Lecture 34 – COVID-19 Tech Lectures©

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Lecture 34 – COVID-19 Patient Safety

Worth 4 credit hours

Lecture 34 – COVID-19 Tech Lectures©

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COVID-19 A year ago, the situation we now face today would have been from a fiction book with that had millions of individuals being affected. The book would have an ending that would have been positive or negative depending what the author chose. Unfortunately, today fiction has been changed to reality with the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or COVID-19 continuing its propagation across the United States and worldwide. Alarmingly the numbers are increasing exponentially with global cases approaching, at the time of this writing. Today COVID-19 is the leading cause of death in the United States with around 50 million, with increases of more than 500,000 new cases per day, and global deaths having exceeded 1 million. In the United States At least 3,611 new Coronavirus deaths and 245,033 new cases were reported on Dec. 16, 2020. Over the past week, there has been an average of 211,008 cases per day, an increase of 29 percent from the average two weeks earlier. These numbers will change as COVID-19 continues onward with numbers being updated in this CE offering. For now the situation seems drastic and without a crystal ball, we are unable to see the future. But the bright side of this pandemic is that there are tools available now to help individuals in the time of need and encouraging signs this pandemic may someday be a learning lesson of the past. What is COVID-19 Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered novel coronavirus. A novel coronavirus is a new coronavirus that has not been previously identified. The virus causing coronavirus disease 2019 (COVID-19), is not the same as the coronaviruses that commonly circulate among humans and cause mild illness, like the common cold. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease.

Scientists first identified a

human coronavirus in 1965. It

caused a common cold. Later

that decade, researchers found

a group of similar human and

animal viruses and named them

after their crown-like

appearance.

Goals and Objectives:

Pharmacy Technician shall:

-What is COVID-19

-History of COVID-19

-COVID-19 Testing

- COVID -19 Symptoms

-Non Drug Protocols for COVID-19

-Drug Protocols for COVID-19

-COVID-19 Vaccines

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Coronoviruses are a large family of viruses that are actually common throughout the world and can cause respiratory illness in people and animals. There are several types of known coronaviruses that infect people and usually only cause mild respiratory disease, such as the common cold. Besides the common cold and example of a serious coronovirus infection was the Severe Acute Respiratory Syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe, and Asia before the SARS global outbreak of 2003 was contained. According to the World Health Organization (WHO), a total of 8,098 people worldwide became sick with SARS during the 2003 outbreak. Of these, 774 died. In the United States, only eight people had laboratory evidence of SARS-CoV infection. All of these people had traveled to other parts of the world where SARS was spreading. SARS did not spread more widely in the community in the United States.

The main way that coronoviruses seems to spread is by close person-to-person contact. The virus is thought to be transmitted most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes. Droplet spread can happen when droplets from the cough or sneeze of an infected person are propelled a short distance (generally up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby. The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eye(s). In addition, it is possible that the virus might spread more broadly through the air (airborne spread) or by other ways that are not now known. Thus the importance of wearing a mask for any virus is advisable to inhibit spread of droplets.

A virus is a small collection of

genetic code, either DNA or

RNA, surrounded by a

protein coat. A virus cannot

replicate alone. Viruses must

infect cells and use

components of the host cell

to make copies of

themselves. Often, they kill

the host cell in the process,

and cause damage to the

host organism. Viruses have

been found everywhere on

Earth. Researchers estimate

that viruses outnumber

bacteria by 10 to 1. Because

viruses don’t have the same

components as bacteria, they

cannot be killed by

antibiotics; only antiviral

medications or vaccines can

eliminate or reduce the

severity of viral diseases,

including AIDS, COVID-19,

measles and smallpox.

Coronaviruses derive their name from the fact that under

electron microscopic examination, each virion is surrounded

by a “corona,” or halo. This is due to the presence of viral

spike peplomers emanating from each proteinaceous

envelope.

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History of COVID-19

The outbreak of coronavirus disease (COVID-19) was first reported on December 31, 2019, in Wuhan, China where it is thought to of made a SARS-CoV-2 jump to humans at one of Wuhan’s open-air “wet markets” in China, a place where customers buy fresh meat and fish, including animals that are killed on the spot.

