'This will have a massive impact': Blood tube shortage could limit non-essential tests

Health-care providers across Canada are being urged to avoid non-essential blood tests amid a global shortage of medically vital blood collection tubes.

“If the tube shortage gets worse and reaches a critical shortage in Canada, you will see labs implementing emergency measures that may include closing outpatient testing temporarily to protect acute care services,” Dr. Daniel Beriault told CTVNews.ca. “This will have a massive impact on patient care in Canada, but we are all hoping it doesn’t get to that point.”

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Beriault is the head of biochemistry at the Unity Health Toronto hospital network, and a member of the Canadian Society of Clinical Chemists, which represents the biochemists who analyze bodily fluids like blood in medical labs. On Tuesday, the group released a practice alert to highlight the urgent need to “conserve testing resources to high priority patients to mitigate the crisis,” which also includes shortages of other essential lab gear like syringes and needles.

Beriault cites several reasons for the blood tube supply issues, all of which are tied to the COVID-19 pandemic: unprecedented demand for tubes for tests, a shortage of medical-grade plastics, transportation backlogs and staffing problems.

“It looks like every province is affected to some degree,” Beriault said.

Blood tube shortages have officially been reported in provinces like Alberta and Newfoundland and Labrador, which have asked health-care providers to cancel or delay non-urgent blood tests.

“We anticipate our supplies will be tight for the foreseeable future,” Alberta Health Services spokesperson Kerry Williamson told CTVNews.ca. “We continue to encourage physicians to limit non-essential or unnecessary test ordering in order reduce consumption and ensure testing continues to be available for those who require it.”

The Medical Laboratory Professionals’ Association of Ontario is calling attention to the issue too, which CEO Michelle Hoad says is compounded by staffing shortfalls in labs that are already overburdened from COVID-19 testing.

“Some of the labs anticipated it was going to be a problem, so a lot actually ordered heavily in the fall of last year to prepare,” Hoad told CTVNews.ca from Hamilton, Ont. “Now they’re starting to really feel the shortage.”

Shortages have also been reported by private companies like LifeLabs, which is Canada’s largest provider of community laboratory services.

Despite the reports and pleas, blood tubes were not on a Health Canada list of medical device shortages at the time of writing. Health Canada says importers and manufactures have been required to report blood tube shortages since Feb. 10, when they were declared an essential Class I medical device, joining N95 respirators and surgical gowns.

“Health Canada has engaged Canadian hospitals, provinces and territories, and industry in order to assess the supply situation of blood specimen collection tubes,” Health Canada spokesperson Marie-Pier Burelle told CTVNews.ca. “Health Canada will continue to work with all key stakeholders to gather information and support continued access to these medical devices.”

At Unity Health Toronto, that kind of help can’t come soon enough.

“At one point my institution was down to two days’ worth of green top tubes left, and seven days of gold top tubes,” Beriault said, the colours referring to tubes for different tests. “Luckily, a hospital down the street helped us out by sending 3,000 tubes until we were able to find alternative tube supply.”

Beriault says they’ve paid it forward by sending tubes to other sites.

The situation is not unique to Canada. In January, the U.S. Food and Drug Administration (FDA) announced widespread blood tube shortages and urged health-care providers to only perform “medically necessary” blood draws. The U.S. has also now limited blood tube exports, which has exacerbated the problem for countries that don’t manufacture them, like Canada. Similar shortages have also been reported in the U.K.

Choosing Wisely Canada was launched in 2014 as a national campaign to reduce unnecessary medical tests and treatments. In February, it sounded the alarm about Canada’s blood tube shortage and issued five recommendations to conserve supplies.

“Still many physicians are not aware that there is a tube shortage,” Beriault said. “There is some waste in lab testing currently, and cutting that down would have the added benefit of helping us conserve lab tubes.”