Children receiving chronic transfusions for stroke prophylaxis need a stable blood supply, which may be endangered during the COVID-19 pandemic. DeBaun proposes rapid initiation of hydroxyurea alongside transfusions in preparation for critical shortages of blood. This proactive approach could be particularly beneficial when the projected trajectory of the COVID-19 case burden indicates that the peak medical resource use will be superior to the available resources (upper branch). In other communities in which the projected trajectory will be less steep, an adaptive approach, with periodic assessment of regional blood bank inventory, may be preferable (lower branch).