title: Management of blood supplies during an influenza pandemic.
abstract: BACKGROUND
  Blood supplies are delicate resources, particularly vulnerable to incidents affecting the health of donors. The critical impact of a pandemic on the availability of red blood cells (RBCs) has been demonstrated in previous research; however, a detailed estimate of the expected deficit is missing. This has become a priority issue in the face of the current influenza pandemic.
  
  
  METHODS
  Data from several major blood donation services were used to analyze management of blood supplies in Germany. Routine management of RBCs was extrapolated to epidemic and pandemic situations using computer simulations with a mathematical model that allows for analysis of deficits in blood supplies.
  
  
  RESULTS
  Routine management and distribution of RBCs are driven by supply, which has marked fluctuations but does not appear to have seasonality. There seems to be a remarkable elasticity in the demand for RBCs that helps to mitigate minor crises in supply, but this is likely to be overstretched during a severe pandemic.
  
  
  CONCLUSIONS
  The supply-driven management of RBCs in Germany implies that assessment of severity of shortages due to a pandemic depends on detailed knowledge about the fraction of transfusions that do not allow for postponement. Pandemic preparedness should include criteria for prioritization of transfusions.
authors.affiliation: Section of Biostatistics, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany. kamch@pei.de
authors.forename: Christel
authors.initials: C
authors.lastname: Kamp
authors.forename: Margarethe
authors.initials: M
authors.lastname: Heiden
authors.forename: Olaf
authors.initials: O
authors.lastname: Henseler
authors.forename: Rainer
authors.initials: R
authors.lastname: Seitz
mesh_terms: D000293:Adolescent; D000328:Adult; D001771:Blood Banks / Q000592:standards / Q000706:statistics & numerical data*; D001782:Blood Donors / Q000706:statistics & numerical data / Q000600:supply & distribution; D002648:Child; D002675:Child, Preschool; D002959:Civil Defense / Q000379:methods / Q000706:statistics & numerical data; D003198:Computer Simulation; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D017707:Erythrocyte Transfusion / Q000592:standards / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007251:Influenza, Human / Q000097:blood* / Q000517:prevention & control*; D008875:Middle Aged; D015233:Models, Statistical; D012621:Seasons; D055815:Young Adult