key: cord-1035459-y83hnpkx authors: Hu, Ping; Kang, Jianxun; Li, Ying; Li, Xiaochun; Li, Meng; Deng, Min; Zhao, Yuwei; Tian, Hao; Li, Rui; Zhang, Jie; Xi, Yan; Li, Wen; Gao, Jialiang; Shan, Hua; Fu, Xuemei title: Emergency response to COVID‐19 epidemic: One Chinese blood centre's experience date: 2020-09-30 journal: Transfus Med DOI: 10.1111/tme.12719 sha: dc17a3c378cf6528958c0167ebe95ef955cb097e doc_id: 1035459 cord_uid: y83hnpkx OBJECTIVE: The COVID‐19 epidemic has caused a significant global social and economic impact since December 2019. The objective of this study was to demonstrate the emergency response of a Chinese blood centre on maintaining both the safety and the sufficiency of blood supply during large, emerging, infectious epidemics. MATERIALS AND METHODS: Early on in the outbreak of COVID‐19, the Chengdu Blood Center developed strategies and implemented a series of measures, including enhanced recruitment efforts, addition of new donation deferral criteria and notification after donation, optimisation of donor experience, development and implementation of a new coronavirus nucleic acid detection technology platform for blood screening and screening all donations for SARS‐CoV‐2 RNA to maximumly protect the safety of blood supply during a time of unclear risk. RESULTS: Starting on February 20, the immediate satisfaction rate of blood product orders in Chengdu city's clinical settings reached 100%, and there was no case of blood transfusion infection. CONCLUSION: The recent experience during the outbreak of SARS‐CoV‐2 reminded us that improvement in the areas of national and international collaborative programmes for dealing with blood availability and safety concerns during early stages of a disaster and regional and national mechanisms for timely communication with the general public on behalf of blood services should help to better prepare us for future disasters. The most immediate impact of COVID-19 was on blood availability. From January 2020, blood shortages began to occur in several parts of China. Multiple factors contributed to decreased blood availability, with the most significant factor being government-mandated extended closure of workplaces and all non-essential public places/services, as well as the call for people to stay at home to create social distancing. These measures greatly interrupted the pre-epidemic blood collection workflow, which predominantly relied on blood mobiles stationed at high-traffic public places and workplace blood drives. [15] [16] [17] [18] [19] [20] [21] In addition to the social distancing measures, which restricted potential donors' mobility, many people also had concerns of contracting the infection by going to a blood centre to donate blood. At the same time, there were media programmes encouraging the public to optimise nutrition intake to enhance immunity. This message likely unconsciously created psychological barriers for people to give blood during the epidemic. To overcome these challenges, the CBC developed a programme to maintain blood availability through enhanced recruitment efforts using media publicity, education and close coordination and cooperation between all stakeholders to achieve synergy and efficiency. we are in action" published on January 26, 2020, was the first public report about COVID-19 by a Chinese blood service and has been read more than 40 000 times. We enhanced our recruitment efforts through the use of short message service (SMS) by increasing both the number of messages and coverage area. Recruitment using mobile phone calling was also implemented. In addition, we worked closely with the city government to organise emergency group blood drives. The Sichuan Provincial Health Commission published a plea encouraging people to give blood. From January 21 to March 24, 2020, more than 670 000 recruitment-related short messages were distributed, and over 5200 recruitment phone calls were placed. Epidemiological data suggest that the main transmission route for SARS-CoV 2 is mostly through contact and droplet transmission; infected individuals with no or mild symptoms can spread the virus as well. [22] [23] [24] Protecting staff from contracting COVID-19 during the blood collection process is a priority for CBC. This is particularly critical for Chinese blood services because, typically, a region is only supported by one blood service, for example, the CBC is the only blood provider supporting Chengdu city with a population of 16 million. If staff member infection occurs and the infection spreads within a blood service, the resultant significant interruption of the blood service's functions may severely compromise an already tenuous blood supply situation. The CBC took the following measures to protect both donors and staff at donation sites: All staff members and donors were asked to wear protective face masks, and body temperature was checked before entering the collection site. Hand sanitisation was required before body temperature was taken. Reminders and barriers were set up to ensure safe physical distance between individuals in the waiting area and during the process of completing questionnaire, physical examination and blood collection. The CBC enforced strict adherence of standard operating procedures (SOPs) for site and equipment disinfection. Facility air ventilation was performed at least twice a day for not less than 30 minutes each time. Surfaces including seats, stairs, escalator handrails, workbenches, floors and instruments were wiped with chlorine disinfectant or 75% alcohol before and after work. Regular and enhanced disinfection of blood delivery vehicles was performed between each trip, especially the steering wheels, door handles and seats. The use of central air conditioning was minimised. Retraining and reminders were provided to the staff to follow established procedures for handling medical waste. An emergency treatment plan was developed for blood, secretions or vomit from individuals diagnosed or suspected of having COVID-19. For any emerging infectious outbreak, one of the challenges is how to maximally protect the safety of blood supply even when only incomplete information is available. So far, there has not been direct evi- 2. All donors were instructed to notify the CBC within 28 days after donation if they or their relatives have symptoms of COVID-19, such as fever, cough, fatigue and shortness of breath, or had been quarantined. Print instructions were provided to all donors. If a blood donor after donation reports suspected symptoms, the CBC would 1, quarantine the associated blood components; 2, retrieve blood components from clinical facilities if they were not yet transfused; and 3, quarantine the staff members exposed to the donor. The CBC followed up with these donors with phone calls. If a donor was later suspected or diagnosed with COVID-19 and the related blood components have been transfused to patient (s), reports would be filed immediately with local health authorities. From January 21 to March 24, 2020, none of the donors and staff were infected with COVID-19. A total of 14 call-back cases were investigated, and no suspected or confirmed infection was found. The CBC made the early decision to screen all donations for SARS-CoV-2 RNA when waiting for additional blood safety information to be available. A new coronavirus nucleic acid detection technology platform for blood screening was developed and quickly implemented (manuscript submitted). Between 27 January and February 29, 2020, a total of 16 287 blood donor specimens were screened, and all results were negative. Convalescent plasma therapy was among the therapeutic methods listed in the fourth edition of the COVID-19 diagnosis and treatment guidelines issued by the Chinese National Health Commission. 27 Within 48 hours of the publication of the new guidelines, the CBC completed convalescent donor testing, plasma collection and preparation. As of March 24, a total of 2800 mL of plasma from eight recovered patients has been provided to hospitals and transfused into critically ill patients. In recent years, the CBC experienced the SARS epidemic (2003), Wenchuan Earthquake (2008) and Lushan Earthquake (2011). Through these public health and natural disaster crises, the CBC has accumulated experiences and developed a system for responding to such unforeseeable challenges. [28] [29] [30] However, a preparedness plan and response to serious public emergencies always faces unexpected challenges due to the unpredictable characteristics of the new crisis. We hope to share the CBC's experiences during the SARS-CoV-2 epidemic. Protecting the availability and safety of blood is a challenge for blood services around the globe. All authors participated in COVID-19 prevention and control work. Clinical features of patients infected with 2019 novel coronavirus in Wuhan Situation update worldwide, as of Di Napoli R. Features, evaluation and treatment of coronavirus (COVID-19). 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All authors have read the manuscript and approved submission to your journal. There is no ethical/legal conflict involved in the article.