Some wet markets sell wild or banned species like cobras, wild boars, and raccoon dogs. In this situation, crowded conditions can let viruses from different animals swap genes that are able to infect people.

The exact animal transmission cause is unknown, but suspicion fell on pangolins, also called scaly anteaters, which are sold illegally in some markets in China. Some coronaviruses that infect pangolins are similar to SARS-CoV-2.

Within a few weeks, the virus had spread rapidly throughout China and within 1 month to several other countries, including Italy, the United States and Germany.

1918 Influenza Pandemic

COVID-19 is not the only pandemic ever in the United States. The 1918, the Spanish flu or Global influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated, it spread worldwide during 1918-1919. In the United States, it was first identified in military personnel in spring 1918.

It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States. Mortality was high in people younger than 5 years old, 20-40 years old, and 65 years and older. The high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of this pandemic.

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Symptoms Some cases may find individuals to be asymptomatic (with no symptoms). In most cases, COVID-19 often begins with malaise (feeling of discomfort), dry cough, dyspnea (difficult breathing), fatigue, fever and in some cases, nausea, vomiting and diarrhea. Symptoms may worsen and lead to severe fever (high), fatigue, sputum production, dyspnea, sore throat and headaches. The progression of COVID-19 symptoms can be from 11 to 14 days. The majority of people (around 80%) can be treated at home and need no hospitalization.

Another interesting symptom in some cases show a loss or reductions in smell (anosmia, hyposmia) or distortions in taste (dysgeusia) having been reported particularly in people with no other symptoms who eventually test positive for COVID-19.

Should symptoms worsen from typical to atypical with high elevated fever, the recommendation is for the individual or someone in close contact call 911.

Testing Testing for COVID-19 is essential in seeing if an individual has or had this virus. With testing, individuals who test positive and have symptoms can get care earlier. Contacts can be traced and self-isolation or quarantine started sooner to help stop the spread of the virus. Currently there are three different types of tests.

Antigen tests

Antigen tests are commonly used in the diagnosis of respiratory pathogens, including the flu virus and COVID-19 which is the majority of rapid diagnostic tests used. They are taken with a nasal or throat swab and detect a protein that is part of the coronavirus. These tests are particularly useful for identifying a person who is at or near peak infection or enough virus spread. Antigen tests are less expensive and generally faster. The downside is that they can be less accurate. That means, if a person does not at peak infection – but is still contagious – the tests may come back negative. Depending on the quality of the antigen test and the test takers, false negatives could be as high as 20%.

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Molecular/PCR tests Molecular or PCR tests detect genetic material – the RNA – of the coronavirus and are sensitive enough to need only a very tiny amount of it. The sample is collected with a nasal or throat swab and they tend to take hours to provide results.

Antibody tests

These are not considered diagnostic tests for COVID-19 infection. Antibody testing, also known as serology testing, is usually done after full recovery from COVID-19.

A blood sample is taken and then the sample is tested to determine if the body has produced antibodies from previous COVID-19 exposure but not positive for the virus.

Non-Drug Protocols Social Distancing / Hand Washing and Hand Sanitizers Social distancing, also called “physical distancing,” means keeping a safe space between yourself and other people who are not from your household.

The recommendation of social distancing is at least 6 feet (about 2 arms’ length) from other people in both indoor and outdoor spaces. Social distancing should be practiced in combination with other everyday preventive actions to reduce the spread of COVID-19, including avoiding touching the face with unwashed hands, and frequently washing hands with soap and water for at least 20 seconds and the wearing of face masks.

Social distancing should be practiced in combination with other everyday preventive actions to reduce the spread of COVID-19, including wearing masks, avoiding touching your face with unwashed hands, and frequently washing your hands with soap and water for at least 20 seconds.

Centers for Disease Control and Prevention (CDC) recommends consumers use an alcohol-based hand sanitizer that contains at least 60 percent alcohol (also referred to as ethanol or ethyl alcohol) in between the washing of hands. Hand Sanitizers containing methyl alcohol or methanol should never be used to potential harmful effects when absorbed through the skin.

