UVALDE, Texas — Last week, hundreds of traumatized Texas residents did the same mourning ritual so many others have done in the wake of a mass shooting: They lined up to donate blood.
Sen. John Cornyn donated the first day a Uvalde blood donor center opened its doors. Members of the military drove over 300 miles from McAllen, Texas, to donate. And governor hopeful Beto O’Rourke did it too. It’s a harrowing truth: School shootings drive blood donations.
“They want to help,” Mohammed Sayed, a director at South Texas Blood and Tissue, told BuzzFeed News. “That feeling of helplessness really stinks for a lot of people.”
South Texas Blood and Tissue provides blood to people living in an area the size of Oklahoma that encompasses over 100 hospitals and clinics. Last Wednesday, the organization set up 10 beds for the steady stream of donors stopping into the Herby Ham Adult Activity Center in Uvalde to donate. Officials said they “topped off at about 800 units in a single day,” compared to the roughly 350 to 400 they see on most other days. Overall, South Texas blood banks have taken in 3,700 units since the shooting, according to a spokesperson.
But while there’s a rush to donate after shootings, it’s the blood on the shelves before the violence happens that actually saves lives in the immediate aftermath. And gun violence threatens an already low blood supply.
The Red Cross, which supplies about 40% of the nation’s donated blood and blood components, experienced the worst blood supply shortage in a decade earlier this year. Since the beginning of the pandemic, there’s been a 10% decline in blood donations, and the Red Cross has had to cancel blood drives and contend with staff shortages. There is an ongoing need for donations since red blood cells need to be used within 42 days and platelets (which help clotting) within five days.
Blood bank inventory varies throughout the country, and some regions have experienced a sharper decline than others. But typically, blood centers like to have at least three days’ supply on hand to be able to meet the estimated needs of patients. This year and last, blood banks have been closer to the one- to two-day range of on-hand stock available to donate.
“From the time somebody comes in to donate blood until the time that blood is ready to go to a patient is anywhere from one to two days,” said Kate Fry-Cicero, the CEO of America’s Blood Centers, which supplies 60% of donor blood in the US. “And so you have to be able to predict how much blood you’re going to need tomorrow to two days beforehand.”
There’s always a slump in donations in the summer because people travel and most schools are closed. But national resources have been severely tapped since the first quarter of 2021, when hospitals restarted elective surgeries that had slowed during the pandemic, Sayed said. Foot traffic in and around blood drive stations also waned as more people began to work remotely.
“A lot of the businesses and a lot of the people who we depend on to donate at these mobile drives, they’re still working from home,” Sayed said.
Tragedies related to gun wounds only exacerbate the issue. Gunshot victims are approximately five times more likely to require blood transfusions. They require 10 times more blood units and are 14 times more likely to die than people seriously injured by motor vehicles, non-gun assaults, falls, or stabbings, according to America’s Blood Centers.
The South Texas trauma experts are ramping up their response methods. After the Sutherland Springs church shooting, when 26 people were killed and 22 were injured, a group of doctors, medical professionals, and first responders in South Texas developed a trauma-response system that allows for on-site transfusions. The group worked with military professionals who had helped wounded combat unit members in Afghanistan to develop the “whole blood” transfusion process.
The process, which uses low-titer Type O whole blood from male donors, was developed to be used on site or while transporting patients in order to improve their survival rates. This type of blood is safe for most people because Type O blood is considered the “universal donor,” and “low titer” means it contains fewer antibodies that can cause patients to react to the transfusion. (Pregnancy and other factors can result in blood antibodies that can be an issue for some recipients.)
The system has been used since 2018 in emergent situations like car accidents. Last week was the first time the process was used at a mass shooting, and in the case of Uvalde, 25 extra emergency units were helicoptered in immediately following the shooting, Roger Ruiz, a spokesperson for South Texas Blood and Tissue, told BuzzFeed News.
“We feel like that probably saved the life of at least one of the injured patients,” Dr. Lillian Liao, a Texas pediatric trauma surgeon who operated on one of the Robb Elementary students, told CBS News about the “whole blood” transfusion process.
So what’s the process from blood donor to recipient anyway?
The reason why blood donated after a mass shooting event is unlikely to immediately help the injured people is that donated blood must go through a screening process that takes about 24 to 48 hours.
Donor blood is first separated into four components: plasma, red blood cells, white blood cells, and platelets. Those components are then quarantined and screened for infectious diseases including hepatitis, West Nile virus, HIV, and others. More than 12 tests are performed to identify the blood type and ensure the blood is safe. That process lasts about 18 to 20 hours. When the blood passes those tests, it’s moved out of quarantine and into inventory, where it can then be sent to any hospital.
Most hospitals have a “standing order” that they receive on weekly or daily bases but can request emergency blood if needed.
“You shouldn’t wait for a catastrophe to happen for you to come in and donate blood because emergencies happen every day for families who are being diagnosed with cancer or in a car wreck,” said Ruiz of South Texas Blood and Tissue.