en-us	Background  
zh-cn	背景 

en-us	This document provides interim guidance on the management of the blood supply in response to the pandemic outbreak of coronavirus disease (COVID-19). 
zh-cn	本文件提供了针对冠状病毒病（COVID-19)大流行的血液供应管理临时指南。

en-us	It is intended for blood services, national health authorities, and others responsible for the provision of blood and blood components and integration of the blood system within the public health system. 
zh-cn	指南面向血液中心、国家卫生主管部门和其它负责提供血液和血液成分以及将血液系统纳入公共卫生系统的机构。

en-us	WHO will continue to update this guidance as new information becomes available. 
zh-cn	随着新信息的出现，世卫组织将继续更新这份指导文件。 

en-us	This document is adapted from the WHO Guidance for National Blood Services on Protecting the Blood Supply During Infectious Disease Outbreaks and risk assessment publications on COVID-19 from regional networks/institutions. 
zh-cn	本文件改编自世卫组织《国家血液中心在传染病暴发期间保障血液供应指南》和区域网络/机构关于COVID-19的风险评估出版物。 

en-us	General considerations  
zh-cn	—般考虑事项 

en-us	The COVID-19 virus outbreak is primarily transmitted by the respiratory route and theoretically by transfusions. 
zh-cn	COVID-19疫情的病毒主要通过呼吸道传播，理论上可以通过输血传播。

en-us	The epidemic has the potential to reduce the supply of blood and blood components and adversely affect blood system activities. 
zh-cn	该流行病有可能减少血液和血液成分的供应，对血液系统的活动产生不利影响。

en-us	Blood services should therefore take steps to assess, plan, and respond appropriately and proportionately. 
zh-cn	因此，血液中心应采取措施，进行评估、规划，并作出适当和相称的回应。 

en-us	The risk of transmission of COVID-19 through transfusion of blood and components is now only theoretical and likely minimal. 
zh-cn	通过输注血液和血液成分传播COVID-19的风险现在只是理论上的，可能风险极低。

en-us	But experience with outbreaks of other coronaviruses suggests that there will be significant impact on blood supplies through reduced blood donation. 
zh-cn	但是其它冠状病毒疫情的经验表明，献血减少会对血液供应产生重大影响。 

en-us	Effective and accurate data-driven risk assessment is necessary to determine the most appropriate and proportionate action, taking into consideration: 
zh-cn	为了确定最适当和相称的行动，有必要开展由数据驱动的有效和准确的风险评估，同时考虑到：

en-us	a) the extent of COVID-19 spread in the country or geographical area; 
zh-cn	a) COVID-19在国内或地理区域内的传播程度；

en-us	b) level of community circulation (limited and contained vs widespread and sustained); 
zh-cn	b)社区传播的程度（有限和受控的与广泛和持续的）；

en-us	c) local epidemiology;
zh-cn	c)当地流行病学情况；

en-us	 d) risk of transfusion transmission in context of overall burden of disease;
zh-cn	d)在总体疾病负担的背景下输血传播的风险；

en-us	 e) quality of health care system;
zh-cn	e)卫生保健系统的质量；

en-us	 f) public health response; blood supply sufficiency;
zh-cn	公共卫生对策；血液供应充足性；

en-us	 g) operational impacts; 
zh-cn	g)运作影响；

en-us	and h) cost effectiveness of blood safety interventions in reducing disease morbidity in relation to the overall situation in the country. 
zh-cn	h)相对于该国总体情况而言，血液安全干预措施在降低疾病发病率方面的成本效益。 

en-us	Blood services must be prepared to move quickly in response to changes, during which blood sufficiency is most likely to be affected. 
zh-cn	血液中心必须作好快速应对变化的准备，在此期间，血液充足性很有可能会受到影响。

en-us	A national rather than sub-national or local approach should be adopted for coherence and coordination and to ensure public confidence in blood safety and supply. 
zh-cn	应采取全国性而不是国家以下级别或地方性办法来实现一致性和协调性，并确保公众对血液安全和供应的信心。

en-us	Blood services should be included in the national outbreak response, through experts linked to the national emergency response team. 
zh-cn	应通过与国家应急小组有联系的专家将血液中心纳入国家疫情应对工作。