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Masks

History has shown the importance of wearing mask in the prevention of transmission of both viruses and bacteria. Unfortunately even today, there are those who question its validity and do not take the “common sense” approach in wearing a face mask which increases the spread of COVID-19 exponentially. The wearing of a mask cannot be overstated when dealing with COVID-19 mainly to prevent spread of the virus through droplets that escape from the mouth when speaking, sneezing and coughing. This is important in preventing one’s self from exposure or exposing someone to COVID-19. Masks are only as good as the material and fitting around the mouth and nose. The best mask available is called the N95 mask, but is not readily available to the public. The N95 mask must be properly fitted to be effective. Another avenue is surgical masks that can be purchased easily. If these are not available, the most effective homemade face Masks are those made with tightly woven fabric and providing a good seal along the edges. Bandanas are not found to be effective. Drug Treatment Protocols Today modern science has better tools to deal with COVID-19 in treatment than was seen with SARS in 2003 or during the influenza pandemic of 1918. Newer more advanced drugs and rapid development of vaccines allow science to provide a brighter outcome in treating this disease state. At this time, any discussion of treatment (or prevention) of COVID-19 must start with a single fact: No treatment has been shown effective and safe in controlled clinical trials.

About Masks: Do not touch mask while it is being worn. Do not leave nose and/or mouth uncovered.

Do not remove mask in public.

Do not share mask.

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Remdesivir Remdesivir (Veklury®) is a broad-spectrum anti-viral and has shown to be effective against a number of viral pathogens (disease causing microorganisms), including SARS-CoV-2. Remdesivir is approved by the Food and Drug Administration (FDA) for the treatment of severe COVID-19 cases in hospitalized adults and children who are in need of oxygen. Remdesivir can cause gastrointestinal symptoms (e.g., nausea), elevated transaminase levels in liver, an increase in prothrombin time (blood clotting), and hypersensitivity (allergic) reactions. Liver function tests and prothrombin time should be obtained in all patients before remdesivir is administered and during treatment as clinically indicated.

Remdesivir is currently administered only as an IV infusion; a 200-mg IV loading dose is followed by a recommended dose of 100 mg IV daily for 5 days. In the United States, the maker of remdesivir Gilead Sciences will charge $520 per vial for patients with private insurance, with some government programs getting a lower price. With a double-dose the first day, that comes out to $3,120 for the five-day treatment course Although this drug is promising, there is much that still needs to be learned on the true effectiveness of this drug in the treatment of COVID-19 patients over the patient’s own individual immune response. Several clinical trials that are evaluating remdesivir for the treatment of COVID-19 are currently underway or in development.

Dexamethasone Dexamethasone, a corticosteroid, is similar to a natural hormone produced by the adrenal glands. It often is used to replace this chemical when the body does not make enough of it. The main purpose of dexamethasone is to relieve inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Dexamethasone is also used to treat certain types of cancer.

Prolonged use (I.e., used for more than two weeks) dexamethasone may be associated with adverse events such as glaucoma, cataract, fluid retention, hypertension, psychological effects (e.g., mood swings, memory issues, confusion or irritation), weight gain, or increased risk of infections and osteoporosis.

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Patients with severe COVID-19 can develop a systemic inflammatory response that can lead to lung injury and multisystem organ dysfunction. It is thought that the potent anti-inflammatory effects of corticosteroids might prevent or mitigate these deleterious effects. Dexamethasone is approved by the Food and Drug Administration (FDA) for the treatment of severe COVID-19 cases in hospitalized patients.

As all corticosteroids, dexamethasone is generally safe if used short term and not associated with serious side effects other than gastrointestinal.

Prolonged use (I.e., used for more than two weeks) may be associated with adverse events such as glaucoma, cataract, fluid retention, hypertension, psychological effects (e.g., mood swings, memory issues, confusion or irritation), weight gain, or increased risk of infections and osteoporosis.

Dosing of Dexamethasone should be 6mg once a day for 7-10 days.

Pricing of this drug is relatively cheap even with drug manufacturer mark-ups due to COVID-19. One unit (tablet) runs around $2 from pre COVID-19 price of $0.10.

