While there's a constant need for blood in the United States, COVID-19 has caused blood donations to plummet. Not okay. Here's everything you need to know about donating blood (and plasma) during the coronavirus pandemic and after.

By Korin Miller
May 11, 2020
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In mid-March, the American Red Cross made a disturbing announcement: Blood donations had plummeted due to COVID-19, sparking concerns of a blood shortage across the country. Unfortunately, there is still a shortage in some areas.

"It's a scary situation," says Andrea Cefarelli, senior executive director of the New York Blood Center. "It's a little different in each area of the country but, in New York, our inventory is down to emergency levels. There's quite an urgent need for blood to build up stockpiles."

Why such a shortage? For starters, in non-pandemic times, only about 3 percent of the U.S. population eligible to donate blood actually does it, says Kathleen Grima, M.D., executive medical director of the American Red Cross. And as of recently, blood donations have dropped drastically because many community blood drives have been canceled due to coronavirus protection measures (more on that below).

Plus, you can't stockpile blood for long periods of time. "There's a constant need for blood and it must be continually replenished since [these] products have a limited shelf life and expire," says Dr. Grima. The shelf life of platelets (cell fragments in blood that help your body form clots to stop or prevent bleeding) is only five days, and the shelf life of red blood is 42 days, says Dr. Grima.

As a result, doctors at many medical centers and hospitals are getting worried. This combination of factors caused a loss of "thousands of units" of blood and blood products, which has "already challenged the blood supply for many hospitals," says Scott Scrape, M.D., medical director of transfusion medicine and apheresis at The Ohio State University Wexner Medical Center. While some hospitals are OK on blood supply at the moment, that can quickly change, says Emanuel Ferro, M.D., a pathologist and director of the Blood Bank, Donor Center, and Transfusion Medicine at MemorialCare Long Beach Medical Center in Long Beach, Calif. "Many surgery centers are planning to re-open for procedures that have been canceled and, because of that, we're going to see an increased need for blood products," he says.

This is where you come in. The Food and Drug Administration (FDA) has continued to encourage people to donate blood during the pandemic, and while many blood drives have been canceled, blood donation centers have stayed open during the pandemic and are happily accepting donations.

Still, you probably have some concerns about going anywhere in public—even if you're doing something good for humanity, like donating blood. Here's what you need to know about what, exactly, you can expect before, during, and after you donate blood, blood donation requirements and disqualifications, plus how it's all changed due to COVID-19.

Blood Donation Requirements

If you're wondering "can I give blood?" the answer is probably "yes." That said, while most people can give blood with no problem, there are some restrictions in place.

The American Red Cross lists the following as basic requirements for donating blood:

  • You're in good health and feeling well (if you think you have a cold, the flu, or something similar, the American Red Cross recommends canceling your appointment and rescheduling for at least 24 hours after your symptoms have passed.)
  • You're at least 16 years old
  • You weigh at least 110 pounds
  • It's been 56 days since your last blood donation

But these basics are slightly different if you tend to donate more regularly. For women who donate up to three times a year, the American Red Cross also requires you're at least 19 years old, at least 5'5" tall, and weigh at least 150 pounds.

The height and weight restrictions aren't arbitrary. A unit of blood is about a pint, and that's what's removed during a whole blood donation, regardless of your size. "The weight limit is to assure that the donor can tolerate the volume that is removed and that it is safe for the donor," explains Dr. Grima. "The smaller the donor, the greater proportion of their total blood volume is removed with blood donation. More stringent height and weight requirements are in place for teenage donors because they are more sensitive to volume changes."

Also worth noting: There is no upper age limit for donating to the American Red Cross, adds Dr. Grima.

Blood Donation Disqualifications

But first, a quick FYI: In early April, the American Red Cross announced that due to “the urgent need for blood during the pandemic,” certain donor eligibility criteria put forth by the FDA will be updated to hopefully allow for more donors. While it’s not yet official when the new criteria will go into effect, a representative of the American Red Cross told Shape that it'll likely be in June.

You have low iron levels. While the American Red Cross doesn't ~actually~ check your iron levels before you donate, the organization's staff does check your hemoglobin levels with a finger stick test. Hemoglobin is a protein in your body that contains iron and gives your blood its red color, explains the American Red Cross. If your hemoglobin levels are lower than 12.5g/dL, they'll request that you cancel your appointment and come back when your levels are higher (typically, you can boost them with an iron supplement or by eating iron-rich foods like meat, tofu, beans, and eggs, but Dr. Ferro says you'll want to talk to your doctor at that point for guidance). (Related: How to Get Enough Iron if You Don’t Eat Meat)

Your travel history. You also can't donate if you've traveled to a malaria-risk country in the past 12 years, according to the American Red Cross. This will be changing to three months in the near future when the organization implements the new eligibility criteria for malaria in June.

