before Euro‐2016.

Communication was a crucial issue during the Paris attacks. A national kit of appropriate communication tools was therefore created to enable rapid and clear dissemination of information, better regulate the high number of blood donors and avoid saturation of the EFS communication systems.

Cooperation with hospitals and local health authorities was reinforced in order to strengthen management and anticipation capabilities. The EFS took part in drafting regional and interregional health response plans for exceptional events, integrating key principles such as damage control and hospitals' capacities. In addition, specific procedures for managing blood product requests during mass‐casualty incidents were developed, including, for example, the option to distribute prepacked crates of RBC concentrates without individual identification, enabling the rapid delivery of large quantities of O‐type RBCs. Regular crisis simulation exercises are also carried out, both internally and in cooperation with the authorities, to keep teams prepared for any emergency.

Paris Olympics 2024

The Paris 2024 Olympic Games represented an exceptional event of unprecedented scale. France welcomed a total of 16 million visitors, including 11.2 million attending the Olympic Games (July 26–August 11) and 4.8 million for the Paralympic Games (August 28–September 8). Among them, approximately 1.9 million were international visitors, with the remaining 9.3 million being French nationals, residents of Île‐de‐France, day trippers or French tourists.

While the majority of events were held in Paris and the Île‐de‐France region, many competitions took place at iconic landmarks such as the Eiffel Tower, Champs‐Élysées and Grand Palais, where temporary sports structures were installed. Additionally, several events were hosted in other regions across France, including Lyon (football), Saint‐Étienne (football), Marseille (football and sailing), Nice (football), Bordeaux (football), Nantes (football), Châteauroux (shooting), Lille (football and handball) and Tahiti (surfing) (Figure 1).

FIGURE 1.

Paris Olympic Games venue map.

Before the start of the Olympic Games, the Olympic Torch Relay travelled across mainland France and the overseas departments from May 8 to July 26. This highly popular event, attracting thousands of spectators daily, covered more than 400 cities, including 65 designated relay cities, and involved 10,000 runners over a period of 68 days.

HOW WE PREPARED

Although this large‐scale event was associated with a substantial influx of spectators, it was not expected to result in significant variations in blood product demand, except in the event of an exceptional public health emergency, a scenario for which the EFS was required to anticipate and establish contingency plans. Nonetheless, potential operational impacts on EFS activities were anticipated, particularly concerning logistical constraints likely to affect both personnel deployment and blood donor accessibility.

Identifying the impacts: Governance and coordination

Although the Olympic Games were not expected to have a direct impact on transfusion activities, it was essential to anticipate and mitigate potential indirect effects. The risk of mass‐casualty incidents (e.g., terrorist attacks, crowd surges) was considered non‐negligible, alongside increased threats such as cyberattacks and potential arboviral outbreaks (particularly dengue [DENV], chikungunya [CHIKV] or Zika). Furthermore, significant logistical challenges were anticipated, including traffic restrictions and venue saturation, which could potentially disrupt staff mobility, delivery of reagents and consumables, blood transport and donor attendance.

To address these challenges, a national steering committee was established in October 2022, nearly 2 years before the Games, to coordinate strategic planning and risk preparedness. This committee appointed high‐level coordinators responsible for liaising with public authorities, integrating risk assessments and mobilizing the regional establishments most likely to be affected.

Institutional coordination between the EFS and both central and decentralized administrations aimed to ensure that the objectives assigned to the national transfusion service were met within this exceptional context. Semi‐annual meetings with the Ministry of Health were organized to accurately evaluate and anticipate hospital activity during the Games. Additionally, EFS was formally integrated into the national crisis management framework, overseen by the Ministry of Health, and collaborated with the national cybersecurity authority to assess and mitigate potential cyber risks.

At the regional level, each EFS establishment was identified by local authorities and incorporated into crisis preparedness protocols. Their role was to assess the blood component needs of healthcare facilities, identify primary and secondary response sites and plan for reinforcement measures to ensure an adequate blood supply in the event of a major health emergency.