Passive Immunity: Natural vs. Artificial

A person may become immune to a specific disease in several ways. For some illnesses, such as measles and chickenpox, having the disease usually leads to lifelong immunity to it. Vaccination is another way to become immune to a disease. Both ways of gaining immunity, either from having an illness or from vaccination, are examples of active immunity. Active immunity results when a person’s immune system works to produce antibodies and activate other immune cells to certain pathogens. If the person encounters that pathogen again, long-lasting immune cells specific to it will already be primed to fight it.

A different type of immunity, called passive immunity, results when a person is given someone else’s antibodies. When these antibodies are introduced into the person’s body, the “loaned” antibodies help prevent or fight certain infectious diseases. The protection offered by passive immunization is short-lived, usually lasting only a few weeks or months. But it helps protect right away.

Natural Infants benefit from passive immunity acquired when their mothers’ antibodies and pathogen-fighting white cells cross the placenta to reach the developing children, especially in the third trimester. A substance called colostrum, which an infant receives during nursing sessions in the first days after birth and before the mother

Corticosteroids Used Other Than Dexamethasone

Prednisone 40 mg

Methylprednisolone 32 mg

Hydrocortisone 160 mg

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begins producing “true” breast milk, is rich in antibodies and provides protection for the infant. Breast milk, though not as rich in protective components as colostrum, also contains antibodies that pass to the nursing infant. This protection provided by the mother, however, is short-lived. During the first few months of life, maternal antibody levels in the infant fall, and protection fades by about six months of age.

Artificial Passive immunity can be induced artificially when antibodies are given as a medication to a non-immune individual. These antibodies may come from the pooled and purified blood products of immune people or from non-human immune animals, such as horses. In fact, the earliest antibody-containing preparations used against infectious diseases came from horses, sheep, and rabbits.

Convalescent Plasma

Passive antibody therapy in the form of convalescent plasma (plasma from previously infected COVID-19 patient) infusion is thought to potentially prevent infection with SARS-CoV-2 or minimize the severity of COVID-19. A typical regimen involves administration of 1 or 2 infusions of 200 mL each.

In August 2020 the FDA issued an emergency use authorization for convalescent plasma in hopes this new form of therapy would be an asset in the treatment of COVID-19. In theory this should be beneficial, but data supporting its use are difficult to interpret due to lack of plasma availability and lack of large group studies. In many cases, this form of treatment was found to be of no benefit.

Although convalescent plasma seems promising, there is much that still needs to be learned on the true effectiveness treatment of COVID-19 patients over the patient’s own individual immune response. More clinical trials are needed evaluating convalescent plasma for the treatment of COVID-19.

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Monoclonal Antibodies Monoclonal antibodies are laboratory-produced molecules that act as substitute antibodies that can restore, enhance or mimic the immune system's attack on cells. In theory these type of antibodies should elicit an immune response similar to convalescent plasma therapy. Current offerings now involve infusions with monoclonal antibodies in both the hospital and outpatient setting for patients with moderate COVID-19 symptoms. The idea is that these agents provide passive immunity for patients with known SARS-CoV-2 infection who have not yet mounted an immune response against the pathogen.

In late November 2020, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) of monoclonal antibodies for casirivimab and imdevimab to be administered together for the treatment of mild to moderate COVID-19 in adults and pediatric patients. In a clinical trial of patients with COVID-19, casirivimab and imdevimab, administered together, were shown to reduce COVID-19-related hospitalization or emergency room visits. Casirivimab and imdevimab must be administered together by intravenous (IV) infusion. Casirivimab and imdevimab are not authorized for patients who are hospitalized due to COVID-19 requiring oxygen therapy.

Although monoclonal antibodies seems promising, there is much that still needs to be learned on the true effectiveness treatment of COVID-19 patients over the patient’s own individual immune response. More clinical trials are needed evaluating monoclonal antibodies for the treatment of COVID-19. Vaccines How body fights illness To understand how COVID-19 vaccines work, it helps to first look at how our body fights illness. When germs, such as the virus that causes COVID-19, invade the body they attack and multiply. This invasion, called an infection, is what causes illness. Our immune system uses several tools to fight infection. Blood contains red cells, which carry oxygen to tissues and organs, and white or immune cells, which fight infection. Different types of white blood cells fight infection in different ways:

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Macrophages are white blood cells that swallow up and digest germs and dead or dying cells. The macrophages leave behind parts of the invading germs called antigens. The body identifies antigens as dangerous and stimulates antibodies to attack them. B-lymphocytes are defensive white blood cells. They produce antibodies that attack the pieces of the virus left behind by the macrophages. T-lymphocytes are another type of defensive white blood cell. They attack cells in the body that have already been infected.

