'This will have a massive impact in Canada,' says one expert: a scarcity of blood tubes may limit non-essential tests.

There has been a huge shortage of blood tubes worldwide; therefore, the health authorities have been advised to avoid unnecessary blood tests.

On top of a spike in COVID-19 cases, winter weather has made it difficult for both staff and potential donors to make it to blood drives and donation centers.  

Currently, we are experiencing critical shortages of blood, which can adversely affect our ability to provide care to patients in need of transplants, major surgeries, trauma treatment, and cancer therapy. Our lives have been affected by this pandemic, which has stretched hospitals to their limits. However, other patients continue to need care."

Dr. Daniel Beriault believes that if the tube shortage worsens, labs will be in immense trouble as they need to implement quick emergency measures.

These measures may include temporarily closing the outpatient testing for protecting acute care service(s)." "This will likely have massive impacts on patients' care in Canada, but we all hope that it doesn't happen."

The CSC represents the biochemists who analyze bodily fluids like blood in medical laboratories. Biérault is the network head of the biochemistry subject at Unity Health Hospital (Toronto). The organization issued an urgent practice alert on Tuesday that highlighted the need for "conserving main testing resources for high-priority patients as a means of mitigating crisis," which includes a shortage of many other essential labs' items, including syringes as needles.

In addition to the COVID-19 pandemic, Bieriault cites other factors contributing to the shortage of blood tubes: unprecedented and high demand for test tubes, shortage of medical grade plastics, transportation backlogs, including lack of staff resources.

Beriault said that he feels that every province has been affected by the shortage in one way or the other.

Blood tube shortage has been reported a lot in provinces such as Alberta and Newfoundland plus Labrador, where many healthcare providers have been asked to either cancel or postpone blood tests that are not urgent.

Kerry Williamson, the spokesperson for Alberta Health Services, said that he anticipates that the supplies will undoubtedly be the ight maybe for the future. They encourage doctors to limit unnecessary non-essential ordering of tests to decrease consumption while ensuring testing is only available for those who need them."

The Medical Laboratory Professionals' Association of Ontario is raising awareness of the problem, which, according to CEO Michelle Hoad, is increased by staffing shortages in labs that are already overburdened by COVID-19 testing.

"Few labs have anticipated that it would be a huge problem. Therefore, lots are ordered in last year's fall for preparing," Hoad said from Hamilton, Ontario. "They are starting to feel the pinch now."

Private companies, including LifeLabs, Canada's largest laboratory services provider, have also reported immense shortages.

Despite various reports and pleas, blood tube(s) were never on the lists of medical device shortage(s) maintained by Health Canada. Since February 10, when blood tubes were designated as essential Class I medical devices, along with N95 respirators and surgical gowns, importers and manufacturers have been required to report shortages.

Health Canada engaged Canadian hospitals, provinces, territories, and industry to assess the supply situation for blood specimen collection tubes, said Marie-Pier Burelle, spokesperson for the agency. "All key stakeholders will continue to work with Health Canada to ensure that medical devices can remain on the market and data can be collected."

This kind of assistance is desperately needed at Unity Health Toronto.

In one instance, my institution ran out of the green top tube(s) after only two days and of the gold top tube(s) after seven days, Beriault explained. Thanks to a nearby hospital, we could procure 3,000 tubes until and unless we were completely able to source alternative tube supplies."

Beriault claims to have sent tubes to few other websites to pay it forward.

Canada is not the only country with this problem. In January, the US Food Drug Administration, i.e., the FDA released a statement indicating widespread blood tube shortage(s) and fully urged physicians to limit blood draws to "medically necessary" situations. Blood tube exports have also been restricted in the United States, aggravating problems for countries that do not manufacture them, such as Canada. There is also a shortage in the United Kingdom.

Choosing Wisely In 2014, the Canadian government launched a national campaign for preventing unnecessary medical testing and treatments. In February, Canadian Blood Services warned of blood tube shortages and offered five suggestions for conserving supplies.

Beriault said lots of physicians are still unaware that tubes are short. It is currently necessary to reduce waste in lab testing for the conservation benefit."

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