You're on medication. Most people can give blood when they're taking medication, but there are some medications that may require you wait to donate. (Check out the Red Cross' medication list to see if yours applies.)

You're pregnant or just gave birth. Also, pregnant women can't give blood due to concerns that it may take necessary blood away from the mom and fetus, says Dr. Ferro. However, you can give blood if you're breastfeeding—you just need to wait six weeks after giving birth, when your body's blood levels should be back to normal, he says.

You use IV drugs. IV drug users also can't give blood due to concerns about hepatitis and HIV, according to the American Red Cross.

You're a man who has sex with men. It's a controversial policy (and one that the American Red Cross recognizes is controversial), but men who have had sex with other men are required to wait a year after their last sexual encounter before donating due to concerns over HIV, hepatitis, syphilis and other bloodborne diseases, per the Human Rights Campaign. (Worth noting: The FDA just lowered that timeframe to three months, but it may take time for blood donation centers to revise their policies.) However, women who have sex with women are eligible to donate without a waiting period, says the American Red Cross.

You just got a non-regulated tattoo or piercing. Wondering if you can donate if you have a tattoo? It is OK to give blood if you recently got a tattoo or piercing, with some caveats. The tattoo needs to have been applied by a state-regulated entity using sterile needles and ink that is not reused, according to the American Red Cross. (It's all due to hepatitis concerns.) But if you got your tattoo in a state that doesn't regulate tattoo facilities (like D.C., Georgia, Idaho, Maryland, Massachusetts, New Hampshire, New York, Pennsylvania, Utah, and Wyoming), you need to wait 12 months. Good news: This wait will also change to three months when blood collection organizations implement the recently released new eligibility criteria. Piercings, which also come with hepatitis concerns, need to be done with single-use instruments. If that wasn't the case for your piercing, you'll need to wait 12 months until you can donate.

You have a chronic health condition. Having certain health conditions, like particular forms of cancer, hepatitis, and AIDS, will also impact your ability to donate. However, the American Red Cross says that people with most chronic health conditions such as diabetes and asthma are OK, as long as your condition is under control and you meet other eligibility requirements. Ditto if you have genital herpes.

You smoke weed. Good news: You can donate blood if you smoke weed, as long as you meet the other criteria, says the American Red Cross. (Speaking of chronic health problems, here's what you need to know about immune deficiencies and COVID-19.)

What to Do Before Donating Blood

Luckily, it's pretty simple. Your local blood donation center will make sure you meet all of the requirements through a simple questionnaire, says Cefarelli. And you'll need to have your ID, like a driver's license or passport, with you.

As for what to eat before donating blood? It's also a good idea to eat iron-rich foods like red meat, fish, poultry, beans, spinach, iron-fortified cereals, or raisins before donating blood, according to the American Red Cross. "This builds up red blood cells," explains Don Siegel, M.D., Ph.D., director of the division of Transfusion Medicine and Therapeutic Pathology at the Hospital of the University of Pennsylvania. Iron is necessary for hemoglobin, which is a protein in your red blood cells that carries oxygen from your lungs to the rest of your body, he says. (FYI: It's also what a pulse oximeter is looking for when it measures your blood oxygen levels.)

"When you donate blood, you're losing iron in your body," says Dr. Siegel. "To make up for that, eat iron-rich foods in the day-or-so before you donate." Maintaining proper hydration is also important. In fact, the American Red Cross recommends drinking an extra 16 oz of water before your appointment.

For the record: You do not need to know your blood type in advance, says Dr. Grima. But you can ask about it after you donate and the organization can send you that information later on, adds Dr. Ferro.

What Happens While You're Donating Blood?

How does it work, exactly? The process itself is actually pretty simple, says Dr. Siegel. You'll be seated in a chair while a technician inserts a needle into your arm. That needle empties into a bag that will hold your blood.

How much blood is donated? Again, a pint of blood will be taken, regardless of your height and weight.

How long does it take to donate blood? You can expect the donation part to take between eight to 10 minutes, according to the American Red Cross. But all in all, you should expect the entire donation process to take about an hour, start to finish.

