ABSTRACT
Background: It's more than 2 years since the strike of a COVID-19 pandemic caused by severe acute respiratory syndrome Coronavirus 2. It had infected nearly 400 million populations globally and affected several important sectors worldwide such as the economy, social and healthcare services. To date, Malaysia recorded more than 3 million confirmed cases of COVID-19. The first nationwide Movement Control Order (MCO) started on 18th March 2020 then followed by multiple series of targeted MCOs on several states with a high surge up of cases. The National Blood Center (NBC) and State Blood Transfusion Services (SBTS) experienced significant reduction of blood collection, the shortage of blood availability and supply. The total blood collection in the year 2020 was 655,069 units, showing a 12% reduction compared with the year 2019. Blood supply management requires an integrated and holistic planning from all stakeholders to ensure the judicious use of blood and blood components in the normal situations, pandemics, crises, or during blood shortages. Aims: This study was to determine the characteristic of blood components mobilized during the COVID-19 Pandemic and to assess the coordination of inter-regional blood availability, supply, and transportation between the blood inventory of NBC, SBTS, or Hospital Blood Bank. Methods: A retrospective study was conducted from 18th March 2020 until 18th August 2021 where multiple series of MCOs were instated. Data from the blood inventory during the 18 months were analysed. All data were retrieved from Blood Bank Information System from NBC and SBTS. Results: A total of 17,144 units of blood components have been mobilized and distributed, comprised of 15,591 units of red cell, 1107 units of platelet concentrates, 299 units of Fresh Frozen Plasma, 125 units of Cryoprecipitate and 22 units of Convalescent Plasma. Overall, there were 20 blood collection centers comprised of NBC, state hospitals, and major hospitals involve as blood providers to the (Table Presented) several affected blood collection centers, beyond the state border. The states with major contributions for blood component mobilization were Kuala Lumpur, Sarawak and Johor while the collection centres that provided the most blood were National Blood Centre (4542 bags), Sultanah Aminah Hospital in Johor (1714 bags) and Malacca Hospital (1630 bags). The blood products have been shipped via hospitals' land transportation, air transportation by courier service and collaborative mercy flight by the Malaysian Air Force to the Malaysia East. The validated blood packaging and transportation procedure have been implemented to preserve the blood cold chain during blood mobilization through the air or by land transportation. Summary/Conclusions: The challenges during a pandemic are to deliver adequate, safe, and quality blood to the patient who needs blood transfusion for life-saving. Dynamic inter-state blood availability, supply and mobilization are essential to overcome the shortfall during a pandemic. Effective communication among NBC, SBTS, interagencies, governmental organizations, and postal service companies were among the great factors of success in transporting blood beyond borders to ensure blood availability. The plan was designed in response to the threat to the national blood supply from any untoward events that lead to blood shortages in a state, regional, or nationwide in Malaysia.
ABSTRACT
Background: COVID-19 is an emerging infectious disease, caused by a novel coronavirus, now named SARS-CoV-2. It emerged in Wuhan city, Hubei province, China in December 2019 and continued peaking thereafter. There were only a few available antiviral treatments, which have limited efficacy on COVID-19 during the initial stage of the pandemic, which urged us to look into the use of convalescent plasma (CP) as an option Historically, CP had been applied to improve the survival rate of patients during various viral epidemics, including SARS, MERS, influenza and Ebola virus disease. It may also be a potentially effective treatment strategy for COVID-19 disease. Aims: This paper illustrated our experiences and strategies with regards to the development of the guideline for collection, processing and use of convalescent plasma (cp) for experimental treatment of covid-19. Methods: This guideline was created by a working group at the National Blood Centre Kuala Lumpur (NBCKL) with the collaboration of infectious disease (ID) experts from Sungai Buloh Hospital, who carefully examined the evidence and the combinations before suggesting the intervention. Results: The development of the guideline involved few phases. These include identification of the problem, systematic literature review for evidence on the guidelines, translation of evidence into a clinical practice guideline and finally, reviewing and submission of the guideline for publication to the Ministry of Health (MOH), Malaysia. Summary/Conclusions: In conclusion, we managed to publish the guideline for CP therapy as a potential treatment for COVID-19. The published guideline was readily assessable on the MOH website. It was a great collaboration between the transfusion and the infectious disease fraternity had made this possible.