The first time a person is infected with the virus that causes COVID-19, it can take several days or weeks for their body to make and use all the germ-fighting tools needed to get over the infection. After the infection, the person’s immune system remembers what it learned about how to protect the body against that disease.

The body keeps a few T-lymphocytes, called memory cells that go into action quickly if the body encounters the same virus again. When the familiar antigens are detected, B-lymphocytes produce antibodies to attack them. Experts are still learning how long these memory cells protect a person against the virus that causes COVID-19.

How COVID-19 Vaccines Work

COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the illness. Different types of vaccines work in different ways to offer protection, but with all types of vaccines, the body is left with a supply of “memory” T-lymphocytes as well as B-lymphocytes that will remember how to fight that virus in the future.

It typically takes a few weeks for the body to produce T-lymphocytes and B-lymphocytes after vaccination. Therefore, it is possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and then get sick because the vaccine did not have enough time to provide protection.

Sometimes after vaccination, the process of building immunity can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building immunity.

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Types of Vaccines

Currently, there are three main types of COVID-19 vaccines. A vaccine prompts our bodies to recognize and protect us from the virus that causes COVID-19. None of these vaccines can give an individual COVID-19.

mRNA vaccines contain material from the virus that causes COVID-19 that gives our cells instructions for how to make a harmless protein that is unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine. Our bodies recognize that the protein should not be there and build T-lymphocytes and B-lymphocytes that will remember how to fight the virus that causes COVID-19 if we are infected in the future. Protein subunit vaccines include harmless pieces (proteins) of the virus that cause COVID-19 instead of the entire germ. Once vaccinated, our immune system recognizes that the proteins don’t belong in the body and begins making T-lymphocytes and antibodies. If we are ever infected in the future, memory cells will recognize and fight the virus. Vector vaccines contain a weakened version of a live virus—a different virus than the one that causes COVID-19—that has genetic material from the virus that causes COVID-19 inserted in it (this is called a viral vector). Once the viral vector is inside our cells, the genetic material gives cells instructions to make a protein that is unique to the virus that causes COVID-19. Using these instructions, cells make copies of the protein. This prompts our bodies to build T-lymphocytes and B-lymphocytes that will remember how to fight that virus if we are infected in the future. To date we have only seen two vaccines offered which are mRNA vaccines. Pfizer Brand vaccine is a mRNA vaccine that recently was given FDA emergency use authorization. The problem with this vaccine is the storage temperature of minus 80 degrees Celsius (C) or minus 112°Farenheit (F) does make shipments and distribution difficult. For Pfizer vaccine, dosing involves two doses of 30-micrograms; one dose followed by another dose in 21 days. Both doses must be Pfizer brand vaccine. Moderna’s vaccine is also a mRNA vaccine but with slightly different structures and makeup also was given FDA emergency use authorization. In contrast, Moderna's vaccine can be kept at about minus-20 degrees Celsius, or about the temperature of a home freezer. Moderna's vaccine is administered as two 100-microgram doses given 28 days apart.

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For both vaccines shipments have been made, but this is still the early stages for this vaccine and delivery / administration of this vaccine to the population remains to be seen as far as extend of distribution and amount of individuals vaccinated. More important the efficacy of these vaccine on the general population of millions. Vaccines and COVID-19 Immunity

Vaccines do not necessarily protect individuals against COVID-19.

Yes studies have shown both Pfizer and Moderna vaccines to have high efficacy or effectiveness rates of 94.5% and 95% effective, respectively. But that efficacy refers to the vaccines’ ability to protect against COVID-19 disease—and not necessarily against infection with the virus. Both trial tests of the vaccines were designed to measure severity the COVID-19 symptom associated with the vaccine given and has nothing to do with immunity to COVID-19.

