Returning to her post behind the reception desk, Courtney Robisom’s features softened into an apologetic smile.
A man had just arrived at the function hall at Alan’s of Boscawen restaurant, accompanying a blood donor to their appointment. Robisom would have to turn him away. All 27 slots at the donation drive were filled as locals responded to the blood crisis declared by the American Red Cross, only the second in the organization’s history.
“Sorry, no walk-ins today,” she said sympathetically.
Customers congested the dining area during Tuesday’s lunchtime rush, but an organized calm reigned over the blood drive. Onion rings and fried calamari suffused the function hall with warmth. A harmonica drawled over the sound system, carrying Billy Joel’s “Piano Man.”
A similar drive at the Tanger Outlets in Tilton earlier this month was frenzied by contrast: The fire alarm sounded during a drill, sending phlebotomists scrambling to safely remove donated blood from the building. As a volunteer, Robisom said she doesn’t receive the same crisis training as staff, but she’s given plenty of consideration to the threat a fire or flood would pose to the Red Cross’s blood collection efforts.
Blood “can’t be out of sight, because if it’s out of sight, then it could become contaminated or who knows what could happen to it,” she said. “It would be a catastrophe for us. We’re so short on blood now that, if we were to lose any blood in any kind of natural disaster, it would affect the people who are in those incidents who need the blood.”
The effects of climate change on blood safety and the blood supply are understudied but not unknown: About 62% of the American population is eligible to donate blood, but only 3% do, according to America’s Blood Centers. Repeat donors are the cornerstone of the blood supply, and disruptions to this minority’s availability during summer months and around the holidays contribute to predictable blood shortages each year.
Compound those realities with environmental conditions like extreme heat and poor air quality, which prevent people from feeling well enough to donate, and they stir what Jennifer Costa, a regional spokesperson for the American Red Cross, views as “the perfect storm.”
“That’s the key: You should only donate if you’re feeling well. We don’t want anyone who is so committed to being a donor but they’re sick as a dog with food-borne illness, similar to when it’s extremely hot out and people tend to feel not too great,” she said.
“While those things may not be felt here in New Hampshire, when you donate blood it becomes part of national inventory. We have the ability to move blood to where it needs to go. Wildfires out west, we’re coming up on hurricane season — these areas look to places like northern New England for blood donation.”
But natural disasters don’t simply augment the demand for blood; they also threaten the very infrastructure that directs blood where it needs to go.
Elvina Viennet, an applied epidemiologist and public health research fellow with Lifeblood, the Australian Red Cross, recalls the catastrophic flooding that destroyed the Lismore blood collection center in the eastern state of New South Wales. Ten months of rebuilding required Lifeblood to activate a temporary, mobile blood donation center to avoid interruptions to the blood supply.
Disasters across the world have wrought the same level of disruption. Earlier this year, a severe snowstorm in Louisiana precipitated a critical shortage of blood and platelets. “It’s the same story: nurse attendance and staff availability issues, transport logistic disruptions, and so forth,” Viennet said.
An April 2025 paper she authored in The Lancet Planetary Health journal urges more research into climate change’s strain on the blood supply and presses the importance of building greater resilience before moments of crisis. Preparedness, to Viennet, would mean anticipating hazards and implementing policy frameworks that minimize disruptions — like if temperatures exceed a certain threshold for a consecutive number of days, then action is taken to mobilize blood donations through a media call, for example, and stabilize the blood supply.
Of special concern to Viennet is the inevitability of accumulating stressors: what might happen if a natural disaster and a pandemic coincide and compound, or if the donor pool becomes even more constrained as climate change contributes to the spread of tropical infectious diseases, like the Zika virus or Dengue fever, which make people, at least temporarily, ineligible to donate blood.
“I’m not a climate change expert. I don’t want to pretend to be what I’m not, but we can see that we’ve got more frequent extreme events, major events, and sometimes if they’re not necessarily more frequent, they are more intense,” Viennet said. “The different threats we identified are not theoretical. We can see it now. […] The main thing is that we need to be prepared.”
The first blood crisis declared by the American Red Cross in January 2022 during one of the viral spikes of the COVID-19 pandemic. The organization is beginning to limit supplies of certain blood types to hospitals given the current crisis.
Since hospitals reach for Type O, the universal blood type, when there isn’t time to determine a patient’s blood type, it is the most frequently requested and most frequently depleted blood type. The current availability of Type O and Type O+ has fallen below a one-day supply, according to Costa.
“Most people don’t think about the health of the blood supply until it tragically collides with their lives. People assume it will be there when they or a loved one need it most, from a child undergoing cancer treatment, a person going in for surgery or with a bleeding disorder, a mother hemoraged during childbirth, a newborn who needs a transfusion,” Costa said. “When you donate, you can feel confident that your blood donation will help a person in need.”
Across the state of New Hampshire, nearly 53% of blood donation slots remain unfilled through the remainder of August, despite the strong showing at Alan’s.
To book a blood donation appointment, visit www.redcross.org.