The situation in Paris and the Île‐de‐France region was particularly critical, as they hosted the majority of Olympic events, including the opening and closing ceremonies and the marathon. Anticipating significant traffic disruptions, the local EFS teams worked closely with the Regional Health Agency (ARS Île‐de‐France) and prefectural authorities to coordinate actions related to staffing, logistics, health, safety, environmental measures and cybersecurity. These collaborations also facilitated the acquisition of special circulation permits and authorizations required for EFS teams and vehicles during the Games.

Furthermore, close cooperation between the French Polynesia Hospital Centre and EFS was established to ensure the timely delivery of emergency blood supplies (lyophilized plasma) to Tahiti and to strategically position them within isolated blood banks in preparation for the Olympic surfing competitions.

Strategic decisions

Maintaining blood inventory levels in Paris and France

EFS's nationwide target inventory levels are set at 13‐day RBC stocks and 12‐week safety inventory for fresh frozen plasma. Under normal circumstances, Paris and the Île‐de‐France region are not self‐sufficient for blood components due to the high concentration of hospitals, and national regulatory teams coordinate the transfer of labile blood components (LBCs) from other regions of France. Additionally, for the Olympic Games, there was considerable uncertainty regarding local blood collection due to traffic challenges and the widespread adoption of remote work by many companies and public administrations. The forecast for blood product requirements has been assessed as identical to a typical summer period, representing a 10% reduction compared to April, for example. The influx of spectators did not directly affect the use of LBCs. Nevertheless, the EFS needed to ensure the ability to meet significant LBCs demands in the event of a mass‐casualty incident.

To achieve this, a national inventory of RBC units was targeted to exceed 90,000 units daily throughout the Olympic period, ensuring sufficient supply for patients across France and the capacity to provide large quantities of blood components in the event of an exceptional health situation, particularly in Paris.

Our stock variation forecasts predicted a weekly shortfall of 1000 RBC units and 250 PCs, resulting from a predicted stable patient demand combined with an anticipated 25% reduction in blood collection in the Île‐de‐France region. A decision was made to define guidelines for collection planning in Île‐de‐France (Figure 2), and to achieve a +2.5% increase in blood collection in other EFS regions, equivalent to 1010 RBC units and 250 PCs collected or prepared per week, between July 14 and August 15, in order to offset the projected stock shortfall. Subsequently, blood exports from these regions were increased to support the Île‐de‐France region.

FIGURE 2.

Guidelines for planning mobile blood collections in Île‐de‐France for the Olympic Games.

These proactive measures allowed regional blood establishments to plan summer collections, staff vacations and temporary workforce needs, accommodating a 15%–30% rise in weekly RBC exports to Île‐de‐France, compared with a typical week when 45% of RBC units originate from other regions. Additionally, apheresis PCs (100/week) and pooled PCs (150/week) were distributed proportionally across regions, optimizing the use of Top and Bottom bags to enhance pooled platelet production capacity. The stock of cryopreserved PCs was also increased from 50 to 120 units to further reinforce supply resilience.

Another objective was to achieve a stable balance between A and O blood group RBCs before July 14, to facilitate stock management and ensure appropriate issuing without increasing wastage due to expiration.

In addition to these measures aimed at maintaining blood inventory levels, a national communication campaign was launched at the end of June 2024 to support donation efforts. Indeed, the stocks were critically low as summer and the Olympics approached, 140,000 donation appointments still available nationwide for the 2 weeks following the communication campaign. Moreover, some collections were cancelled at the same time due to the legislative elections in France that needed the venues usually dedicated to blood collection [4].

Stocks of blood products at major trauma centres were monitored daily to ensure availability and timely replenishment, in accordance with routine procedures.

Operational adjustments

To address anticipated logistical disruptions from traffic restrictions and venue saturation, access routes for staff and couriers had been identified and organization locally adapted if necessary. This request is part of a broader project led by the Paris Police Prefecture, covering all vehicles that may be deemed ‘priority’ during this period.

EFS sites and hospital blood component stocks were reinforced to support first‐response hospitals in Paris and across France affected by the Olympics or the Olympic Torch Relay.