You don't have to sit there and stare at the wall while you donate (although that's an option)—you're free to do whatever you want while you donate, as long as you sit relatively still, says Cefarelli: "You can read a book, use social media on your phone…the donation uses one arm, so your other arm is free." (Or, hey, it's a great time to try meditating.)

What Happens After You Donate Blood?

When the donation process is over, the American Red Cross says you can have a snack and a drink and hang out for five to 10 minutes before going about your life. But are there any blood donation side effects or other things to take into consideration?

Dr. Siegel recommends skipping exercise for the next 24 hours and taking a pass on alcohol for that amount of time, too. "It can take a bit of time for your body to adjust before your blood volume goes back to normal," he says. "Just take it easy for the rest of that day." As part of its natural protection, your body springs into action to make more blood after you donate, explains Dr. Ferro. Your body replaces the plasma within 48 hours, but it can take four to eight weeks to replace the red blood cells.

"Leave the bandage on for a couple of hours before removing it, but wash your arm with soap and water to remove the disinfectant to prevent itching or a rash developing," says Dr. Grima. "If the needle site starts to bleed, hold your arm up and compress the area with gauze until the bleeding stops."

It's a good idea to drink an extra four 8-ounce glasses of fluid afterward, says Dr. Grima. The American Red Cross also recommends having iron-rich foods again after you donate. You can even take a multivitamin that contains iron after you donate to replenish your iron stores, says Dr. Grima.

If you feel faint, Dr. Grima recommends sitting or lying down until the feeling passing. Drinking juice and eating cookies, which increases your blood sugar, can also help, she says.

Still, you should be good to go with no issues after donating. It's "very rare" that you would have some kind of health issue afterward but Dr. Siegel recommends calling your doctor if you feel lethargic, as this could be a sign of anemia. (Speaking of which, anemia might also be the reason you're bruising easily.)

What About Donating Blood During Coronavirus?

For starters, the coronavirus pandemic has led to a lack of blood drives. Blood drives (often held at colleges, for example) were canceled across the country after the pandemic hit, and that was a huge source of blood, especially among young people, says Cefarelli. As of now, many blood drives are still canceled until further notice—but, again, donation centers are still open, says Cefarelli.

Now, most blood donations are done by appointment only at your local blood center to try to help maintain social distancing, says Cefarelli. You do not need to get tested for COVID-19 before donating blood, but the American Red Cross and many other blood centers have started incorporating additional precautions, says Dr. Grima, including:

  • Checking the temperature of staff and donors before they enter a center to make sure they are healthy
  • Providing hand sanitizer for use before entering the center, as well as throughout the donation process
  • Following social distancing practices between donors including donor beds, as well as waiting and refreshment areas
  • Wearing face masks or coverings for both staff and donors (And if you don't have one yourself, check out these brands making cloth face masks and learn how to DIY a face mask at home.)
  • Emphasizing the importance of appointments to help manage the flow of donors
  • Increasing enhanced disinfecting of surfaces and equipment (Related: Do Disinfectant Wipes Kill Viruses?)

Right now, the FDA is also encouraging people who have recovered from COVID-19 to donate plasma—the liquid part of your blood—to help develop blood-related therapies for the virus. (Research is specifically using convalescent plasma, which is an antibody-rich product made from blood donated by people who have recovered from the virus.) But people who never had COVID-19 can also give plasma to help burn, trauma, and cancer patients.

When you do a plasma-only donation, blood is drawn from one of your arms and sent through a high-tech machine that collects the plasma, according to the American Red Cross. "This blood enters an apheresis machine that spins down your blood [and] removes plasma," says medical technologist Maria Hall, a specialist in blood banking technology and manager of the lab section at Baltimore's Mercy Medical Center. Your red blood cells and platelets are then returned to your body, along with some saline. The process takes just a few minutes longer than donating whole blood.

If you're interested in donating blood or plasma, contact your local blood center (you can find one near you by using the American Association of Blood Banks donation site finder). And, if you have any additional questions about the process of donating blood or safety precautions an individual donation site is taking, you can ask then.

"There is no known end date in this fight against coronavirus" and donors are needed to make sure blood and blood products are available for people in need, now and in the future, says Dr. Grima.

The information in this story is accurate as of press time. As updates about coronavirus COVID-19 continue to evolve, it's possible that some information and recommendations in this story have changed since initial publication. We encourage you to check in regularly with resources such as the CDC, the WHO, and your local public health department for the most up-to-date data and recommendations.

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