A quick “Can I donate blood” self-assessment tool amid the COVID-19 outbreak

Sir,

A novel coronavirus (nCoV) suddenly got into our site from Wuhan in December 2019 [1]. This nCoV was subsequently renamed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and besides the disease it causes as Coronavirus Disease-2019 [COVID-19]. The outbreak of COVID-19 has stomped the health care system in almost all the nations of the world [2]. Blood Transfusion Services [BTS] at each hospital, hold a primary position and facilitate the smooth functioning of all elective and urgent surgical interventions including various traumas, emergency, obstetric and cancer care throughout a duration of 24x7. One of the major challenges ahead of us is to maintain high spirits and persistent enthusiasm among volunteer donors to continue donating their whole blood [WB], even during this pandemic. We believe that there might be a lot of paranoia, uncertainty and false assumptions in the minds of donors about blood donation amid this pandemic. In addition, due to the government's interventions, such as mass lockdown and containment measures for social gatherings, in the wake of this COVID-19 outbreak, the arrangement of voluntary blood donation drives has been debarred [3]. Likewise, the general public has been reluctant to come to hospital-based blood centers to donate blood. This has led to a significant reduction in the number of blood collected globally. By calling for efforts such as public education and clarification of frequently asked questions, we believe that blood donation can be encouraged. In reality, the safety of both donors and employees should remain a priority of any BTS during this time. This implies frequent and consistent cleaning of donor stations, including surfaces with potential contamination and wearing protective face masks by donors as well as the BTS personnel. In addition, employees must be properly equipped to conform to all the requisite standards, including the donning of the personal protective equipment (PPE) and the management of biological waste produced.

Furthermore, COVID-19 can exhibit in a varied manner, starting from an asymptomatic carrier state to full-blown acute respiratory illness. In 2003, the world health organization acknowledged there were no known cases of SARS-CoV due to transfusion of blood products. However, at this juncture, the transfusion related transmission of nCoV, although remote, remains a reasonable possibility. In addition, with more asymptomatic carriers of the disease, blood safety merits consideration. Current predictions are based primarily on the new guidelines released by AABB, and more than ever, a vigilant approach, including thorough donor surveillance, is needed [4]. Once presenting with flu-like illnesses, the current eligibility rules laid by AABB and FDA prohibit these individuals from donating their blood. Moreover, the concerns are more legitimate when it involves adults who are asymptomatic and come forward to the blood centers as “apparently” healthy blood donors. They may pose a serious health risk to the blood community. These “asymptomatic” rather “innocent blood donors” (IBDS) may not even be fully aware of their viral status at the time of WB donation. We as a blood center catering to a 1200-bed tertiary care teaching hospital in the Dehradun district of Uttarakhand, North India, wanted to deal with this issue. Therefore, we created a “Can I Donate?”, a self-estimation tool (SAT) amid this pandemic to facilitate an estimation of the magnitude of the current pandemic, its implications for blood safety and to encourage self-deferral among these IBDs if they found themselves unsuitable for WB donation (Table 1 ). In addition, we also handed them the published SAT material to carry the same and help propagate the word amongst their peers and other potential IBDs. We believe that speedy sharing of any scientific information is an efficient tool to reduce public panic over any pandemic, including COVID-19, especially among those willing to donate their blood on a voluntary basis. As suggested by Raturi et al. [5], in addition to the otherwise existing donor screening questionnaire, the SAT content was designed and distributed by us. The awareness of COVID-19 is growing on n daily basis. Nevertheless, with these criteria in place, we wish to encourage our blood donors to self-evaluate the seriousness of the present pandemic and its implications for blood safety. The existing blood donor screening protocol [6] together with SAT and a standard mini-physical examination should be able to deter either those with active respiratory symptoms or even the so-called “asymptomatic” IBDs from donating blood.

Table 1.

Suggested SAT for both symptomatic and asymptomatic rather “innocent blood donors”.

S. No.	Category of symptoms	Suggested deferral period
1	Asymptomatic  Feeling well and  Meet the general eligibility conditions for donation  If not a close contact with someone diagnosed with or suspected of having COVID-19	Accept their donation
2	Asymptomatic  If close contact with someone diagnosed with or suspected of having COVID-19	Wait for 14 days with an advice for “home quarantine” and or a self-deferral
3	Asymptomatic  Travelled outside the country and or recently returned from “government identified COVID-19 hotspots” within the country	Wait for 28 days starting from the date of return as a “home quarantine” and or a self-deferral
4	Symptomatic  A mild bout of flu-like illness  Associated symptoms such as sore throat or tickly cough  History of antibiotics or anti-pyretic intake	Wait for 14 days
5	Symptomatic  Body temperature more than or equal to 38°celsius  Moderate to severe symptoms as influenza-like or other respiratory infections  Diagnosed with or suspected of having COVID-19 with positive laboratory report by PCR method	Wait for 28 days as a self-deferral criteria or until proved negative by COVID-19 testing reports by PCR method

SAT: self-assessment tool; COVID-19: coronavirus disease – 2019; PCR: polymerase chain reaction.

Research involving human participants and/or animals

Human participant.

Informed consent

As per the department policy, an informed consent is obtained from all donors prior to blood donation in accordance to our department protocol.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional ethics committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding and resources

None.

Disclosure of interest

The author declares that he has no competing interest.