In the Paris region, supplies and equipment, across warehouses as well as collection, production and distribution sites, were prepositioned in advance, with critical stock levels maintained above normal (reagents, in vitro diagnostic medical devices).

Staff management

The anticipated workplan was essential to enable regional blood establishments to adjust staff management, including temporary staffing and vacation scheduling for medical‐technical personnel in blood collection teams, laboratories and strategic positions. The goal was to define work arrangements early, allowing employees to plan for the summer 2024 holiday period in accordance with leave procedures, which require staff to submit leave preferences at the start of 2024, with approvals in February. As an exceptional measure in 2024, the summer holiday period was extended from May 1 to October 31 (instead of June 1–September 30). This forward planning required incorporating the additional staffing needs into the 2024 budget, prepared in October 2023. A general agreement was reached to allow for greater variations in blood product inventories, enabling reinforcement of teams by up to 8.5 full‐time equivalents.

Staff schedules for immuno‐haematology and issuing laboratories, as well as blood collection and logistics, were adapted. For example, during the Olympic Games, immuno‐haematology and issuing EFS labs with only one technician on nights and weekends, typically within adult trauma centres or emergency medical services, were reinforced, while other trauma centre sites maintained nominal staffing except during leave periods. At other trauma centre sites, staff have been maintained at nominal levels (except during leave periods). Paediatric trauma centre sites were strengthened with two technicians scheduled for the opening and closing ceremonies and on‐call coverage throughout the Games. During the Paralympics, reinforcement focused only on sites with a single technician on nights and weekends in adult trauma centres.

Summer 2024 collection forecasts were also adjusted to account for the weekly increased exportation of blood products to Île‐de‐France, ensuring adequate staffing. The collection schedule in Île‐de‐France prioritized avoiding major events during the period while conducting collections before and after these events (Table 1).

TABLE 1.

Forecast and actual collection figures for the Île‐de‐France region during the weeks surrounding the Olympic Games, compared with 2023.

	2003			2004
Île‐de‐France	Forecast	Collected	Achieved compared to forecast	Forecast	Collected	Achieved compared to forecast
Week 23	5098	4738	92.94%	5065	4724	93.27%
Week 24	4971	4869	97.95%	5354	5241	97.89%
Week 25	4665	4655	99.79%	5150	4849	94.16%
Week 26	4908	4318	87.98%	4878	4390	90.00%
Week 27	4768	4321	90.63%	5202	5183	99.63%
Week 28	3662	3192	87.17%	4933	5242	106.26%
Week 29	4440	4322	97.34%	4851	4553	93.86%
Week 30	4245	4101	96.61%	4559	4247	93.16%
Week 31	3999	3680	92.02%	4660	4044	86.78%
Week 32	4172	3938	94.39%	4590	3901	84.99%
Week 33	3320	2762	83.19%	3649	3047	83.50%
Week 34	4567	4483	98.16%	4711	4191	88.96%
Week 35	4676	4661	99.68%	5106	4588	89.86%
Week 36	4475	4306	96.22%	4496	3852	85.68%
Week 37	4661	4652	99.81%	4972	4246	85.40%
Week 38	4426	4359	98.49%	4672	4068	87.07%
Week 39	5048	4467	88.49%	5043	4303	85.33%
Week 40	5073	4487	88.45%	5040	4278	84.88%
Week 41	5160	4601	89.17%	5313	4487	84.45%
Week 42	5263	4641	88.18%	5244	4569	87.13%
Week 43	5040	4568	90.63%	5195	4863	93.61%

Specific arrangements were made for EFS Headquarters in La Plaine Saint‐Denis, near Stade de France and the Olympic swimming pool. To reduce staff travel, full mandatory remote work was implemented during both Olympic and Paralympic Games, while ensuring continuity of essential functions such as building maintenance, information technology (IT), mail services and operational or cybersecurity crisis management.

The EFS crisis management system operates through various regional and national channels under the authority of the EFS Chief Executive Officer (CEO). When significant events occur, or are likely to occur, that could affect the institution's operations, a crisis unit is activated to implement business continuity plans or determine the most appropriate responses, also under the CEO's authority. The CEO designates an operational director to lead this crisis unit, which is structured into four divisions: Decision‐Making, Situation Assessment and Organization, Communication and Expertise and Guidance. For the duration of the Games, the national crisis unit remained on permanent standby.

