• R Swanevelder, P-L Wessels, V J Louw, A Swarts, M Lennards, and K Van den Berg.
• Medical Division, South African National Blood Service, Roodepoort, South Africa.
• S. Afr. Med. J. 2024 Nov 4; 114 (11): e2001e2001.

BackgroundThe COVID-19 pandemic, first reported in December 2019, affected every sector of every country worldwide. Health services were the first to experience the direct impact. Blood services were advised to decrease blood utilisation in anticipation of reduced blood collections. The South African National Blood Services (SANBS) saw a substantial decline in blood demand following the institution of strict national lockdown measures, but the impact of the epidemic and various mitigation strategies remained unknown.ObjectiveThis retrospective study reviews red blood cell (RBC) utilisation during a 4-year period from 2019 to 2022 in the South African (SA) population, stratified by public and private healthcare sectors.MethodsTo measure the impact of COVID-19, blood utilisation pre COVID-19 was compared with an acute COVID-19 period and a post-acute period. Each period covered 450 days. Blood utilisation was evaluated against the background of reported COVID-19 cases and national lockdown regulations.ResultsWith the onset of the COVID-19 pandemic, overall RBC utilisation dropped by ~17%. The initial decline was more pronounced in the public sector. Overall, utilisation recovered to pre-COVID-19 levels in the post-acute COVID-19 period, but at different rates in the public and private sectors.ConclusionThere was a significant change in RBC utilisation during the course of the COVID-19 pandemic, much more pronounced in the public sector, which services 85% of the SA population. During the post-acute COVID-19 period, blood utilisation recovered, but at a much slower rate in the public sector. The COVID-19 pandemic accentuated the differences in blood utilisation patterns between the public and private healthcare sectors in SA, and each sector's resilience in adapting to the challenges of the epidemic.

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