Climate Disasters Are Worsening a U.S. Blood Shortage

This summer’s floods, hurricanes and wildfires have prevented blood collection at a time when U.S. hospitals are already low on supply

By Ariel Wittenberg

On September 21, 2023

 The nation’s donated blood supply is currently at “critically low levels,” and climate change is partly to blame.

That’s according to the American Red Cross and other blood donation organizations, which say the floods, hurricanes and wildfires seen across the country this summer have prevented blood collection and contributed to a nationwide shortage.

“Patient emergencies don’t stop, people don’t stop getting sick just because we have weather disasters, so it can be a challenging time for us when we are hit with extreme weather,” Baia Lasky, medical director for the American Red Cross, said.

The American Red Cross — which supplies 3,500 health care centers nationwide — has seen its blood supply drop nearly 25 percent since August. The nonprofit says it is now short by 30,000 units of blood, partly due to canceled donations from disasters.

In recent years, severe weather has increasingly disrupted blood collection, Lasky said. In 2022, the American Red Cross had to cancel 1,300 blood drives due to the weather — a 23 percent increase in cancellations over the previous year.

The nonprofit is still tallying how much extreme weather “chipped away” at the nation’s blood supply this summer, Lasky said. Hurricane Idalia alone prevented the collection of some 700 units of blood and platelets.

“We are seeing these weather systems that cause cancellation of blood drives and they are more intense, and we are seeing them more often,” Lasky said.

Blood is not the only medical supply that has been affected by extreme weather, which is becoming more frequent in a changing climate. Natural disasters and storms can disrupt the manufacture and supply for intravenous bags and equipment, for example.

But blood is unique; nothing can replace it, and it has an extremely limited shelf life. Red cells, used to help those urgently losing blood during trauma or surgery, last for only 42 days after donation. Platelets, which are crucial to treat certain cancers, last just five.

The American Red Cross needs to collect roughly 12,500 donations per day to meet demand — but doing so has been a struggle since the start of the Covid-19 pandemic. Recurring donors don’t visit blood centers as frequently, and recruiting new regular donors has been difficult. Meanwhile, lockdowns forced the cancellation of donation drive events that can bring in hundreds of units of blood in a single day. Those events still haven’t come back to pre-pandemic levels, thanks, in part, to fewer employees working at offices where they might participate in a blood drive.

The low blood supply this summer has caught the attention of the federal government, with the Department of Health and Human Services launching a campaign, dubbed “Giving = Living,” to encourage donations this August.

“A consistent supply of blood and plasma is critical to the health of our nation,” Assistant Secretary for Health Rachel Levine said in August.

‘DOMINO EFFECT’

Extreme weather has always hampered blood donation to some degree.

For example, in 2012, Superstorm Sandy forced the New York Blood Center to close all of its locations for multiple days, creating a shortfall among the 200 area hospitals the company supplies. But because Sandy occurred before coronavirus, other donation organizations were easily able to step up and fill the regional blood gap, center Director Christine Foran said.

Post-pandemic, however, blood-collecting organizations depend on every single donation. Just one weather event can exacerbate a shortage. That’s especially true during the summer, when the schools that hold many donation drives are closed.

“It’s one thing to have just the pandemic or just the weather, or just the summer, but when you start to pile three or more on top of it at the same time with a really strong demand coming from hospitals, it’s a recipe for a really constrained inventory,” Lasky, at the Red Cross, said.

This year, extreme weather has exacerbated the regular summer lull.

“Blood is going out through the hospitals faster than it is being donated,” said Liz Lambert, a spokesperson for Vitalant, which runs 115 collection centers across the country and provides blood to 900 hospitals.

One Vitalant donation center in McAllen, Texas, was closed for months after severe flooding in May damaged the building. Vitalant was able to park “blood mobile” collection buses nearby to continue some donations until the center reopened in August, but “it was not at the same pace they would typically be able to collect,” Lambert said.

“Any time you have not enough people coming in on a particular day, there is a domino effect because you can’t make those donations up,” she said.

Vitalant typically tries to maintain a four-day supply of all blood types at hospitals. This summer, Lambert said, it saw a 15,000-donation shortfall, which meant some of its hospitals only had a one-day supply.

“The fewer donations available to send to hospitals, the trickier it is to ensure every need is met,” she said.

Roslyne Schulman, director of policy development at the American Hospital Association, said that, among her members, “blood inventories, in general, remain lower than ideal due to recent natural disasters.”

Blood centers and hospitals have been able to meet “urgent patient demand,” she said, but when blood shortages become severe, some have been forced to delay elective surgeries in order to conserve blood for the patients who need it the most.

DONATION AS ADAPTATION

It’s not the first time disasters driven by climate change have harmed the health care supply chain.

Hurricane Maria’s direct hit on Puerto Rico in 2017 devastated the island — and multiple factories owned by Baxter International Inc. that manufacture plastic intravenous bags. The result was a nationwide shortage of the small bags used to quickly mix and deliver medicines or salt water to patients.

Such IV bags are typically considered the safest ways to deliver medicines to patients, especially if they might have trouble ingesting or swallowing drugs. Caleb Dresser, an emergency room physician at Beth Israel Deaconess Medical Center, remembers the stress of trying to conserve limited resources for the sickest patients, providing Gatorade to dehydrated patients who might otherwise have been rehydrated intravenously.

“I have distinct memories of having to reduce the use of IV saline, we had to switch how we gave antibiotics,” said Dresser, who is also director of health care solutions at Harvard University’s Center for Climate, Health and the Global Environment. “The effects of that one hurricane were felt hundreds of miles away in Boston.”

The aftermath of Maria and the current blood shortage are examples of how “climate-change-driven disasters can disrupt the availability of medical necessities, including blood,” Dresser said.

While the lack of saline bags was stressful, Dresser said there were other, if less ideal, ways to take care of patients. That’s different than the current shortage.

“There’s no substitute for blood,” he said.

It’s important for policymakers to think about how to make the health care system more resilient to climate change and the increasingly frequent and powerful disasters that come with it, Dresser said. But individuals can also help right now, he said.

“We don’t just have to think about preparing for climate shocks at a systems level, and how that will impact supply, but on an individual level, we need to actually donate blood,” he said.

Lasky, at the Red Cross, agrees.

Donating blood, and doing so regularly, can help ensure hospitals have enough supply even when disasters cancel local collections.

“For those people who are not impacted by a storm or a wildfire, it’s all the more reason to come out and support blood donation, because you are helping out people in the region who have been impacted,” she said.

This piece was republished from Scientific American.