en-us	Blood services should activate their emergency response plans. 
zh-cn	血液中心应该启动其应急计划。

en-us	Networks of cooperating blood services across regions can help maintain the availability of blood and blood components. 
zh-cn	跨区域合作的血液中心网络有助于维持血液和血液成分的提供。 

en-us	Mitigating the potential risk of transmission through the transfusion of blood and blood components  
zh-cn	降低通过输注血液和血液成分传播病毒的潜在风险 

en-us	Respiratory viruses have never been reported to be transmitted through blood or blood components; therefore, any potential risk of transmission by transfusion of blood collected from asymptomatic individuals is theoretical. 
zh-cn	从未有过呼吸道病毒通过血液或血液成分传播的报告；因此，输注采自无症状者身上的血液导致病毒传播的潜在风险是理论上的。

en-us	Any actions taken to mitigate risk are therefore precautionary. 
zh-cn	为降低风险而采取的任何行动因此都是预防性的。

en-us	Options include donor education, self-deferral or deferral of at-risk donors, quarantine of blood components, retrieval of in-date products based on a report of post-donation illness in the donor, screening of donations using laboratory tests, and pathogen reduction: 
zh-cn	备选办法包括献血者教育、高危献血者自行推迟或推迟献血、血液成分检疫、根据献血者的献血后疾病报告检索相关日期的血液制品、利用实验室检测筛查捐献的血液，以及减少病原体： 

en-us	Potential donors should be educated about the need to self-defer based on risk factors for COVID-19 or feeling unwell. 
zh-cn	应该对潜在捐献者进行教育，让他们知道如果存在COVID-19的风险因素或感觉身体不适，需要自行推迟献血。

en-us	Current donor screening measures excluding symptomatic individuals who are unwell or with signs and symptoms of fever and respiratory disease (such as cough or breathlessness) must be strictly complied with. 
zh-cn	必须严格遵守当前的献血者筛查措施，排除身体不适或有发热和呼吸系统疾病的体征和症状(如咳嗽或呼吸困难）的个人。

en-us	Persons who donate should inform the blood centre immediately if they develop a respiratory illness within 28 days of donation. 
zh-cn	献血者如果在献血后28天内出现呼吸系统疾病，应立即通知血液中心。 

en-us	Persons who have fully recovered from confirmed COVID-19, those with possible direct exposure to COVID-19 from a confirmed case, and those who have travelled from areas with ongoing community transmission should refrain from blood donation for at least 28 days. 
zh-cn	已完全康复的COVID-19确诊病人、可能直接接触过COVID-19确诊病例的人，以及来自正在发生社区传播的地区的人应至少在28天内避免献血。

en-us	This may take the form of self¬deferral or mandatory deferral. 
zh-cn	这可以采取自行推迟或强制推迟的形式。

en-us	In the event of widespread transmission, donor restrictions based on definitions of exposure risk and duration of deferral may need to be reduced to fit the local situations so as not to affect availability of blood for critical transfusion therapy. 
zh-cn	在广泛传播的情况下，可能需要减少基于暴露风险和延迟时间定义的献血者限制，以适应当地情况，从而不影响对关键输血治疗的血液供应。 

en-us	Quarantine of components with delayed release based on absence of a reported subsequent illness in the donor is an option in the event of widespread and sustained transmission. 
zh-cn	在广泛和持续传播的情况下，如果献血者没有报告后续疾病，对血液成分进行检疫并延迟释放是一种选择。

en-us	But this is difficult to implement and disrupts existing processes and workflows, leading to greater potential for errors. 
zh-cn	不过这很难实施，并且会中断现有流程和工作流，导致更大的出错可能性。

en-us	Release of blood into available inventory is delayed, and quarantine of platelets is particularly problematic given their short shelf-life. 
zh-cn	血液释放到现有库存中的时间会被推迟，并且血小板检疫特别成问题，因为其保质期短。 

en-us	A system must be in place for donors to report post-donation illness consistent with COVID-19 or contact with a case that is confirmed post-donation. 
zh-cn	必须建立一个系统，供捐献者报告与 COVID-19相符的献血后疾病，或献血后与确诊病例接触的情况。