Arboviral threats

In France, since the 2010s, human autochthonous cases of West Nile virus (WNV) have been reported mainly in the Mediterranean, and more recently (2023) along the Atlantic coast [5]. Similarly, an increase of local outbreaks has been observed for arboviruses transmitted by Aedes mosquitoes including DENV, CHIKV and Zika [6]. Moreover, co‐circulation of several arboviruses during the same season has also been observed. The French health authorities recommend the implementation of WNV‐nucleic acid testing (NAT) screening for donations collected in affected areas (French administrative department level) and for donors returning from affected areas located in France or abroad. Regarding arboviruses transmitted by Aedes mosquitoes, the national recommendations let the possibilities to implement NAT or to defer travellers coming from affected areas (French territories or abroad) for 28 days. In addition, it is recommended to quarantine blood products (essentially RBC products since platelets are systematically inactivated) issued from donations collected in the affected area since the first autochthonous case report until the NAT results. According to the number of involved donations in this retrospective testing, the blood bank organization and the blood supply are potentially compromised. Considering these provisions, it was decided to exceptionally implement preventive measures within the framework of the 2024 Olympic Games to ensure the blood supply especially in the Ile‐de‐France region hosting a large number of Olympic events.

With the goal to maintain the availability of blood products collected in departments where WNV was likely to circulate, WNV‐NAT was introduced in departments possibly affected by WNV circulation and known to significantly contribute to the national solidarity for self‐sufficiency. WNV‐NAT screening was performed with cobas WNV assay (Roche Diagnostics) from July 1st to September 15, 2024 in 14 departments, including 10 affected by the WNV circulation in previous seasons, and 4 departments especially involved in maintaining self‐sufficiency at the national level (Figure 3). In addition, donors coming back from WNV affected areas were also tested for WNV‐RNA by NAT [7].

FIGURE 3.

Systematic blood donation screening areas using nucleic acid testing (NAT) for West Nile virus (WNV) and dengue (DENV) viruses, Summer 2024. EFS, Etablissement français du sang.

DENV and CHIKV infections are not endemic to mainland France. Autochthonous cases are secondary cases from travellers returning from areas where these viruses circulate. During the Olympics, our objective was to anticipate the risk of local transmission in large cities that contribute significantly to self‐sufficiency in blood products, and to prevent, especially in areas with Olympic events, the risk of detecting imported cases associated with people coming from areas or countries with active circulation (e.g., South America or Asia). Factors taken into account included the density of vectors at municipality level, the location of events, and the massive presence of visitors from all over the world. The preventive strategy consisted of implementing the NAT screening duplex assay for DENV and CHIKV using the cobas CHIKV/DENV assay (Roche Diagnostics) between July 23 and September 15 on donations collected in seven major urban areas, mainly in southern France (Aix‐en‐Provence, Bordeaux, Lyon, Montpellier and two cities hosting events: Marseille, Nice). In addition, areas hosting Olympic events in and around Paris were added to anticipate organizational impacts and blood product availability in the event of local transmission (Figure 3).

This strategy has been approved by the health authorities and the High Council for Public Health [8].

Cybersecurity enhancements

The Tokyo 2021 Olympic Games experienced a significant wave of cyberattacks, with organizers reporting over 450 million attempted breaches [9]. Anticipating the Paris 2024 Olympics, a substantial increase in threats was expected, with projections suggesting that attacks could be eight to ten times higher. In this context, the EFS continued to step up its protection and response measures in this area. The EFS also further integrated into the interministerial cyber crisis framework in preparation for both the Olympic and Paralympic Games.

The entire blood supply chain IT system was secured, with technical protections reinforced and cybersecurity awareness campaigns conducted for all staff. In 2023, all blood chain production units reviewed and adjusted their exercises and Standard Operating Procedures, ensuring that every department developed contingency and continuity plans and conducted crisis simulations.

