Blood donation during the coronavirus pandemic

Introduction: Despite years of research and scientific work, it has not yet been possible to produce such a valuable medication as blood. The pandemic does not reduce the need for blood, quite the opposite. However, due to the pandemic, the number of blood donors has dropped dramatically across the country. The aim of the study was to find out the opinions and attitudes of the respondents towards blood donation during the pandemic period and to assess their knowledge of the principles related to safe blood donation during this period. Material and methods: The study was conducted using a diagnostic survey method and the tool was our own research questionnaire. The study was conducted in February 2021, using Google Forms platform. In total, data were collected from 150 individuals (females: 60.6%, males 39.4%) aged between 16 and 73 years (mean 31.4 ± 12.4 years). Statistical analyses used a significance level of p = 0.05. Results: Nearly 39.7% of the respondents were regular blood donors, 12% of the respon - dents donated blood several times (12.3%). Blood was donated more often by men, people aged over 30 years, urban residents, and people with higher education (p < 0.001). Most people continued to donate blood despite the COVID-19 pandemic (49.7%). Respondents who have donated blood so far still mostly want to donate blood after the pandemic (90%), among those who have not done so 38% want to do so after the pandemic (p < 0.001). The vast majority of respondents believed it was safe to donate blood during the pandemic (93%), and most were aware that symptoms of infection disqualify a blood donor (83.2%). Only 43.2% knew that “Convalescents who donate plasma are entitled to a blood donation deduction”. Conclusions: The current pandemic situation is not an obstacle to donating blood. Blood donations should not be withheld unless there are health contraindications. Due to addi - tional procedures, it is still safe to donate blood. Efforts to promote blood donation during the COVID-19 pandemic should be continued.


Introduction
Recently, due to the coronavirus pandemic, most scheduled surgeries have been canceled, but many patients after accidents, transplants, and during cancer treatment need blood. Planned surgeries are now gradually being restored and there is an increasing demand from hospitals for blood and its components.

Blood donation during a pandemic
The temperature should be measured before leaving home.
Those with a temperature above 37.3°C will not be allowed to donate blood and should also consult their family doctor. All blood collection sites have a pre-qualification station where the donor fills out a pre-qualification questionnaire, disinfects their hands, and each donor's temperature is measured (with a non-contact thermometer). After the initial qualification, the donor is registered and subject to the second qualification.
A erson who, among others, has not been abroad for the last 14 days, their body temperature does not exceed 37.3°C, has no symptoms of infection, is not under quarantine, epidemiological surveillance and during the last 14 days had no contact with a person with confirmed infection with coronavirus, can donate blood. Due to the current epidemiological situation, it is recommended that donors be registered for blood donation without accompanying persons. Donors waiting to donate blood maintain the necessary distance. Each blood donor receives a mask, gloves and a disposable pen. Only disposable equipment is used to collect blood and samples for testing. Donating blood, even during a pandemic, is safe. Blood donors can go to the Regional Blood Donation and Hemotherapy Centers without worrying about their health and the health of their relatives, which is necessary to successively rebuild the Centers' stocks before the epidemic [1].
The privileges of blood donors (including convalescent plasma donors) include [2][3][4]: • time off from work or school (one day) and during an epidemic or pandemic -two days (the day of donation and the following day); • reimbursement of travel expenses to the blood donor center; • discounts on public transport (33%) after three donations; • tax benefits -accounting for donating blood or blood components as a donation; • regeneration meal of 4500 kcal; • receiving free results of laboratory tests, i.e., determination of blood type A, B, 0 and Rh (receiving a blood type identification card after the third donation), complete blood count, markers for hepatitis B and C, AIDS and syphilis infection; • discounts on certain medications (for Distinguished Voluntary Blood Donors); • out-of-sequence use of health care services in the scope of inpatient health care services and specialist services in outpatient health care (Distinguished Voluntary Blood Donor).
The health benefits of blood donation include lower risk of myocardial infarction [5], better control of type 2 diabetes [6], lower blood pressure [7], lower total cholesterol, LDL cholesterol, and triglycerides [8], lower risk of cancer [9].
Due to the epidemiological situation, the new requirements for blood donations are to refrain from blood donation when there are symptoms that may indicate COVID-19 infection (fever, dry cough, runny nose, shallow breathing, shortness of breath) and to report to the blood center if similar symptoms occur up to 48 hours after donation. Additional procedures include respect of the distance and hand disinfection, mouth and nose coverings, initial temperature measurement, and completion of a questionnaire regarding travel abroad and contact with a person infected with coronavirus [1]. In addition, donors who donate blood without knowing that they are ill, and in whom, within 14 days, medical services detect COVID-19 (positive laboratory tests) are asked to report this fact to the Regional Blood Donor Center and the field branch [10].