en-us	Blood and components collected within 14 to 28 days of disease onset in the donor or after contact exposure may be recalled as a precautionary measure. 
zh-cn	作为预防性措施，可召回献血者在发病后14至28天内或出现接触风险后捐献的血液和血液成分。

en-us	Although risk of transfusion transmission is theoretical, notification of the clinician of confirmed infection in the donor may also be considered if the blood or components have been transfused. 
zh-cn	尽管输血传播的风险是理论上的，但如果血液或血液成分已经输入他人体内， 也可以考虑通知临床医生献血者确诊感染的情况。 

en-us	Testing of the blood supply is premature in the absence of cases of transfusion transmission or demonstrated infectivity of the COVID-19 virus in blood collected from asymptomatic persons. 
zh-cn	在没有输血传播病例或没有证据表明 COVID-19病毒在采自无症状者身上的血液中具有传染性的情况下，血液供应检测为时过早。 

en-us	Pathogen reduction technologies (PRTs) have been demonstrated to be effective against SARS-CoV and MERS-CoV in plasma and platelets. 
zh-cn	病原体减少技术已被证明能有效对抗血浆和血小板中的SARS-CoV和MERS-CoV。 

en-us	However, PRT requires significant logistical and financial investment. 
zh-cn	然而，病原体减少技术需要大量的物流和财政方面的投资。

en-us	PRT for whole blood is less widely available and studies of inactivation of coronaviruses in whole blood are lacking. 
zh-cn	对全血应用病原体减少技术不太普遍，缺乏全血中冠状病毒灭活的研究。

en-us	Introduction of PRT for the COVID-19 virus would not be cost effective or proportionate and is not recommended. 
zh-cn	将病原体减少技术应用于 COVID-19病毒既不划算也不适当，因此不推荐。 

en-us	Current manufacturing processes for plasma derivatives can inactivate and remove viruses related to the COVID-19 virus. 
zh-cn	目前血浆衍生物的生产工艺可以灭活和去除与COVID-19病毒相关的病毒。

en-us	As an enveloped virus, the COVID-19 virus is susceptible to many of the steps involved in preparation of therapeutic agents from fractionated plasma; thus, there is no presumed risk for transmission through these products. 
zh-cn	作为一种包膜病毒，COVID-19病毒对从分级血浆中制备治疗剂的许多步骤敏感；因此， 不存在通过这些产品传播病毒的假定风险。 

en-us	A haemovigilance system should be in place to capture any possible cases of transmission through blood and components. 
zh-cn	应建立血液监测系统，以捕捉任何通过血液和血液成分传播病毒的可能病例。

en-us	Haemovigilance is invaluable in helping to understand the risk from blood and components and the overall effectiveness of the measures taken by the blood service. 
zh-cn	血液监测在帮助了解血液和血液成分的风险以及血液中心所采取措施的总体有效性方面非常重要。 

en-us	The decision as to whether to implement precautionary measures with their resulting impact on blood sufficiency and operational resources must be carefully considered. 
zh-cn	必须仔细考虑是否要实施预防性措施及其对血液充足性和业务资源的影响。

en-us	Measures introduced during one phase of the outbreak may also become impractical or unsustainable at another phase. 
zh-cn	在疫情的某个阶段采取的措施也可能在另一个阶段变得不切实际或不可持续。

en-us	For example, a country with no locally acquired cases may opt as a precaution to defer donors recently returned from affected areas. 
zh-cn	例如，作为一项预防性措施，一个没有本地获得性病例的国家可以选择让最近从受影响地区返回的献血者推迟献血。

en-us	This is possible if the numbers of deferred potential donors are low and can easily be managed without affecting supply. 
zh-cn	如果推迟献血的潜在献血者数量少，并且可以在不影响供应的情况下轻松加以管理，这种做法是合适的。

en-us	However, once more countries are affected and particularly when locally acquired cases start to appear, the risk becomes more general and it is harder to identify individual at-risk donors. 
zh-cn	然而，一旦更多的国家受到影响，特别是当本地获得性病例开始出现时，风险就变得更加普遍，更难确定有风险的献血者。

en-us	In such situations, deferral becomes impractical and unsustainable. 
zh-cn	在这种情况下，推迟献血变得不切实际和不可持续。 

en-us	Mitigating the risk of staff and donor exposure to COVID-19 virus  
zh-cn	降低工作人员和献血者暴露于 COVID-19病毒的风险 

