This document provides interim guidance on the management of the blood supply in response to the pandemic outbreak of coronavirus disease (COVID-19). It is intended for blood services, national health authorities, and others responsible for the provision of blood and blood components and integration of the blood system within the public health system. WHO will continue to update this guidance as new information becomes available.

This document is adapted from the WHO Guidance for National Blood Services on Protecting the Blood Supply During Infectious Disease Outbreaks1 and risk assessment publications on COVID-19 from regional networks/institutions.2

General considerations

The COVID-19 virus outbreak is primarily transmitted by the respiratory route and theoretically by transfusions. The epidemic has the potential to reduce the supply of blood and blood components and adversely affect blood system activities. Blood services should therefore take steps to assess, plan, and respond appropriately and proportionately.

The risk of transmission of COVID-19 through transfusion of blood and components is now only theoretical and likely minimal. But experience with outbreaks of other coronaviruses suggests that there will be significant impact on blood supplies through reduced blood donation

Effective and accurate data-driven risk assessment is necessary to determine the most appropriate and proportionate action, taking into consideration: a) the extent of COVID-19 spread in the country or geographical area; b) level of community circulation (limited and contained vs widespread and sustained); c) local epidemiology; d) risk of transfusion transmission in context of overall burden of disease; e) quality of health care system; f) public health response; blood supply sufficiency; g) operational impacts; and h) cost effectiveness of blood safety interventions in reducing disease morbidity in relation to the overall situation in the country.

Blood services must be prepared to move quickly in response to changes, during which blood sufficiency is most likely to be affected. A national rather than sub-national or local approach should be adopted for coherence and coordination and to ensure public confidence in blood safety and supply. Blood services should be included in the national outbreak response, through experts linked to the national emergency response team. Blood services should activate their emergency response plans. Networks of cooperating blood services across regions can help maintain the availability of blood and blood components.

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