Additionally, a budget of €200,000 was allocated for the acquisition of backup laptops and smartphones to ensure operational continuity in the event of a cyberattack.

HOW IT WENT

The first observation is that no major disruptions or incidents occurred during the Olympic period. Between May 8 and September 8, 2024, only 548 cybersecurity incidents affecting entities involved in the organization of the Paris 2024 Olympic and Paralympic Games were reported [10].

In 2024, a total of 38 cases of autochthonous WNV infections have been reported in five departments of metropolitan France [11]. Four of them had been targeted for preventive screening of blood donations: Gard, Gironde, Herault and VarIn the latter two departments, the first human cases were detected in blood donors [7]. The targeting of potentially at‐risk departments could therefore be considered effective. The impacts associated with the implementation of WNV‐NAT screening after alerts were avoided by the preventive strategy (that included 176,128 donations among those 10 were found positive), and the availability of blood components during the Olympic Games was fully ensured.

For DENV, a total of 83 autochthonous human cases were reported in 2024 accounting for 11 outbreaks mainly in villages in southern France, and one CHIKV case was reported in the Paris region [12]. To our knowledge, no cases have been linked to an introduction by a visitor at the Olympics, but it should be noted that imported cases originating from local outbreaks are not systematically identified. The single area affected by CHIKV was submitted to preventive DENV/CHIKV NAT. Small outbreaks (one to two cases) occurred in two of the seven urban areas where NAT had been implemented. The DENV outbreaks with the highest number of cases (maximum n = 25) occurred in small municipalities where deferral measures were applied and had no impact on blood product self‐sufficiency. No large outbreaks were identified in big cities. In retrospect, the DENV and CHIK screening effort did not contribute to blood safety (no positives among 61,633 donations tested) but was justified given the context.

Overall, although the circulation of arboviruses in France in 2024 did not pose a significant threat, the preventive measures based on NAT screening for the main arboviruses implemented by the EFS during the Olympic Games helped to guarantee self‐sufficiency and maintain the full availability of blood components, with the aim of ensuring optimal continuity of activity, particularly in case of a crisis context.

The preventive strategy against arboviral threats successfully ensured the self‐sufficiency and availability of blood products throughout the Games. Among 176,128 donations tested with the WNV‐NAT assay, 10 were positive (including six autochthonous cases), while none of the 61,633 donations tested for DENV were positive.

By the end of the period, RBC and platelet stocks remained stable or even in surplus, requiring EFS to manage an overstock of blood products. The decline in blood collection was only 8%–10%, significantly lower than the 25% initially projected, and patient demand did not increase. Blood collection in the Île‐de‐France region met these targets in the weeks surrounding the start of the Olympic Games, with stable labile blood products requests and a good national reserve level. The projected exchanges between other EFS regions and Île‐de‐France were therefore adjusted downwards in light of these factors (Table 2). A balanced stock and distribution between A and O blood group RBC units was successfully maintained (Figure 4). A slight decrease in blood collection occurs in late August and September 2024, partly due to delayed holiday leave of the staff (Table 1). A national media campaign was launched on 24 August to increase whole blood collection by encouraging people to make appointments, raise awareness among young people and also promote plasma donation.

TABLE 2.

Red blood cell bag exports achieved to Île‐de‐France, adjusted weekly based on actual collections in the Île‐de‐France region and the level of red blood cell issuing.

		A+	A−	O+	O−	B+	B−	AB+	AB−	Total
	Usual forecasts of RBC bags collected in France for the benefit of Ile‐de‐France	925	208	1201	313	294	66	58	12	3077
	Olympic games forecasts of RBC bags collected in France for the benefit of Ile‐de‐France	1282	272	1576	405	386	85	58	14	4078	Achieved compared to forecast
Exports achieved to Île‐de‐France, adjusted weekly based on actual collections in the Île‐de‐France region and the level of RBC issuing	Week 29	1151	270	1571	507	389	119	57	15	4079	100%
	Week 30	1161	272	1490	507	330	100	56	12	3928	96%
	Week 31	1242	251	1227	362	362	89	37	14	3584	88%
	Week 32	1047	183	1238	352	378	69	21	7	3295	81%
	Week 33	747	138	939	208	247	52	43	12	2386	59%
	Week 34	0	110	1000	276	250	39	31	10	1716	42%
	Week 35	1	106	583	148	126	34	0	0	998	24%
	Week 36	1	158	298	326	200	41	19	11	1054	26%
	Week 37	753	127	995	253	335	65	28	10	2566	63%
	Week 38	901	188	993	335	258	64	41	9	2789	68%

Abbreviation: RBC, red blood cell.

