Chinese Canadians collect personal protective equipment for donation to front-line medical staff

2020/03/27 1 Comment

Of note:

Members of Canada’s Chinese community have been gathering medical supplies to donate to health-care workers battling the novel coronavirus, saying they are responding to requests from front-line workers looking for personal protective equipment.

They say they are being asked for equipment such as surgical masks, N95 masks, face shields and gowns.

British Columbia’s Public Health Officer Bonnie Henry said Monday that she was not aware of shortages of such supplies, but two days later, she acknowledged the province is currently at a “tenuous level” of personal protective equipment.

“It’s a challenge that we have nine long-term care facility outbreaks where additional protections are needed in those facilities,” Dr. Henry said Wednesday in her daily media briefing. “And then we now have an increasing number of people in hospital and [we are] going through way more personal protective equipment than we expected.”

She added the province is now looking to increase stockpiles, including considering alternative supplies from around the world.

The shortage of gear pushed health-care workers, through social media, to call on dentists and members of the public to make donations. “To our dental colleagues: Do you have surpluses of face masks or other PPE? … Us front-line health-care workers are in desperate need of them,” one post says.

Vancouver dentist Patrick Wu began donating medical supplies after receiving calls and messages from physicians and nurses. “They feel unsafe at their workplace,” he said.

As dental offices have suspended non-essential services, Dr. Wu collected items such as masks, gloves, surgical gowns and shoe covers from his and his colleagues’ clinics. He then delivered them to hospitals in Vancouver and area last week.

After an article about his efforts was published in a Chinese-language newspaper over the weekend, more health-care workers reached out to him, he said, prompting him to establish a group to collect more resources.

“It is unbelievable; it’s overwhelming – the number of nurses and doctors [who] have asked us for donations. … I only have so little to give so that urged me to quickly form this group.”

Dr. Wu said in the past few days many people had approached him and wanted to contribute, including a Vancouver dental laboratory.

Businesswoman Caryn Zhang has been mobilizing members in the Chinese community to give away medical supplies.

Within a week, Ms. Zhang said they have donated hundreds of protective suits, goggles, face shields and masks to St. Paul’s Hospital, Vancouver General Hospital and Surrey Memorial Hospital.

The equipment has come from local residents and Chinese Canadians who had gathered it to donate to health-care workers in Wuhan, China, when the crisis first became public in January. Those supplies are no longer needed as urgently overseas, as China begins to emerge from the worst of the outbreak.

Ms. Zhang said her group has also asked Canadian citizens and permanent residents who are returning to Canada from China to bring with them as much as they can. As well, she said the group also has connections with factories in China that produce medical masks.

“We just want the doctors to be safe,” she said. “If [health workers] around us collapse, then this country will be devastated.”

One emergency doctor working in a hospital within Fraser Health Authority said he had to buy himself masks from a hardware store to ensure his safety.

The Globe and Mail has granted the doctor anonymity because of his concerns he would face repercussions from his employer for speaking out. He said he isn’t sure whether his hospital has sufficient supplies in stock but said the essential equipment is not in the hands of front-line health workers.

Dr. Henry said this week that donations of medical supplies from groups could also be a challenge for a health-care setting.

“The challenge we have is that the equipment, the personal protective equipment, may not be the right thing for a health-care setting, and that has happened in a couple of cases where people have been well-meaning, but have delivered things that were inappropriate,” she stated.

“So we are working through our federal counterparts to make sure that everything that is needed is asked for and is co-ordinated, is done through our federal counterparts to make sure that we are not spending a lot of time and energy and ending up with something that is not appropriate or is unsafe.”

Source: Chinese Canadians collect personal protective equipment for donation to front-line medical staff

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The Intersection of Race and Blood

2019/05/15 Leave a comment

A reminder of the complexities of the human body and race, and the need to encourage more minority groups to donate blood and stem cells:

“We need black blood.”

I didn’t know what to say to this, not least because it had been said by the head of donor services at England’s National Health Service Blood and Transplant. The interview was for a book I was writing on blood, a topic I knew a little about by then, but the baldness of his statement still shocked me. Surely we’re all the same under the skin?

I knew the history of race and blood was an ugly one. America’s earliest blood bank, founded in 1937 at Cook County Hospital in Chicago, noted race on donor forms and other blood banks followed suit. During World War II, African-American blood was labeled N for Negro (and some centers refused African-American donors outright) and given only to African-American soldiers. Writing to Eleanor Roosevelt, the chairman of the American Red Cross, Norman H. Davis, admitted that segregating blood was “a matter of tradition and sentiment rather than of science,” but didn’t stop doing it until 1950. Louisiana banned the segregation of blood only in 1972.

But the Red Cross was wrong: While no one is suggesting forced segregation of blood bags, it’s now scientifically established that blood can be racially or ethnically specific.

