The American Red Cross, which is responsible for nearly half of the U.S. blood donation, has declared an emergency blood shortage as of December 2024. A stocked blood supply is essential, often meaning the difference between life and death for patients undergoing surgeries, suffering traumatic injuries from car accidents, experiencing childbirth complications, or battling chronic illnesses like cancer or severe anemia. Every two seconds, someone in the U.S. is in need of a blood transfusion. Yet, despite this constant demand, the number of people donating blood through the Red Cross has dropped by 40% over the last 20 years. This means that in the early 2000s, approximately 4.67 million more donations were being made to the Red Cross. Historically, blood donations decline during colder months as seasonal respiratory illness, like the flu, reduce donor turnout but, with the addition of COVID-19, even fewer people are turning out to donate. Moreover, COVID-19 has made more people embrace remote work, making it harder to meet people where it would be convenient to donate.

U.S. South Region Blood Supply February 2025 Report prepared by America’s Blood Centers and summarized using https://BioRender.com by Erika Bowen. This highlights 7 of 12 blood centers that are in need of donations. This includes Arkansas, Louisiana, Mississippi, Alabama, Tennessee, Georgia, Florida, South Carolina, North Carolina, and Virginia.

Because winter blood donations are consistently low every year, there is now a heavy reliance on donations during the warmer months. Unfortunately, now even these months are seeing a drop in donor turnout, further straining the blood supply. Just in July 2024 the Red Cross reported a 25% inventory decrease due to heat waves and seasonal hurricanes creating low turn out for blood drives or cancellations of blood drives altogether. Particularly in the south, we are facing a serious blood supply crisis, as shown in the latest South Region Blood Supply report below. According to the data, 12 blood centers in the region account for 25% of the national blood supply, yet 3 of these centers have only a 1-day supply or less: a dangerously low level that puts patients at immediate risk. The distribution of supply levels is also concerning: 25% of blood centers are at critical levels (0-1 day of supply), 33% have only 1-2 days’ worth, and just 25% have a safer supply of 3 or more days. Recent events have exacerbated this crisis. In 2024, Hurricanes Helene and Milton devastated parts of the Southeast, leading to the cancellation of over 100 blood drives and leaving thousands of vital blood donations uncollected. These disruptions have significantly strained the blood supply, making the need for donations even more critical.

Backing the Red Cross’ plea for donations, America’s Blood Centers (ABC) and Blood Centers of America (BCA), which supply most of the remaining U.S. blood donations, have reported similar dangerous shortages. The Association for the Advancement of Blood & Biotherapies (AABB), which summarizes these 3 institutions’ blood supply levels, shows in a real-time graph on their website that O- and O+ blood supply is at a critically low level.

But other than being told by the American Red Cross emergency announcement, how can we as everyday people understand why being low on O- and O+ blood is dangerous? Also, why does AABB seem to only track O+ and O- blood when there are all kinds of other types out there? The answer lies in the science of blood donation: how blood types work, why some are more in demand than others, and what makes O- so essential in emergencies.

The Science Behind Blood and Donations

Other than being a surprise guest that makes some people suddenly find the floor interesting, blood serves as the body’s delivery system carrying oxygen, nutrients, and protection to where they’re needed while also taking away waste to keep everything running smoothly. For these different purposes, blood is composed of four main things: plasma, red blood cells, white blood cells, and platelets.

Red blood cells directly determine a person’s blood type, which is a way to categorize blood based on special markers or features of an individual’s red blood cells. Typically, a person’s blood type can be given one of eight designations: A-, A+, B-, B+, AB-, AB+, O+, and O-. But why do these different blood types exist in the first place? Humans have different blood types due to their role in disease resistance. While white blood cells fight infections, red blood cells also contribute to this defense. Certain blood types offer protection against specific infections, helping populations survive over time. If we all had the same blood type, a single disease could wipe out entire populations more easily. The genetic differences in blood type frequencies across ethnic groups shown in the table below further highlight how red blood cells have evolved in response to regional disease pressures. Since different parts of the world have been home to different infectious diseases, natural selection has shaped the distribution of blood types to offer protection against local threats.

You can think of antigens or special red blood cell type markers like tickets to a UGA football game at Sanford Stadium; they determine whether you belong inside and what section you can sit in. Your immune system acts like stadium security, checking tickets to make sure only the right fans, or red blood cells, get in.

• If you have antigen A (blood type A), it’s like having a ticket for the lower level seating.
• If you have antigen B (blood type B), you’re in the upper level seating.
• If you have both antigens (blood type AB), you can sit on either level.
• If you don’t have either antigen (blood type O), you have a general admission ticket and can sit anywhere you like.

Fans within the upper level, A and AB, and fans within the lower level, B and AB, can mix together without any issues, but those with tickets to only the upper level, A, and tickets to only the lower level, B, wouldn’t mix; just like how someone with type A blood cannot receive type B blood, and vice versa. Stadium security, or your immune system, would recognize them as being in the wrong section and kick them out to maintain order.

