LOS ANGELES -- When Dr. Imran Siddiqui went to bed Thursday night, he set the alarm for 4:30 a.m.
As the director for both the Desert Valley Medical Group in Victorville and a nearby nursing home, Siddiqui's days have been long and stressful since the COVID-19 pandemic began its deadly assault on California more than six weeks ago. But it's faith as much as duty that will require him to rise early each morning for the next month.
Because in addition to being a doctor, Siddiqui is a devout Muslim, and like thousands of other faithful first responders, he will be waking before dawn for a large breakfast, then going without food and water throughout the daylight hours of Ramadan, the Islamic month of fasting that ends May 23.
"My weakness in Ramadan is not food, it's not water," Siddiqui said. "It's coffee. I need to have a cup of coffee in the morning. Or two cups."
The fast is obligatory, one of the five pillars of Islam. Yet for frontline healthcare workers, observing it could be extra difficult this year. The novel coronavirus has overwhelmed emergency rooms and intensive care units, infecting more than 9,000 U.S. healthcare providers and killing more than two dozen, according to a study released earlier this month by the Centers for Disease Control and Prevention.
Uneven reporting across the country, the CDC added, means the real numbers are almost certainly much higher.
And that has some doctors and Islamic scholars questioning whether working long hours in a challenging environment without food and water is wise.
"This has been a discussion," said Dr. Faisal Qazi, a neurologist and an assistant professor at Western University and UC Riverside. "In Ramadan fasting, you're not hydrated, so it's different than other forms of intermittent fasting."
The use of personal protective equipment, including masks, could increase the chances of dehydration. Religious officials in the United Arab Emirates have said that those treating COVID-19 patients there are exempt from fasting, but most Islamic leaders in the United States insist healthy caregivers here should have little problem fasting.
"This COVID-19 situation doesn't really change that normality," said Dr. Aasim I. Padela, an emergency medicine physician at the University of Chicago Medical Center and director of the Initiative on Islam and Medicine. "Now what has been a concern is that frontline workers like me who are fasting and making very critical decisions or surgeons who are making critical decisions ... people are saying it might be more difficult, I might become more dehydrated because I have to wear all these extra layers of protection.