The American Red Cross has declared an emergency blood shortage, saying patients are at risk of not getting lifesaving transfusions.

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Donors are needed now more than ever as the Red Cross faces a national emergency shortage, with the number of donors at a 20-year low. Medical director Dr. Eric Gehrie says the Red Cross has experienced a loss of 300,000 donors since the COVID-19 pandemic alone.

“It means that hospitals will order a certain number of units of blood, and those orders are not being filled fully,” he said. “So hospital blood banks are low on blood.”

Gehrie says the Red Cross supplies about 40% of the nation’s blood supply. He says emptier shelves could force hospitals to make excruciating decisions about which patients are prioritized for blood.

“Doctors have to make choices about which patients can receive a transfusion in a given day,” he says. “Surgeries like heart can be delayed waiting for the available blood to be collected and sent to the hospital.”