In addition to these seating rules, stadium security (your immune system) has specific enforcers assigned to different sections. Just like A antibodies attack A antigens, B antibodies attack B antigens, and so on, security teams are trained to spot and remove anyone who doesn’t belong. If a fan tries to enter a section they don’t have a ticket for, security will quickly escort them out just like how your immune system attacks and removes mismatched blood cells. This strict enforcement is always present to keep everything in order and ensure that only the right red blood cells (or fans) stay in their designated areas.

Now, if you have an O ticket, you can technically sit anywhere but, would you really want to be an Alabama fan surrounded by UGA fans in a section? Probably not. This brings us to another important marker: Rh factor, which is like the team colors you’re wearing. Even within the same section, fans are further divided. For the sake of the analogy:

• If you have Rh-positive (+), it is like being a Alabama fan
• If you have Rh-negative (-), you are a UGA fan

Of course, at an away game in Athens, Alabama fans might be outnumbered, so the stadium might allow some UGA fans to sit among them in their subsection just like how Rh-negative blood can be given to Rh-positive recipients. But as a lone Alabama fan, you wouldn’t dare sit in the middle of a die-hard UGA student section just like how Rh-positive blood cannot be given to someone with Rh-negative blood. 

Agglutination is like the physical act of security removing an unauthorized fan from the section. For example, if a fan with a B section ticket sneaks into Section A, security (B antibodies) will immediately recognize they don’t belong. But instead of just one security guard escorting them out, imagine a whole group of security officers rushing in, grabbing the fan, and causing a commotion as they forcefully remove them. This buildup of security and disruption represents how mismatched blood cells clump together, blocking circulation and triggering an immune response just like an overcrowded, chaotic scene in the stadium.

Agglutination is an extremely dangerous outcome when a patient receives the wrong blood. The kidneys can filter out small amounts of incorrect blood, but a large transfusion of mismatched blood can overwhelm the body, leading to kidney failure or even death. However, agglutination is not always harmful; in fact, it plays a crucial role in blood type identification. In laboratory testing, blood is exposed to specific antibodies, and phlebotomists observe whether agglutination occurs. This reaction helps determine a person’s blood type by revealing which antigens are present on the red blood cells, ensuring safe transfusions and medical treatments. The blood type least likely to cause agglutination, the ultimate MVP of blood donations, is O-.  With the absence of all 4 antigens, the immune system will not react to this blood no matter what type of antibodies you may have thus, it is referred to as the universal donor. 

Ensuring a Safe and Sufficient Blood Supply

Because blood compatibility is so critical, ensuring a safe and sufficient supply requires careful regulation and organization. The risks of transfusion errors and the sheer volume of blood needed each year makes it essential to have large blood centers and hospitals managing donations, testing, and distribution. As part of this structure, the World Health Organization (WHO) has helped standardized blood donation amounts in ‘units’ which translates to roughly 500mL of blood where, in the U.S., the Food and Drug Administration (FDA) enforces WHO recommendations by developing and enforcing regulations, providing guidance on donor eligibility and testing, and inspecting blood establishments. The human body contains an average of 1.47 gallons (5,564.55 mL) of blood where a donor gives about 0.132 gallons (500 mL). This is roughly 8.9% of the total blood volume, about the size of a 16oz bottle of soda, and is a safe and efficient amount established to extract from a donor. Each year, around 7 million individuals donate blood in the U.S., contributing to more than 14 million units transfused annually. This is enough people to fill Sanford Stadium over 150 times and actually, meets the estimated need of about 10.6 million units a year. Yet, It’s important to note that blood components have limited shelf lives. Red blood cells last up to 42 days, and platelets must be used within 5 days necessitating a constant and steady supply of donations which we currently do not have. 

There are different types of blood donations because patients have varying medical needs, and separating blood into its individual components allows for more efficient and effective treatments. Instead of using whole blood for every patient, blood banks can maximize each donation by collecting and distributing specific parts of the blood where they are needed most. The most common type is whole blood donation, which is crucial for surgeries, trauma care, and patients experiencing significant blood loss, with one unit typically collected per donation. However, through apheresis, a process that separates specific blood components and returns the remaining elements along with saline, donors can provide targeted donations to meet specialized medical needs. Apheresis enables us to have:

• Red blood cell-only donation: allows donors to give two units at once, benefiting patients with anemia, trauma victims, and those undergoing surgery, as red blood cells are essential for oxygen delivery.
• Platelet donations: helps cancer patients undergoing chemotherapy, organ transplant recipients, and individuals with clotting disorders.
• Plasma donations: critical for emergency medicine, clotting disorder treatments, immune deficiency therapies, and the production of life-saving medications for patients with chronic illnesses.
• Specialized donations: a broad umbrella term for the collection of hyper specific blood components for researching or producing therapies to treat diseases such as in cancer or autoimmune conditions; these are less for emergency situations and but still just as important for the advancement of medicine. 