en-us	Any transmission from a donor is far more likely to occur through the respiratory route than through parenteral routes (including phlebotomy during blood donation). 
zh-cn	献血者更有可能通过呼吸途径而不是肠胃外途径（包括献血期间的抽血）传播该病毒。

en-us	It is possible that an infected donor who is asymptomatic, pre-symptomatic, or has very mild symptoms may infect other donors and staff. 
zh-cn	无症状、出现症状前或症状非常轻微的受感染献血者可能会感染其他献血者和工作人员。

en-us	Strategies taken to mitigate this risk should be proportionate and evidence-based and should follow the public health measures taken in the country. 
zh-cn	为减轻这种风险而采取的策略应该是适当的和基于证据的，并且应该遵循国内采取的公共卫生措施。

en-us	Blood donor centres and manufacturing premises are not acute care medical facilities, and so public health measures appropriate to the general public rather than clinics and hospitals should be applied. 
zh-cn	献血中心和生产场所不是急救医疗设施，因此应采用适合普通公众而不是诊所和医院的公共卫生措施。 

en-us	Donors and potential donors should be informed of the importance of self-deferral if they are feeling unwell, and of reporting immediately to the blood service any COVID-19 related illness within 28 days after donation. 
zh-cn	应该让献血者和潜在献血者知晓的重要事项是，如果感觉身体不适，他们应自行推迟献血，在献血后的28天内应立即向血液中心报告任何与 COVID-19相关的疾病。

en-us	If COVID-19 is confirmed in a blood donor or staff, the management of contacts should follow national public health guidelines. 
zh-cn	如果献血者或工作人员确诊感染了 COVID-19，应按照国家公共卫生指南实施接触者管理。 

en-us	The safety of the donation process should be ensured through the use of appropriate protective measures by staff. 
zh-cn	工作人员应采取适当的保护措施，确保献血过程的安全性。

en-us	Organisation of donation procedures to minimise contagion between donors, including physical distancing where feasible, may be considered while assuring proper flow of work.
zh-cn	可考虑献血程序的安排以最大限度地减少献血者之间的传染，包括在可行的情况下保持身体距离，同时确保工作的正常进行

en-us	 It is not necessary for precautions taken in health care settings with sick patients to be applied to donor centres unless the donor centre is sited within hospital premises or there is evidence of their effectiveness in community settings. 
zh-cn	献血中心没有必要实施在有病人的卫生保健环境中采取的预防措施，除非其位于医院内或有证据表明这些措施在社区环境中有效。 

en-us	Standard laboratory biosafety practices, based on national or international guidelines, should be followed in all circumstances. 
zh-cn	在任何情况下都应遵循基于国家或国际准则的标准实验室生物安全做法。

en-us	If blood service laboratories provide any pre-transfusion investigations, samples from patients suspected or confirmed with COVID-19 should be handled in accordance with COVID-19 guidance. 
zh-cn	如果血液中心的实验室进行任何输血前调查，应按照COVID-19指南处理疑似或确诊的COVID-19患者的样本。 

en-us	Staff should be educated about COVID-19 and advised not to come to work if they feel ill or may have been exposed. 
zh-cn	工作人员应接受关于COVID-19的教育，如果他们感觉身体不适或可能已经暴露，建议他们不要来上班。

en-us	Infection prevention and control measures should be reinforced. 
zh-cn	应加强感染预防和控制措施。

en-us	During widespread community transmission, staff may be reduced through illness; blood centres should consider measures to mitigate the impact on essential activities. 
zh-cn	在广泛的社区传播期间，工作人员可能因生病而减少；血液中心应考虑采取措施减轻这种情况对基本活动的影响。 

en-us	Mitigating the impact of reduced availability of blood donors  
zh-cn	减轻献血者减少的影响 

en-us	Reduction of donor numbers before, during and after a COVID-19 outbreak is a major risk for blood services. 
zh-cn	COVID-19疫情之前、期间和之后献血者人数的减少是血液中心面临的一大风险。

en-us	Blood services should consider the sufficiency risk early to enable preparedness and response. 
zh-cn	血液中心应尽早考虑充足性风险，以便能够防范和应对该风险。

