Just a minute before the blood drive was due to start this week in the old Dress Barn in Steeplegate Mall, two people had gathered outside at the entrance to donate.

Typically, at blood donation drives, a small queue forms at the entrance when donors arrive for the first appointments of the day, said Sue Lang, a longtime Red Cross volunteer.

But recently the donor pool had become sparse. Lang, who checked people in at the entrance, noticed that many people did not show up, even if all appointments were occupied.

The trickle of donors in the abandoned Dress Barn at Steeplegate Shopping Center is a microcosm of a problem plaguing hospitals across the country. Jennifer Costa, a spokeswoman for the Red Cross, said most parts of the country, including New Hampshire, are facing unprecedented blood shortages.

If the high demand and low supply continue, healthcare providers may need to start rationing blood to those most in need, which may delay or cancel non-essential procedures.

Summer is a notoriously tough season in the blood donation community.

Most people choose to travel or spend time outdoors when faced with a choice between vacation and watching the blood flow from their arm.

A summer on the heels of a pandemic is even tougher. As more and more people cry out for vacation, not only are donations falling, but travel-related injuries that often require blood to treat, such as car accident wounds, are on the rise.

In addition, patients who postpone care during the pandemic are sicker and more likely to need a blood transfusion, Costas said.

This perfect storm of factors has created a scarcity that Costas and her colleagues have not experienced while working for the Red Cross.

“This is the most intense thing they have felt this lack,” she said.

Every day, the New Hampshire Red Cross must collect 165 liters of blood – worth about 1,155 people – to meet the needs of the hospitals. Now the organization needs 17 additional volunteers a week to make up for the deficit, Costa said.

Several companies have come together to encourage people to donate. Amazon offered $ 5 gift cards, the NH Hospital Association issued a press release urging people to stop “critical shortages of all blood types,” and donors who took part in the blood drive Tuesday afternoon had the chance to win a “Father’s Day” BBQ Package ”from Ace Hardware.

For many years the American Red Cross has relied on a small fraction of the population for blood supply. Hospitals rely on about 3% of Americans who keep donating to meet their blood needs.

Lang, type O-, is one of those 3%. For years she volunteered for blood donation campaigns of the Red Cross and donated blood even longer. The Red Cross app on her phone found that she has donated blood 107 times since 1978 – a habit she supported with regular iron supplements.

“I just hope they have enough when I need it,” she said.

Many of the other donors who showed up to donate on Tuesday were regulars like Lang.

Liz Purington and Emily Jerome, who both work at Concord Hospital, got together as they did every 56 days. They’ve seen subtle signs of a shortage in the workplace – they often need to do blood type tests well in advance of surgery to make sure they’re adequate.

As much as the Red Cross relies on repeat donors like Jerome, Purington and Lang, Costas said the organization is trying to expand its volunteer base.

“It’s really about increasing that 3% figure,” said Costas.

James Potter, executive vice president of the NH Medical Society, who happened to donate blood at Steeplegate Mall on Tuesday, said New Hampshire hospitals have not yet had to postpone or cancel operations because of the lack of blood.

But Michael Gilbert, the chief medical officer of the Catholic Medical Center, said many hospitals are only one bad accident away from considering this option.

He said if a hospital needs to implement a “massive transfusion protocol,” a situation where the hospital needs to give large amounts of blood quickly, they may need to reevaluate where to put their limited red blood cells.

He said MTPs can occur as a result of a number of circumstances such as complicated childbirth or end-stage liver disease. Just last week, two New Hampshire hospitals started the protocol.

“If this happened in a state hospital, that hospital may need to consider postponing elective surgery,” he said.

Those who wish to donate blood can find a donation site near them by visiting redcrossblood.org or calling 1-800-RED-CROSS.