Amid horror in Orlando, a renewed focus on FDA blood donation rules

Topics: Hospitals, Emergency Response, Regulatory, Federal Government, Politics and Policy, Lesbian, Bisexual, Gay, Transgender

By Josh Zeitlin, contributing editor

After this weekend's mass shooting in Orlando, Florida, the blood-donation foundation OneBlood on Sunday sent out an urgent call for blood donors -- but due to FDA restrictions on donations from men who have sex with men (MSM), many would-be donors were confused about just who could answer the call. 

Officials have identified Omar Mateen as the man who opened fire in a gay nightclub early Sunday morning, killing 49 and injuring more than 50 others in the deadliest mass shooting in U.S. history. Mateen was also killed by police.

Violence prompts debate on FDA blood donation policy

Until recently, FDA rules prevented all MSM from donating blood -- a restriction implemented in the early days of the AIDS crisis, when no test could detect the presence of HIV in the blood supply.

In December, FDA released a final rule that eased the decades-old policy, allowing MSM to donate blood if they have abstained from sex with another man for at least one year. While blood tests can now detect HIV in as few as nine days after transmission, the one-year restriction was implemented because it reflects the period of time during which an individual can be HIV positive but still test negative for the virus.

Following Sunday's mass shooting, OneBlood said there was "an urgent need for O Negative, O Positive and AB Plasma blood donors." That same day, hundreds of people lined up to give blood at OneBlood donation centers. The response was so great that the organization asked those with blood types other than those most in-demand to hold off on donating "until we can assess what else we need."

During the rush to donate blood, several people reported on social media that OneBlood was accepting blood donations from all MSM. However, OneBlood said such reports were false. A OneBlood spokesperson told the Washington Post's "Wonkblog" that no MSM -- not even those eligible under the revised FDA guidelines -- have been able to donate blood at the group's centers.

The spokesperson said OneBlood's system has not been updated to allow MSM to donate blood if they have abstained from sex with another man for at least one year and it likely will not be updated until later this year.

FDA in its final rule did not specify an implementation deadline. The final rule states, "You may implement these recommendations once you have revised your donor educational material, [Donor History Questionnaire (DHQ), including full-length and abbreviated DHQs, and accompanying materials to reflect the new donor deferral recommendations."

The controversy prompted debate about whether the federal rules that prevent MSM from donating blood are discriminatory, with many people noting the irony that MSM are unable to donate blood to help after a crime that targeted the LGBT community.

One hospital's response

In the wake of the mass shooting, first responders transported the most severely injured patients to Orlando Regional Medical Center (ORMC), a Level I trauma center, while those with less-severe injuries were transferred elsewhere.

Early Sunday morning, ORMC doctors and nurses received a page notifying them of a mass-casualty event -- even as the shooting itself continued.  

The first victims arrived after 2 a.m. ET.

Most patients were taken to the ICU or a critical step-down unit, while others were taken directly to an OR. The hospital admitted 44 patients, while nine victims either "arrived deceased or succumbed to their injuries," according to a hospital tweet.

The stream of patients "was relentless," an ORMC staff member told People Magazine. "It was like everyone showed up all at once, and then more people kept coming. Like, one minute we were waiting, and the next minute, it was chaos."

The hospital and hospital grounds barred visitors on Sunday "out of consideration" for patients, staff and family safety, according to Orlando Health. ORMC set up a family information center at a nearby hotel for families waiting to hear the condition of their loved ones.

As of Sunday afternoon, ORMC had identified all patients at the hospital and was "working on reuniting patients with their families." The hospital also lifted its lockdown at about 4 p.m. ET on Sunday.

The mayor of Orlando on Sunday said that the White House had waived the Health Insurance Portability and Accountability Act (HIPAA) to allow hospital staff to communicate with families, according to The Atlantic's Matt Ford.

However, HHS Assistant Secretary for Public Affairs Kevin Griffis in a tweet said no waiver was granted, adding that "HIPAA gives health care [professionals the] ability to disclose limited health care info in appropriate circumstances."

As of 10:30 a.m. ET Monday, Orlando Health said six victims had been discharged and 29 remained, while no additional patients had died. Later that evening, Orlando Health said "all patients currently have a positive prognosis and appear to be improving."

Orlando Health stressed that responding to a mass shooting "is something that we train for regularly," adding, "This is something we have been planning for over 20 years, and unfortunately it occurred." ORMC conducts weekly trauma simulations and also periodically carries out "large-scale, city-wide simulations," according Orlando Health.

Call for action

Amid Sunday's tragedy, some advocates have renewed calls for the agency to change its blood-donation policy, while others have called for legislative action to reduce gun violence.

Sen. Richard Blumenthal (D-Conn.) in a statement said, "The Senate's inaction on commonsense gun violence prevention makes it complicit in this public health crisis."

Democratic and Republican lawmakers also called for taking additional steps to combat terrorism.