With an understanding of blood compatibility and frequency, it becomes clear why the AABB primarily tracks O+ and O- blood types. O- is the universal donor for red blood cells, meaning it can be transfused to patients of any blood type without triggering an immune reaction. This makes it crucial in emergencies when there’s no time to determine a patient’s blood type.

Troublingly, O- blood levels have remained consistently low this year. When this happens, hospitals and emergency personnel shift to using O+ blood, the most common blood type, which can be given to any patient with a positive Rh factor covering about 85% of the population. While O+ is typically reserved for non-emergency situations, such as planned surgeries and routine transfusions, shortages of O- make it a necessary fallback in critical cases. Tracking these two blood types over time serves as a strong indicator of overall blood supply health in the U.S. and right now, the warning signs are clear: we are at risk.

With such unstable reserves, hospitals in Athens-Clarke County, and surrounding areas may struggle to meet emergency demands, especially for universal donor blood types like O-. The urgency of this situation cannot be overstated. Without an increase in donations, the region risks shortages that could delay life-saving treatments for trauma victims, surgical patients, and those with chronic illnesses requiring regular transfusions.

Where and How to Donate in Athens, GA

There are four major donation centers in Athens where eligible individuals can contribute:

1. Athens Red Cross Blood and Platelet Donation Center(Clark Crossing Shopping Ctr, 3525 Atlanta Hwy, Athens, GA 30606)
   • Accepts all blood donations, including Whole Blood, Power Red, Platelet, and AB Elite Plasma Donations.
2. Octapharma Plasma(1055 Gaines School Rd Ste 105, Athens, GA 30605)
   • Accepts plasma donations only
3. Grifols Biomat USA – Athens West(3190 Atlanta Hwy Suite 112-B, Athens, GA 30606)
   • Accepts plasma donations only
4. Grifols Biomat USA – Downtown Athens(233 W Hancock Ave, Athens, GA 30601)
   • Accepts plasma donations only

Eligibility varies depending on the type of donation and the center:

• Red Cross Blood Donation: Blood donors must generally be at least 16-17 years old (with parental consent in some states), weigh at least 110 lbs, and be in good health. Check full Red Cross eligibility requirements.
• Plasma Donation (Octapharma & Grifols Biomat USA): Plasma donors must typically be 18 years or older, weigh at least 110 lbs, and pass a health screening. Compensation is offered for plasma donations at these centers. Check Octapharma Plasma requirements and check Grifols Biomat USA Plasma Center requirements.

Contrary to popular belief, most blood donations are by default voluntary and unpaid following WHO guidelines that promote ethical donation practices, while plasma donation is often compensated due to the specialized nature of the collection process. The Red Cross does not pay for standard whole blood donations but may offer compensation for specialized donations in specific cases due to how rare it may be to find someone with this specificity. In times of emergency shortages, the Red Cross occasionally offers small gift cards on site or incentives through its rewards program. Why? This distinction in payment practices exists because, while the FDA does not prohibit paid blood donations, the WHO strongly recommends that blood be sourced from unpaid volunteers. The goal is to reduce the risk of infectious diseases and maintain public trust by preventing financial incentives from leading to unsafe donation practices. In contrast, plasma donation centers such as Octapharma and Grifols do compensate donors, as plasma is not used for direct transfusion but is instead processed into life-saving medications for chronic illnesses.

In moments of crisis, whether it’s a severe car accident, a complicated surgery, or a medical emergency, having access to a stable blood supply can mean the difference between life and death. So, how can we address this growing emergency before it reaches a breaking point? Driven by a passion for volunteering, scientific progress, supporting Athens, or even earning extra income, there are ways for you to help stabilize the region’s critical blood supply. If you are eligible to donate, please consider giving blood at the Red Cross or donating plasma at Octapharma or Grifols Biomat USA now. Your donation directly supports local hospitals, trauma victims, cancer patients, and those in need of life-saving transfusions ensuring that Athens and the greater southern region has the resources it needs in an emergency. 

Ways to Support the Blood Supply Crisis Beyond Donating

Of course, not everyone is able to donate blood or plasma, and that’s okay. There are still meaningful ways to make a difference. If you can’t donate, you can:

• Host or sponsor a blood drive through your student organization, workplace, or community group.
  • The Red Cross has the infrastructure to support your own blood drives 
• Spread awareness by sharing the blood shortage emergency on social media or through your professional networks.
• Encourage eligible friends and family to donate 
• Volunteer at local blood drives or plasma centers to support donation efforts in non-medical roles
  • After all, 90% of the Red Cross are volunteers 

While all donations are vital, giving during times of shortages or disasters is especially critical. These urgent needs are tracked and displayed in real-time online by organizations like America’s Blood Centers (ABC), AABB, and the Red Cross. Donating now and staying prepared to donate again when future shortages arise can help save lives when every drop counts the most.