en-us	Blood donation numbers should be closely monitored so that measures can be taken quickly to pre-empt any decline in donor attendance or to consider importation of blood and components. 
zh-cn	应密切监测献血者人数，以便能够迅速采取措施，防止献血者人数下降，或考虑进口血液和血液成分。

en-us	This is particularly critical for components with short shelf life, such as platelets, where a constant supply is needed for patients dependent on platelet transfusions. 
zh-cn	这对于保质期短的血液成分尤其重要，例如血小板，依赖血小板输注的患者需要持续的供应。

en-us	A proactive communication strategy is needed to address donor anxiety, which often stems from lack of awareness, misinformation or fear of becoming infected during blood donation. 
zh-cn	需要一种积极主动的沟通策略来解除献血者的焦虑，这种焦虑通常源于缺乏意识、错误信息或害怕在献血过程中被感染。

en-us	Effective public awareness campaigns on the importance of maintaining an adequate national blood supply, need for blood donors, and safety of the donation process should be disseminated continuously. 
zh-cn	应持续开展有效的公众宣传活动，宣传维持充足的国内血液供应的重要性、对献血者的需求以及献血过程的安全性。 

en-us	Containment strategies may limit the ability of donors to attend donation sessions and prevent blood collection teams from visiting areas associated with infection clusters or where public health restrictions are in place. 
zh-cn	遏制疫情的战略可能会限制献血者参加献血的能力，并阻碍采血团队造访与聚集性感染有关的地区或正在实施公共卫生限制措施的地区。

en-us	Strategies to overcome this may include rapid switching of sites for blood collections where feasible, providing donor transportation, intensifying efforts to schedule appointments for donations, or adjusting operating hours. 
zh-cn	克服这一阻碍的策略可包括在可行的情况下快速切换采血点、提供献血者运送服务、加强安排献血预约的努力或调整工作时间。

en-us	Blood collection activities may need to be organized on a more targeted basis through recall of healthy repeat donors. 
zh-cn	可能需要通过召回健康的重复献血者，在更有针对性的基础上组织采血活动。

en-us	Routine practices for donor management and infectious disease testing should not be changed. 
zh-cn	献血者管理和传染病检测的常规做法不应改变。

en-us	However, in the event of extreme blood shortages, reduction of whole blood donation intervals may be considered for donors with robust haemoglobin levels who are able to tolerate more frequent donations. 
zh-cn	然而，在血液严重短缺的情况下，对于血红蛋白水平高且能够耐受更频繁献血的献血者，可以考虑缩短全血献血的间隔时间。 

en-us	Systems should be in place to enable re-entry of infected donors after recovery. 
zh-cn	应建立系统，使受感染的献血者在康复后能够重新进入。

en-us	Most can donate again 28 days after full recovery. 
zh-cn	大多数人可以在完全康复28天后再次献血。

en-us	This may also support the collection of convalescent plasma for treatment of COVID-19 patients (see Section 7: Collection of convalescent plasma). 
zh-cn	该系统也可以支持采集用于治疗COVID-19患者的恢复期血浆（见第7节：恢复期血浆的采集）。 

en-us	Importation of blood and components from unaffected areas of the country or another unaffected country (if permitted by regulatory authorities) is a potential solution if there are insufficient local stocks, although if widespread transmission is occurring, this may be difficult. 
zh-cn	如果当地库存不足，从该国未受影响的地区或另一个未受影响的国家（如果监管机构允许）进口血液和血液成分是一个可能的解决办法，尽管如果正在发生广泛传播，这可能很困难。

en-us	There are also logistical issues with safely transporting blood and components. 
zh-cn	在安全运输血液和血液成分方面也存在物流问题。 

en-us	Managing the demand for blood and blood products  
zh-cn	管理对血液和血液制品的需求 

en-us	Blood services should continually assess their blood stocks carefully in anticipation of uncertainty in the scale of collection activities. 
zh-cn	血液中心应持续地仔细评估其血库，以防采血活动规模的不确定性。

en-us	During widespread transmission, demand for blood and components may decrease as the health care system shifts toward treating increasing numbers of COVID-19 patients and elective surgeries and non-urgent clinical interventions are deferred. 
zh-cn	在广泛传播期间，随着卫生保健系统转向治疗越来越多的COVID-19患者，以及选择性外科手术和非紧急临床干预措施被推迟，对血液和血液成分的需求可能会减少。

