177 Prelude 1. Letter to the Editor Dear Editor, It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolish- ness, it was the epoch of belief, it was the epoch of incredulity... Dickens On March 12th, the Dutch government announced its first measures to combat COVID-19 in the Netherlands through implementation of strict social distancing (e.g. closing of public venues and employees working from home) as part of maximum control measures, lasting until April 6th.1 For Sanquin, the national blood establishment solely responsible for the blood supply in the Netherlands, it was vital the organization continue to operate. The leadership knew that as outbreaks may adversely impact blood supply and its related activities, steps would be needed to assess, plan and respond appropriately in a time like this.2 Thus, the employees directly involved in the supply chain, from collection to distribution, remained hard at work. However, as Sanquin is not merely a blood establishment, but an umbrella organization for research and laboratory services, diagnostics, reagents and plasma products, these employees also remained active in brainstorming and implementing new initiatives. In the first week of strict social distancing, from March 16th to 20th, an acceleration of activities occurred. Within Sanquin’s management, a task force and crisis management team were created that met daily to review the evidence and determine vital occupational health measures for the organization. While offices were abandoned, the collection centers were flooded. This was a dual effect resulting from national media coverage that advocated for the need for continual blood donation (bolstered by a ‘tweet’ from the Minister of Medical Care and Sport), followed by reports of Sanquin Research’s first initiative to test blood donations for SARS-CoV-2 antibodies to track the level of immunity in the population. The effects were staggering: more than 10,000 whole blood donations were made (compared to 8,000 on average), which had not happened since 2014. There were 6,400 registered new donors (compared to an average of 1,250 in a ‘normal’ week). Telephone and social media lines were overloaded with approximately 10,000 inquiries and comments. For the first time in years, the large collection centers offered weekend opening times. (An ongoing study is being conducted on the effects of COVID-19 events on donor behavior). On March 23rd, governmental measures were made much more stringent, with all public events requiring a permit being banned until June 1st. Within this second
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