|Credit WHO/O. O’Hanlon|
Here in the United States recovered COVID-19 survivors are encouraged to donate plasma for convalescent therapy trials, and – due to ongoing concerns about blood shortages – are generally allowed to donate blood after it has been at least 14 days since their last COVID symptoms (including fever, cough and shortness of breath).
The CDC monitors and reports on their Multistate Assessment of SARS-CoV-2 Seroprevalence in Blood Donors, and in their latest report (Nov 13th) state:
There have been no reported cases of people getting SARS-CoV-2, the virus that causes COVID-19, from a blood transfusion. Generally, respiratory viruses such as SARS-CoV-2 are not spread by blood transfusion.
Even so, people who want to donate blood are evaluated for any current or past illness. If they are ill at the time of donation, they cannot donate blood. For example, they must have normal body temperature on the day of donation. See FDA recommendations for blood donation among persons diagnosed with or suspected to have COVID-19 for more information.
The blood establishment’s responsible physician must evaluate the prospective donor and determine eligibility (21 CFR 630.5). The responsible physician may want to consider the following:
- individuals diagnosed with COVID-19 or who are suspected of having COVID-19, and who had symptomatic disease, refrain from donating blood for at least 14 days after complete resolution of symptoms,
- individuals who had a positive diagnostic test for SARS-CoV-2 (e.g., nasopharyngeal swab), but never developed symptoms, refrain from donating at least 14 days after the date of the positive test result,
- individuals who are tested and found positive for SARS-CoV-2 antibodies, but who did not have prior diagnostic testing and never developed symptoms, can donate without a waiting period and without performing a diagnostic test (e.g., nasopharyngeal swab).
Other countries have adopted different rules on blood donations, their time and rationale for ending isolation or quarantine, and their definition of `recovered’ from COVID – but despite these differences – most fall fairly close together.
Which makes the following announcement from China’s National Health Commission two days ago a bit of an outlier, in that buried deep in the announcement is the order to refrain from accepting blood donations from COVID-19 survivors for at least 6 months.
It is a long, detailed, and tedious document that specifies everything from blood storage, transportation and supply to the clearing of door handles, staircase handrails, elevators and buttons and other facilities or devices.
I’ve only included the pertinent excerpt, so follow the link to read the full document if you are inclined.
Notice on the issuance of guidelines for the prevention and control of the new crown pneumonia epidemic in blood stations in autumn and winter
Release time: 2020-11-17 Source: Medical Administration and Hospital Authority
National Health Office Medical Letter ( 2020) No.930
2. In the supplementary consultation content, if the blood donor has experienced any of the following conditions, it is recommended to postpone blood donation, and the postponement time is at least 28 days after the end of the relevant conditions:
( 1) I have fever or respiratory symptoms;( 2) Have had close contact with persons or patients with fever or respiratory symptoms;( 3) There has been a history of contact or epidemiological association with people infected with the new coronavirus or clustered patients;( 4) Recent residence history abroad or in high-risk areas;( 5) Have received influenza or new coronavirus vaccination .It is recommended that common conditions such as occasional coughing should be screened during health consultations.
3. For those who have been diagnosed with new coronavirus infection, they will temporarily refuse to donate blood within 6 months after being cured and discharged.
The following notice, published today in China Youth Daily, has been appearing across Chinese state media the past 24 hours.
The National Health Commission issued a notice yesterday (November 17) to issue the “Guidelines for Prevention and Control of New Coronary Pneumonia Epidemics in Blood Stations in Autumn and Winter”. The “Guidelines” stipulate that for people who have been diagnosed with new coronavirus infection, they should temporarily refuse to donate blood within 6 months after being cured and discharged. The temperature of each blood donor is measured and accurately recorded. If the blood donor has a body temperature of ≥37.3℃, the staff should inform the blood donor to postpone blood donation, arrange for him to leave the consultation site, and remind the blood donor to go to the designated fever clinic in time.
It isn’t clear what evidence (if any) they have to support this strict and highly conservative approach. And given the extremely limited number of new cases reported by China over the last 6 months, this would hardly seem to be a big concern.
China, admittedly has a very low tolerance for COVID-19 risk after finally getting their epidemic under control last spring, and has not shied away from drastic, and oft times draconian, measures to prevent and contain further spread of the virus.
China has previously required a 14-day home quarantine following release from the hospital with COVID, and has repeatedly locked down and tested millions of people following the detection of even a handful of new cases (see Beijing Cancels Hundreds Of Flights & Reports 31 New COVID-19 Cases).
It seems likely that the risk of transmission via the blood supply after 14 days is incredibly small, but not zero. With the virus raging in Europe and North America, any contribution to the epidemic from the blood supply would be both insignificant, and probably undetectable.
But in China, where – if their surveillance and reporting is to be believed – community transmission of the virus is very rare, I suppose even one or two infections via the blood supply could risk restarting their epidemic.
This is likely more of a reflection of how fragile China’s control of the virus truly is, and how much they fear the introduction and spread of the (presumably) more transmissible COVID strains that have emerged globally over the past 6 months.
While China, Taiwan, Hong Kong, Japan, South Korea, and several other Asian nations have managed to keep community transmission relatively in check, the real test comes this winter, and already we are seeing some cracks appear in South Korea and Japan.