en-us	But blood transfusions will still be necessary for emergency situations such as trauma, post-partum haemorrhage, severe infant anaemia, blood dyscrasias, and urgent surgeries requiring availability of blood. 
zh-cn	但是在紧急情况下，如外伤、产后出血、严重的婴儿贫血、血质不调以及需要血液的紧急外科手术，输血仍然是必要的。

en-us	Increased stocks may also be needed to support COVID-19 patients with severe sepsis or requiring extracorporeal membrane oxygenation support. 
zh-cn	可能也需要增加储备来支持患有严重败血症或需要体外膜肺氧合支持的COVID-19患者。 

en-us	Good patient blood management will help safeguard blood stocks. 
zh-cn	良好的患者血液管理将有助于保障血液库存。

en-us	The blood service must clearly communicate with health care professionals responsible for transfusion activities to ensure that blood and components are only used when clinically appropriate. 
zh-cn	血液中心必须与负责输血活动的卫生保健专业人员清楚地进行沟通，确保血液和血液成分仅在临床合适时使用。 

en-us	Ensure undisrupted supplies of critical material and equipment  
zh-cn	确保关键材料和设备的不间断供应 

en-us	Transport and trade restrictions, quarantine requirements, border control measures and production disruptions may decrease the global supply chain of critical materials and equipment used in blood and component collection, laboratory testing (including immunohaematology reagents and infectious disease screening assays). 
zh-cn	运输和贸易限制、检疫要求、边境控制措施和生产中断可能会减少血液和血液成分采集以及实验室检测（包括免疫血液学试剂和传染病筛查试验）中使用的关键材料和设备的全球供应链。

en-us	The blood service must take steps to ensure continuity of supplies. 
zh-cn	血液中心必须采取措施确保供应的连续性。 

en-us	Communication  
zh-cn	沟通 

en-us	Public and stakeholder confidence in the blood system is important. 
zh-cn	公众和利益攸关方对血液系统的信心很重要。

en-us	The blood service must communicate clearly to ensure that the national emergency response team, donors and recipients, and the public are properly informed and understand planned actions. 
zh-cn	血液中心必须清楚地进行沟通，确保国家应急小组、献血者和受血者以及公众得到适当的信息并了解计划的行动。

en-us	Messaging and actions should be proportionate, evidence-based and consistent with overall national emergency response messaging. 
zh-cn	信息传递和行动应该是适当的、基于证据的，并与整个国家应急信息传递保持一致 ,。 

en-us	Within the blood service, all staff should understand the infectious threat and actions taken to ensure safety and reliability of the blood supply and the safety of staff and donors. 
zh-cn	血液中心的所有工作人员都应了解传染病的威胁以及为确保血液供应的安全性和可靠性以及工作人员和献血者的安全而采取的措施。 

en-us	Collection of convalescent plasma  
zh-cn	恢复期血浆的采集 

en-us	Experience suggests that empirical use of convalescent plasma (CP) may be a potentially useful treatment for COVID-19. 
zh-cn	经验表明，对于COVID-19，凭经验使用康复期血浆也许是一种可能有用的治疗方法。

en-us	Detailed risk assessment must always be conducted to ensure that the blood service has sufficient capability to safely collect, process and store these specific blood components in a quality-assured manner. 
zh-cn	必须始终进行详细的风险评估，以确保血液中心有足够的能力以保证质量的方式安全地采集、处理和储存这些特定的血液成分。

en-us	WHO has previously released interim guidance for the use of CP collected from patients recovered from Ebola Virus Disease. 
zh-cn	世卫组织此前发布了关于如何使用从埃博拉病毒病康复患者身上采集的康复期血浆的临时指导文件。

en-us	Additionally, the WHO Blood Regulators Network Position Paper on Use of Convalescent Plasma, Serum or Immune Globulin Concentrates as an Element in Response to an Emerging Virus (2017) provides helpful considerations.
zh-cn	此外，世卫组织血液监管机构网络关于使用恢复期血浆、血清或免疫球蛋白浓缩物作为应对新出现病毒的要素的立场文件（2017年）提供了有用的注意事项。