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Miles and Brytney Cobia, both physicians in Birmingham, Alabama, had been taking every precaution while working at their hospital, especially since Brytney is pregnant with the couple's second child.

Outside of work, they'd been seeing only family, and a very few close friends, who'd been similarly compulsive about being cautious in a state that's now seeing some 2,000 new cases of COVID-19 each day.

The Cobias cancelled a planned vacation to Florida in July given the state's soaring case counts, opting for a long weekend at a secluded Alabama lake instead.

The weekend of July 11-12, they invited only their closest family members, including their parents who are in their 60s, to join them primarily for an outdoor gathering lakeside. All of these family members had been taking the utmost precautions as well.

They spent the majority of the time outside (more than 90%), and not everyone was together at once, so they were mostly able to keep a safe distance.

But they didn't wear masks.

Now, eight of the 11 people who went to the lakehouse -- including the Cobias -- have tested positive for COVID-19. They said they also suspect their 2-year-old daughter has the virus based on symptoms.

"We did not mask while visiting with family because we let our guard down and thought we were safe," Miles said in a . He said he wanted to share his story to encourage others to take every precaution possible.

"We had a false sense of security," Miles told 麻豆传媒. "We haven't been going to bars, weddings, mass beach gatherings. We felt we were doing something isolated, that we'd be okay."

"We hope our story can teach people to take the maximum precautions if they do gather," he said.

Patient Zero?

On that fateful weekend, family members started arriving around noon on Saturday, and different family members came up at different times. They were outside largely the entire time, until going to bed around 10 p.m. Only seven people stayed in the house overnight, and each family unit had separate bedrooms on separate floors. Guests left by Sunday afternoon.

Brytney was the first to show symptoms, which began in earnest on Monday. She had a low-grade fever at 99.5°F, congestion, sneezing, a sore throat, and fatigue.

A hospitalist (she didn't want to name the hospital), she said she suspects she was the group's patient zero, though she's not sure how she got the disease. The hospital wouldn't allow her on the COVID wards since she's pregnant, and she had sufficient personal protective equipment (PPE), wearing mostly N95 masks, but sometimes opting for a surgical mask.

All patients in the hospital are routinely tested for COVID, and the hospital has a dedicated medical floor and a dedicated ICU for COVID patients, she said.

"In the 14 days before symptom onset, we hadn't been anywhere besides home and work, so my best guess is that I was exposed by another employee, or perhaps by a patient who had a false-negative test," she said.

She noted that many patients who are not on the COVID wards don't wear their masks. When she walks into their rooms, it's "on the side of their bed, or on the tray table."

She said she'll often ask them to put their masks on, but there are scenarios where that's nearly impossible, like end-of-life visits. These patients can have multiple visitors and when walking into such a situation, it's difficult to ask everyone to mask up.

'Use Us as an Example'

Still, Miles and Brytney thought through other possible sources of infection. They're sure it wasn't other family members because they weren't going out either. Their daughter was in daycare, but there were no other known cases in her class. It likely wasn't Miles, who finished a neurology fellowship at the end of June and hadn't been in the hospital since. They'd disinfected all the surfaces at their lakehouse rental.

They notified their family members who'd been with them at the lakehouse and advised them to get tested that Thursday or Friday, recommending that they wait 72 hours after exposure before testing to help avoid false negatives.

Thus far, almost everyone has had a relatively mild course. Miles had only mild congestion, mild headache, some fatigue, and decreased appetite. Their toddler had a very brief, mild fever that resolved quickly.

Other family members in the same age group have suffered worse symptoms. Some have had temperatures of 101-102°F, diarrhea, and nausea. One of the older attendees has pneumonia but is managing at home. Everyone has an oxygen saturation monitor and have had normal blood oxygen levels. No one's had severe shortness of breath.

But every single one of them has lost their sense of smell, whether they had congestion or not, Miles said.

Both Miles and Brytney say they're doing better now, more than a week into their illness. He's still congested, while she's more fatigued, which is likely compounded by pregnancy, she said.

Miles did take some heat for the tweet, from commenters who said a doctor should have known better, but he's owned up to the decision.

"We take full responsibility for the mistake," he tweeted. "We had become used to relying on this small group for socialization during this and it's devastating that even this failed. Regardless, I want people to use us as an example and learn just how contagious COVID-19 can be."

It's an important message as "COVID fatigue" sets in even deeper, he said: "People are starting to do things like go to weddings, but there's still a risk associated with that. There may even be a higher risk now than compared with March or April. The amount of virus is higher now."

Alabama enacted a , and the Cobias will have theirs on when gathering with family from now on.

"The reality is, nobody is safe," Brytney said. "We have to balance our mental health with staying safe."

, she urged, "Keep your mask on. Don't be me. Don't wear a mask everywhere else in the world EXCEPT around your core. Your core is probably more important to you than anyone! Don't trust any of them -- least of all yourself! Don't be patient zero for the ones you love."

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