Blood donations are at dangerously low levels. Red Cross says the impact could be dire.

The American Red Cross announced Monday the organization faces a blood shortage so severe it cannot provide enough blood to some hospitals that need it for patients.

The Washington D.C.-based nonprofit, which collects and distributes about 40% of the nation's blood donations, said the emergency shortage means some patients may get less blood than they need or hospitals may struggle to find suitable matches for patients with rarer blood types.

"In more extreme situations," said Eric Gehrie, executive medical director for the American Red Cross, shortages may result in "cancellation of surgeries," including heart surgeries when hospitals and doctors don't believe they have enough blood to safely operate.

This isn't the first time the Red Cross has called on the public to replenish ebbing blood donations to head off shortages. Last summer, the Red Cross warned that blood supplies were critically low when storms and vacation travel disrupted normal collections. During the COVID-19 pandemic, the Red Cross said the shortage of donations had reached a crisis.

Other blood donation organizations also report inventories are running low but they stopped short of calling the situation an emergency. The organizations say this is a more challenging era for collecting blood due to changes since the pandemic. Employer-based blood drives are becoming a less robust source of blood donations as more Americans work from home. And fewer high schools and colleges are holding blood drives for eligible students, experts say.

"The pandemic has really taken a toll on our blood donations," said Christine Foran, director at New York Blood Center, which supplies hospitals in New York City and surrounding communities. "Society has changed."

COVID-19 pandemic drains blood donations

The Red Cross describes the shortage as an emergency because it has the potential to disrupt care, officials said.

"Emergency means that hospitals are requesting blood from the American Red Cross," Gehrie said. "And we don't have enough blood to meet their patients' needs."

In 2023, the Red Cross collected nearly 4.4 million blood and more than 1 million platelet donations from more than 2.4 million donors. The organization supplied 6.2 million blood products to 2,500 hospitals. In 2022, the organization's tax filing showed it collected "biomedical services" revenue of nearly $1.9 billion on expenses or more than $2 billion.

The Red Cross has about 300,000 fewer donors than it did in 2019, before the COVID-19 pandemic, Gehrie said.

The organization's donations are at their lowest level in 20 years and have become especially strained in the new year. Red Cross and other blood collection centers typically see blood inventories shrink in January. Donors are often busy during the holidays and may have little extra time to donate. And respiratory viruses such as the flu and COVID-19 ramp up during the winter, keeping some donors home while they recover.

Red Cross said it's had about 7,000 fewer blood units than needed in the past couple of weeks. That shortage means hospitals must rely on their own blood banks to fill that gap.

Hospitals will need more blood throughout the month and supplies will be stressed because of the winter lull in donations, Red Cross officials said.

Independent blood collectors report thin supplies

America's Blood Centers is a nonprofit representing more than 600 independent sites that handle up to 60% of the nation's blood donations.

Kate Fry, CEO of America's Blood Centers, acknowledged blood "inventories are not at levels we'd like to see."

The Washington D.C.-based organization said about 1 in 3 collection sites have less than a two-day supply of blood. Just 7% of centers have enough blood to meet normal medical demands. These centers have at least a three-day supply of blood products.

It typically takes 24 to 36 hours to test and process a new blood donation to make sure it's ready for a hospital to use, Fry said. That's why donation centers typically like to have enough blood on hand for at least three days of what a hospital might need for emergency care and scheduled operations. Anything less is cutting it close for doctors and patients.

Still, Fry said blood collection centers for decades have anticipated a supply crunch during January, designated in 1970 as National Blood Donor Month. It's the longer-term challenges that have flummoxed blood donation organizations.

She said about 3% of eligible people donate blood each year even though studies show 62% of the population is eligible. Donations from people under the age of 50 are particularly low.

Corporate blood drives provided up to 30% of donations for the America's Blood Center collection sites before the COVID-19 pandemic, but those job-based blood drives have slowed because so many companies allow remote work, Fry said.

"It's really hurting blood donation," Fry said.

Blood drives at high schools and colleges that attract teen and young adult donors have generated 20% to 30% of donations. she said. While these school drives slowed when the pandemic lockdowns kept students at home, Fry said they are starting to rebound.

Foran, of New York Blood Center, said while high school donations are on the upswing, they are still not to the levels before 2020. The New York center could rely on about 75,000 blood units from high school students before the pandemic. School collections are about half that amount now, Foran said.

Diverse donors, blood types and platelets needed

Supplies of different types of blood – A, B, O and AB – vary by region of the country.

Foran said her group has shortages of B-negative and O-negative, which is known as the universal blood type and the most commonly transfused when a patient's blood type is unknown. Just 7% of the population has O-negative blood.

The Red Cross's Gehrie said nearly every hospital needs Type O blood and platelets.

The emergency announcement is, in part, a plea for the public to step up and donate.

"One of the main hopes we have from this public outreach is to be able to increase our inventory of group O red cells and platelets," Gehrie said.

Blood donation groups said they need more donors from non-white communities. Communities of color generate about 20% of blood donations, Fry said. In addition to the major blood types, there are hundreds of antigens for red blood cells, some of which are unique to racial and ethnic groups. Some patients who need frequent transfusions to treat hereditary diseases such as sickle cell are more likely to build antibodies, and such patients are more likely to need a more precise blood match, Fry said.

"We can really find that precise (match) from somebody of a similar ethnic background to the patient," Fry said.

Blood banks also need platelet donations. Cancer patients undergoing chemotherapy can have low red blood cell and platelet counts.

Where can I donate blood?

People who want to donate blood must be in good health and meet weight and height requirements. People must be 17 or 16 with parental consent and weigh at least 110 pounds. People can be excluded if they are sick, taking antibiotics, have a high fever, or due to other medical factors,

Eligible donors can contact these organizations:

◾ Association for the Advancement of Blood & Biotherapies, www.WhereToDonateBlood.org 301-907-6977

◾ America’s Blood Centers, www.americasblood.org, 202-393-5725

◾ American Red Cross, www.RedCrossBlood.org,1-800-733-2767

Ken Alltucker is on X, formerly Twitter, at @kalltucker, or can be emailed at alltuck@usatoday.com.

This article originally appeared on USA TODAY: Red Cross on alert as blood donations are at dangerously low levels