After working for weeks to prepare for the coronavirus pandemic, Dr. Mustafa Ahmed is now fighting his own case of COVID-19.
"For me it was just like being hit by a train," he says.
Ahmed is an interventional cardiologist at the University of Alabama at Birmingham, a major medical hub for the state. Now, Alabama's largest city is under a shelter-in-place order, as city leaders here have taken a more aggressive approach than the state officials have in order to curtail the spread of the disease.
Ahmed's symptoms came on fast — intense headache, fever, muscle aches, and fatigue.
"It's a scary thing when you get this because you're seeing colleagues and health care workers around the world really struck down with this," Ahmed says.
He's 38 and had been in good health. Now he's in single room isolation at home, using technology to connect remotely with family around the world, and his colleagues at UAB.
Because of a lack of widespread testing, he says there's no way to pinpoint how he became infected.
"Is it from just walking around?" he asks. "Is it on the way into work? Is it people you passed the week before that don't want to social distance?"
Universal questions, Ahmed says, that could only be answered with universal testing, something that's not possible right now.
"This is a weekly moving target," he says.
He says testing at UAB has expanded from weeks ago when tests were scarce and results took days to process. Now results are back in hours, and there's promise of a more rapid test.
"Where we are right now, this minute is a long, long — what's the best way to say this? — is a hell of a lot better than where we were this time last week," Ahmed says.
Regardless of the testing capacity, there's no question that there's community spread happening in Birmingham right now. UAB and other local hospitals started getting their first wave of severe cases last week.
"We're just starting and it's going to get much, much worse, says Ahmed.
The prospect has city leaders trying to get the word out.
Birmingham Mayor Randall Woodfin has been holding tele-town halls to relay a sense of urgency to various communities including neighborhood and church leaders, students, and Spanish speakers.
Woodfin says when 12 days of voluntary social distancing didn't work, the city adopted a shelter-in-place ordinance.
"To lock this city down," Woodfin says. "To stop [nonessential] movement because we needed to take every measure to prevent community spread."
The action is at odds with state policy.
"I do not think our economy needs a full shelter-in-place order," Alabama Gov. Kay Ivey said at a press briefing.
"My word of caution to those who want to take a more direct action is this – government can choke businesses," she said.
Mayor Woodfin disputes that it's an either/or proposition.
"If government doesn't take action, it can also cost people their lives," he says.
Dr. Ahmed at UAB agrees, and says nowhere in the world are health officials saying they did too much.
"No one," he says. "Every single place seems to have wished that they did more and acted earlier."