That means that people who are vaccinated are not necessarily immune to getting infected; but they are more likely to experience fewer symptoms and not get as sick as those who aren’t vaccinated.

That is a good sign, which does allow quicker and easier recovery times for those infected who use the vaccine, but the idea of a vaccine that offers total immunity is not available at this time.

Because the vaccines do not necessarily protect against infection, that means that public health measures such as wearing masks, social distancing and avoiding indoor gatherings are still critical to containing the virus. More data will provide clues about whether people who are vaccinated and never experience symptoms can still spread the disease to others. But that’s not known at this time.

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Conclusion

A better understanding about COVID-19 allows the Pharmacy Technician to better serve the needs of their customers, friends, family and more importantly, themselves.

We have seen many advances in science to offer hope and a bright future in the treatment of COVID-19. In diligent use of proper non-drug protocols such as social distancing, hand washing and the wearing of masks we can greatly prevent the spread of COVID-19 virus to ourselves and others. With new drug protocols, we see a future of better treatment, less hospitalization and deaths of COVID-19 patients. If there is to be light at the end of the tunnel, we need everyone to understand the importance of becoming involved. If we are to see normalcy (our best case scenario), we need to continue onward in abiding by guidelines of CDC and viewing and using science as our secret weapon against this terrible pandemic. About the Author Joe Medina, CPhT, Pharmacist has helped thousands in the passing of the Pharmacy Technician national exam and was the former Program Director of a Pharmacy Technician Program at two community colleges in Colorado. Mr. Medina is a lifetime national advocate for the Pharmacy Technician Profession and well known on a national level through his company Tech Lectures®. Mr. Medina has helped produce several textbooks and co-authored the “Pharmacy Technician Workbook & Certification Review” through Morton Publishing and most recently “The Pharmacy Technician” through Learning Express Publications in 2018. Mr. Medina also has published over a dozen continuing education articles for national magazines. With fifteen years as a Pharmacy Technician and twenty plus years as a Pharmacist and Technician Educator, Mr. Medina understands the needs of the Pharmacy Technician and the important role they play in interacting with Pharmacists, Medical paraprofessionals and the community in the Pharmacy setting.

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Arentz M, Yim E, Klaff L. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA. 2020 Mar 19. doi: 10.1001/jama.2020.4326. Cates J, Lucero-Obusan C, Dahl RM et al. Risk for in-hospital complications associated with COVID-19 and influenza—Veterans Health Administration, United States, October 1, 2018-May 31, 2020. Morb Mortal Wkly Rep. 2020;69:1528–1534. Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19) in the U.S. [cited 2020 Feb 21]. https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

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https://www.healthline.com/health-news/best-materials-for-covid19-face-masks https://www.hopkinsmedicine.org/news/newsroom/news-releases/covid-19-story-tip-the-importance-of-wearing-a-mask Keller, M.A., Stiehm, E.R. Passive immunity in prevention and treatment of infectious diseases. Clinical Microbiology Reviews. October 2000, pp. 602-614, vol. 13, no. 4.

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Lecture 34 - Patient Safety - COVID-19 True or False _____ 1. Majority of “rapid diagnostic tests” for COVID-19 is the molecular tests _____ 2. Remdesivir can cause elevated transaminase levels in the kidneys _____ 3. A few T-Lymphocytes are also known as “memory cells” _____ 4. Pfizer brand vaccine is what is known as an mRNA vaccine _____ 5. Current vaccines do not necessarily protect individuals from COVID-19 _____ 6. Hand sanitizers should contain at least 60% ethyl alcohol _____ 7. Masks are only as good as the material and fitting around the mouth and nose _____ 8. Dexamethasone is often used to replace a natural hormone produced by the adrenal glands _____ 9. Passive immunity is when an individual is given someone else’s antigens _____ 10. Monoclonal antibodies are used to substitute that can enhance the immune systems attack on cells _____ 11. Viruses such as COVID-19 cannot be treated with antibiotics _____ 12. We need to recognize the seriousness of COVID-19 and realize our responsibility in following CDC guidelines

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