FIGURE 4.

Ratio between A and O blood group RBC units during the weeks surrounding the Olympic Games.

Regional coordination facilitated equitable distribution and strengthened local capacities along the Olympic Torch Relay route.

DISCUSSION

The Paris 2024 Olympics underscored the importance of early, multi‐layered preparation for large‐scale public events. EFS's centralized structure and comprehensive approach, covering every step from donor collection to patient transfusion, enabled the effective maintenance of transfusion safety and logistics, providing a model for other national systems facing similar challenges (Table 3).

TABLE 3.

Risk management during the Paris 2024 Olympic and Paralympic Games (Etablissement français du sang).

Area	Risk identified	Mitigation strategy	Impact/outcome
Blood inventory management	Insufficient blood supplies in Île‐de‐France due to reduced local collections, traffic issues and stable needs	Maintain national RBC inventory >90,000 units/day Reinforce exports to Île‐de‐France (+15%–30%): +2.5% increase in blood collection in other regions Increase cryopreserved PCs Balance A and O blood group stocks National communication campaign	Stable or surplus RBC and platelet stocks Decline in blood collection only 8%–10% (vs. 25% forecasted) No shortage; overstock management required
Operational logistics	Disruptions due to traffic restrictions, venue congestion and access limitations	Identify and secure priority routes for couriers/staff Preposition supplies and equipment in key locations Reinforce blood stocks at hospitals along Olympic and Torch Relay routes	No logistical disruption reported Timely delivery and replenishment ensured
Staff management	Staffing shortages due to overlapping vacation periods and increased operational needs	Early planning of summer work schedules (May–Oct) Extend holiday period to distribute leave Temporary reinforcement up to +8.5 full time equivalent Adapt lab and collection team schedules Implement remote work when possible	Adequate staffing maintained across all sites No service interruption Smooth coordination between regions Slight decrease in blood collection in September due to delayed staff holidays
Arboviral threats (WNV, DENV, etc.)	Possible contamination due to mosquito‐borne virus outbreaks	NAT screening for Risk‐based selection of testing areas (WNV, DENV) NAT of returning donors	Self‐sufficiency preserved 10 WNV‐positive donations detected; none for DENV No impact on blood safety or supply
Cybersecurity	High risk of cyberattacks	Strengthen information technology (IT) emergency medical services protections Conduct staff awareness and crisis simulations Allocate budget for backup devices	Full continuity of operations maintained
Overall outcome	Complex, multi‐risk environment during the Games	Coordinated national strategy integrating logistics, health and cybersecurity planning	No major incidents Stable national blood supply Reinforced preparedness for future large‐scale events

Abbreviations: DENV, dengue; NAT, nucleic acid testing; PC, platelet concentrate; RBC, red blood cell; WNV, West Nile virus.

Proactive measures, including an early governance framework, rigorous risk modelling and nationwide coordination, proved essential. Lessons learned from previous mass events, such as Euro‐2016, the Rugby World Cup 2023 and the 2015–2016 terrorist attacks [3], were invaluable, fostering anticipation, adaptability and close collaboration with authorities, health agencies and hospitals to ensure blood supply under any circumstances.

EFS's integrated model, overseeing the entire supply chain, was pivotal in securing national readiness and resilience.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

Thibert J‐B, Meinrad H, Bocquet T, Jacques M, Baudonet T, Tiberghien P, et al. Paris Olympics and Paralympics: Insights from nationwide coordination in preparedness, supply chain management and blood inventory. Vox Sang. 2026;121:1525–1535.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.