Minnesota's blood supply for surgeries and transfusions is draining, in part because companies and schools haven't resumed collection drives that they canceled during the pandemic.

Memorial Blood Centers announced an emergency shortage Thursday that left it below the recommended five- to seven-day stockpile to ensure an adequate supply for Minnesota hospitals. Supplies were down to a day or two for type O blood that any patients can receive, and for rarer type B negative blood.

"I liken it to having a case of long COVID. It just doesn't seem to be getting any better," said Phil Losacker, community relations manager for Memorial, which is the primary supplier of blood products to HCMC, Children's Minnesota and other hospitals. "Our access to donors out in the community has been severely limited."

A shortage after any holiday is common, especially Labor Day, but a combination of factors has made this one worse and possibly longer-lasting. The American Red Cross reported last week that it was sending more blood to U.S. hospitals than it was taking in and that it received 30,000 fewer donations than expected in August.

"Many corporations don't host blood drives (any longer) because they have remote workers," said Sue Thesenga, a spokesperson for Red Cross' Minnesota and Dakotas region.

Blood collection centers were concerned before the pandemic about the lack of youth to replace longtime volunteers whose donations were slowing in their senior years. Matters worsened when COVID-19 emerged and donor events were canceled or curtailed to reduce the spread of the coronavirus that causes the infectious disease.

Memorial participated in 977 fewer blood drives in the first nine months of 2023 in Minnesota compared to the same time period in 2019. The result was a 47% decline in blood units collected and a 50% decline in first-time donors, who are more likely to take part in school or workplace events.

Minnesota's two largest trauma centers, HCMC in Minneapolis and Regions Hospital in St. Paul, reported no impact on patient care yet and said all surgeries remained as scheduled.

Emergency declarations usually drive donors and prevent hospitals from reaching such crisis points, but that isn't ideal, said Dr. Jed Gorlin, medical director for Memorial and chief medical officer for America's Blood Centers, a national advocacy group. "We don't want to train the public to only come in when there are these blood emergencies. What we want is to maintain people being regular blood donors."

Memorial is simultaneously encouraging the resumption of school and corporate events, and nudging donors from past events to make appointments at its local collection centers. Red blood cells can be donated anywhere, but platelets also are in short supply, and are needed to prevent or reduce bleeding in surgeries and treatments. Platelets can only be donated at collection centers.

John Blackford of Chanhassen felt no claustrophobia serving on Navy submarines when he was younger, but he felt too squeamish to donate until he learned he had too much iron in his blood and that it was good for his health. His blood levels stabilized long ago, but the 42-year-old got in the habit of donating and was back at Memorial's collection center at Eden Prairie on Saturday.

"I just feel good after I do it," he said. "It's good to give back. Its part of my Saturday routine — I just go here, bring a newspaper, read, get it done."

A few chairs down, Wayzata High School English teacher Kathryn Kottke was grading a stack of literature essays while donating platelets, which takes a little over an hour.

"I can't leave," she said. "So I'm now a captive grader."

Donors sometimes receive gift cards, beyond the snacks and drinks to rehydrate afterward, but giving blood is mostly an unpaid service. Blood center leaders are considering more incentives to invigorate the donor population, such as Surly Brewing's popular offer over the past decade of a pint glass and a beer voucher in exchange for a pint of blood.

The Minneapolis beermaker is hosting its next collection event from 3-8 p.m. Wednesday, and expanded capacity at Memorial's request because of the blood shortage. Other upcoming events are listed on the Memorial and Red Cross websites.

Gorlin has short-term optimism because high schools are back in session and many still host events that will replenish the blood supply. Memorial also will gain a wider donor pool when it switches Sept. 25 to conform with new federal guidelines.

Men who are sexually active with other men were generally barred from donating because of the elevated prevalence of HIV in that population, but the U.S. Food and Drug Administration found earlier this year that the policy was overcautious given the precision of modern blood testing for the sexually transmitted infection.

The Red Cross switched Aug. 7 to the new federal guidance, which removes sexual orientation from consideration but still defers donations by anyone who has had anal sex in the last three months with new or multiple partners.

Long term, Gorlin remains concerned about the generational shift and the fact that younger donors aren't replacing older ones. At 67, he estimated he has donated 30 gallons of blood products in his lifetime.

For-profit companies pay people for their plasma, the liquid component of blood, and Gorlin said that might be a consideration to kickstart a new generation of donors.

"Will we be able to maintain a donor base without paying?" he asked. "I don't know."

Correction: A previous version of the photo caption for this story mistakenly said Kathryn Kottke was donating plasma at Memorial Blood Center in Eden Prairie.