Material and methods
The study was carried out using the diagnostic survey method, and the tool was the authors' questionnaire. The questionnaire consisted of 14 questions. The questions were related to blood donation during the pandemic. The study was conducted on

Results
Nearly 39.7% of the respondents were regular blood donors,  (Fig. 1). It was further examined whether the respondents were aware of the privileges of blood donation. Respondents most often considered "A voluntary blood donor who donates blood or its components, including plasma after COVID-19 disease, is entitled to exemption from official duties on the day they donate blood or its components and on the following day" as the true sentence (85,8%). Slightly less than half (49.7%) were aware that "Voluntary blood donors who have donated at least 3 donations of blood or its components, including plasma after COVID-19 disease are entitled to a 33% discount on travel on domestic public transport," the least number of people were aware (43.2%) that "Convalescents who donate plasma are entitled to a donation deduction for blood donation purposes."

Discussion
The influenza A virus subtype H1N1 (H1N1) pandemic had a significant impact on blood supplies due to donors' fear of exposure to the virus at a blood center [11,12]. Similarly, the COVID-19 pandemic has already led to a significant reduction in blood supplies due to the cancellation of numerous out-of-hospital and mobile blood collection events, as well as a significant reduction in the number of donors arriving at fixed blood donation centers. For example, as a result of the current pandemic and restrictions due to social distancing, nearly 4,000 American Red Cross blood donation drives have been cancelled in the United States through April 2020 [13].
Moreover, the number of eligible donors during the pandemic inevitably decreased due to the increasing number of people infected or quarantined after an exposure to infected individuals.
In addition, blood collection centers have introduced additional screening criteria, rejecting donors with travel histories due to "hot spots" of infection in the past 14 days. In the context of the pandemic, there is also increasing pressure on blood donation centers and hospital transfusion medicine services and their staff, as increasing number of workers must stay in isolation [14].
One of the major challenges ahead of us is to maintain high spirits and persistent motivation amongst the volunteer donors to keep donating blood, even during the crisis of COVID-19 pandemic. Analysis of demographic data indicates a high probability of an increased demand for blood and blood components in the future. There is a clear downward trend in the youngest group of donors (18)(19)(20)(21)(22)(23)(24), which makes us look at the future with great concern. It will become increasingly important to motivate people of all ages to donate blood and to aim for them to become regular donors, but the greatest attention should be focused on the youngest donors, as this is the group that will be able to donate blood and blood components for the longest it would be advisable to analyze the factors which demotivate women to donate blood, as currently less than 10% of women in Poland are regular donors [15]. in the future. The study showed that 87.3% of the respondents were willing to donate blood in the future. Moreover, the researchers also analyzed the effect of gender of the respondents on the willingness to donate blood in the future; however, they found no statistically significant differences [19]. The analysis of our study also showed the relationship between past and present (during the pandemic) blood donations and willingness to donate blood in the future and the education of the respondents -the respondents with higher education were the most willing to declare themselves in this aspect. Respondents' sex and place of residence had no effect on their decision to donate blood.

Conclusions
The COVID-19 pandemic is causing a shortage of blood supplies worldwide. Although there is no convincing evidence that this virus can be transmitted by transfusion, the disruption that occurs in everyday life dramatically affects the quantity of donated blood. In conclusion, COVID-19 is a pandemic crisis that needs a collaborative effort from blood donors, community, blood transfusion services, and administration. The current pandemic situation is not an obstacle to donating blood.
Blood donations should not be withheld unless there are health contraindications. The pandemic is not reducing the need for blood; in fact, the number of blood donors across the country has dropped dramatically due to the pandemic. Due to additional procedures, it is still safe to donate blood. Individuals who have symptoms suggestive of COVID-19 should refrain from donating blood.