With the Covid-19 outbreak in the US affecting many areas with large Arab-American populations, medical professionals from the community are at the forefront of the battle to treat overwhelming numbers of people affected.
States such as Michigan, New York, Florida and California, which have been hit hardest by the rapid spread of the respiratory disease, are also home to most of the nearly 3.5 million Arab Americans in the US.
Even the man at the centre of the presidential task force to address the crisis, Secretary for Human and Health Services Alex Azar, is of Lebanese descent.
The impact of the pandemic on the US, with more than 430,000 cases and nearly 15,000 deaths so far, is familiar to some Arab-American medics who have worked in man-made disasters such the Syrian civil war.
Zaher Sahloul, a critical care doctor at Christ Advocate Medical Centre in Chicago and president of refugee assistance group MedGlobal, said the situation at his hospital was closer to a “war zone".
Dr Sahloul, who is of Syrian descent, said the system was being overwhelmed by the number of patients while facing a shortage of resources.
He has led medical aid missions to Syria for the past nine years to help civilians affected by the fierce fighting, which destroyed many medical centres.
Now back in Chicago, he says the medical instinct to help in an unravelling health system is similar, although the deprivation was much higher in Syria.
"No matter what we do, some of the patients will die. It is painful but life prepares you for disasters," Dr Sahloul told The National.
“My hospital here in Chicago has more ventilators than the whole of the Gaza Strip and Syria combined."
But it was also reaching full capacity and having to move Covid-19 patients to different wards, while doctors were forced to use the same mask for days, he said.
The state of Illinois has over 15,000 cases and more than 400 have died because of the coronavirus.
The state is home to more than 111,000 Arab-Americans, according to the Arab American Institute.
Dr Salhoul said the pandemic would create empathy for Syrian healthcare workers and what they have gone through, sometimes sacrificing their own lives trying to save others.
In Michigan state, home to a quarter of a million Arab-Americans, even medical professionals not normally involved in treatment are trying to help the system cope with the more than 20,000 Covid-19 cases detected as of Wednesday, of whom nearly 1,000 have died.
One of them is Dealla Fakhouri, a nurse in the clinical research division at Henry Ford Hospital in Detroit who transferred to the intensive care unit in late March.
“I wanted to go where I can help,” said Ms Fakhouri, who is of Jordanian descent.
She described a harrowing situation that “nobody can ever be completely prepared for”.
Most of the patients under Ms Fakhouri's care are on respirators, hooked up to tubes and monitors, and their families are bracing for the worst.
"It's very overwhelming but also empowering to be on front lines to help these patients," she told The National from her home, where she is isolating herself from her family to protect them.
As an Arab-American, Ms Fakhouri said, it was wonderful to be able to give back to the country and the state where she grew up.
But she also emphasised the contributions of all health workers, regardless of their origin.
“Being Arab-American is a bonus, it’s wonderful, but I do want to say that the nurses I work with, no matter their nationality or ethnicity, we are all in this together.”
She considers herself one of the lucky ones as her hospital has not had shortages of gowns, ventilators and other essential equipment.
Not far from the Detroit suburb where Ms Fakhouri works, Belal Abdallah, a veteran doctor in the Michigan community, said Arab-Americans has been coming together and volunteering their services to help those in need.
"The community has risen to the call during this pandemic, with people helping each other out with food delivery, transportation, shelter," Dr Abdallah told The National.
“I am also proud of the fact that most of the community understood the importance of social distancing."
All restaurants, cafes and salons have complied with Michigan Governor Gretchen Whitmer's order to shut.
But Dr Abdallah, who emigrated from Lebanon in 1973 and has been practising medicine since 1995, is worried about underlying medical conditions in the community as it faces the virus.
“We have many in the community with diabetes, hypertension or who smoke," he said.
One of the cases with which he is involved is that of a Lebanese-American patient in his forties who is suffering acute respiratory distress syndrome, also know as Ards.
Dr Abdallah said he had been drawing up contingency plans since the first Covid-19 case landed in the US on January 15.
“I created a plan to go virtual and rolled out video with instructions later in March,” he said.
The biggest challenge “is determining which patients, whether young or old, are at risk for developing Ards and respiratory failure and death”, Dr Abdallah said.
His hope is that, until a vaccine is developed, people behave "as if the virus is in the air, with everyone else potentially infected and perhaps asymptomatic”.