Most people know about the eight major blood groups: A, B, AB and O, each of which can be positive or negative (the Rh factor). These are determined by genes, and what group you are depends on what combination of proteins and sugars — antigens — are on the outside of your red blood cells. The International Society of Blood Transfusion lists 360 known antigens, but the combinations are infinitely more. Many have no bearing on routine blood transfusion, though all were discovered because they caused a problem with compatibility.

A successful blood transfusion relies on sameness. If incoming blood has an antigen that you lack, your body can react badly to it. In extremely rare cases, the reaction can be fatal; and even if not, it can tax the immune system in people who are already weakened by their condition. Also, you will make an antibody, a sort of immune storm trooper, to better recognize the same antigen next time. Patients who need regular blood transfusions — those who have sickle cell disease, thalassemia or leukemia, for example — may face an ever decreasing pool of suitable blood because they keep creating antibodies.

Wouldn’t it be easier if all our blood was the same? Blame bugs. Much of the variance “has been driven by evolutionary selection by bacteria, malaria and parasites,” says Connie Westhoff, executive scientific director at the National Center for Blood Group Genomics at the New York Blood Center. If malaria finds its way into the bloodstream via a particular antigen, that antigen may change to defend itself, leading to different blood types. Cholera thrives better on intestinal cells derived from O-type stem cells, but O is also more protective against malaria. For many complicated reasons, only 27 percent of Asians have type A, but 40 percent of Caucasians do. Type B is found more commonly in Asia than Europe.

This works not just with blood types. Sickle cell trait is now known to protect against malaria, which is why sickle cell, a painful and debilitating disease caused by malformed blood cells, is found frequently — but not only — in people with African heritage, because malaria thrives in Africa.

This past winter, the case of a little girl named Zainab Mughal in South Florida illustrated all this complexity perfectly. Zainab, who is now 3, has neuroblastoma, an aggressive cancer, and her treatment — chemotherapy and stem cell transplants — means she will need blood.

But she also has rare blood. She belongs to the fewer than 1 percent of the population missing an antigen that the other 99 percent have, making her blood some of the rarest in the world. In her case, she lacks both the antigens Indian B and Big E. Via appeals to the American Rare Donor Program, and then the International Rare Donor Panel in England, Zainab’s local blood banker, One Blood, found five donors with the same extremely rare type.

It was a tall order: the Indian B antigen is known to be lacking in the blood of Iranians, Pakistanis and Indians, so donors had to have both parents from these populations. Two donors live in the United States, two in Britain and one in Australia. Most people, says Susan Forbes of One Blood, “don’t understand the need for a diverse blood supply.”

Publicity about Zainab’s case, though it was extreme in its rarity, helped raise awareness.

Yet it is a difficult message: that our blood is different, red and white cells both. When it comes to finding stem cells for bone marrow transplants, the search has to be equally discriminatory. This time the issue is HLA, the human leukocyte antigens present in white blood cells.

“The reason why ethnicity comes into the picture,” says Dr. Abeer Madbouly, a senior scientist at Be the Match, a program run by the National Marrow Donor Program, the largest stem cell donor registry in the world, “is that HLA encodes the immune system, and the immune system goes through particular conditions based on where you are.” Depending on the threat, each population will develop particular sets of HLA types. In a diverse population like that of the United States, finding a matched donor becomes more challenging for a patient with a mixed ethnic background.

“Let’s say you have someone with African roots and someone from Asian descent coming together, and then they have an offspring of mixed ethnicities,” Dr. Madbouly said. “You have an African HLA and an HLA type common in Asian areas coming together to form a new type of HLA that is not common in either.” Though Be the Match added nearly two million donors to its registry last year, only 30 percent were what Dr. Madbouly calls “diverse.” That’s not enough.

Zainab’s blood is rare, and so is her situation. What concerns blood bankers on a daily basis is a more common condition caused by uncommon blood. Sickle cell disease is predominantly found in African-Americans, and thalassemia among South Asians, and both conditions require precisely matched blood. But there is a shortfall between ethnic minority patients who need blood, and ethnic minority donors. In New York, Caucasians are 35 percent of the population but 58 percent of donors. Twenty-eight percent of New Yorkers are African-American but only eight percent of donors, and that’s after five years of hard work and outreach by the New York Blood Center with its PreciseMatch campaign.

Even so, there was trouble when the Blood Center began in 2009 to offer the option to “self-declare” ethnicity on its donor forms. This was efficient: without a budget to precisely screen every donation, they could home in on antigens known to be specific to certain populations. At first there were problems, when staff members were initially upset by this apparent division of blood by ethnicity. “We didn’t educate the staff,” says Dr. Westhoff, “to know that we weren’t segregating the blood just to be segregating. We were doing it to send all the African-American units to the sickle program children because they were doing much better with blood that came from this same ethnic group.”

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