The folks who should be influencing policy on COVID-19 in Cobb schools are making a renewed effort to be heard. This letter urging the Cobb County School District to mandate masks bears the signatures of 240 physicians.

Dear Superintendent Ragsdale and Members of the Cobb County School Board:

We the undersigned are writing to you as physicians and advanced practice providers who are also parents, and/or taxpayers, and/or members of the Cobb County community or care for patients in Cobb County. We are deeply concerned that our district has chosen to disregard best practices for mitigation for the 2021-2022 school year despite the current public health guidelines and increasing number of cases, including outbreaks at multiple schools throughout the county.

Despite assurances to the contrary prior to this school year, the district is not adhering to Centers for Disease Control and Prevention guidelines. The CCSD recently released Public Health Protocols for 2021-2022 do not comply with the most recent guidance from the CDC, American Academy of Pediatrics and the Cobb & Douglas Public Health for safe school reopening and COVID-19 risk mitigation. It was noted in that communication that these current protocols are “based on the same priorities which successfully navigated us throughout last year.”

We succeeded in keeping schools open and spread down through the use of mitigation measures including masks, physical distancing where possible, a strict quarantine and isolation policy, and a robust virtual option which served the purpose of reducing the number of individuals in the school building, allowing for distancing. Now the district has decided to eliminate all of these measures, putting our students and your staff at risk.

The current recommendation from the Cobb & Douglas Public Health officials is for all schools and school districts to follow CDC guidelines. CDC guidelines include the use of masks while indoors for all individuals above the age of 2:

Due to the circulating and highly contagious Delta variant, CDC recommends universal indoor masking by all students (age 2 and older), staff, teachers, and visitors to K-12 schools, regardless of vaccination status.

In addition, the CDC recommends a multilayered approach to prevention, including distancing and screening testing:

When it is not possible to maintain a physical distance of at least 3 feet, it is especially important to layer multiple other prevention strategies, such as screening testing. Screening testing, ventilation, handwashing and respiratory etiquette, staying home when sick and getting tested, contact tracing in combination with quarantine and isolation, and cleaning and disinfection are also important layers of prevention to keep schools safe.

Regarding staff and students who are exposed, there is no carve-out for those whose exposures occur in the school building. While we all acknowledge the importance of in-person schooling, this must be balanced with the safety of the students, staff and community.

Again, from the CDC:

Students, staff, and educators who have been in close contact with someone who has COVID-19 should receive diagnostic testing and should begin quarantine. Exceptions include someone who has been fully vaccinated and shows no symptoms of COVID-19 does not need to quarantine but should be tested 3-5 days following a known exposure to someone with suspected or confirmed COVID-19 and wear a mask in public indoor settings for 14 days or until they receive a negative test result and those who have recovered from COVID-19 within the past 3 months.

We agree with the open letter sent to all Georgia school superintendents, on 7/20/21 in which the Georgia America Academy of Pediatrics (representing 1,800 pediatricians across our state) has urged school districts to follow the AAP Guidance for schools:

All students older than 2 years and all school staff should wear face masks at school (unless medical or developmental conditions prohibit use).

In addition, “Include multiple layers of other protection such as social distancing and good ventilation. The recommendations are that schools maintain at least 3 feet of physical distance between students in classrooms wherever possible, combined with indoor mask wearing, to reduce transmission risk.”

As of Aug. 13, there is high level of community spread of the virus that causes COVID-19. In Cobb, currently there are 493/100k cases, a rate that Dr. Janet Memark, Cobb and Douglas Public Health District director, calls alarming.

In addition, our test positivity rate is 12.8%, which indicates that insufficient testing is occurring to detect all of the cases. The leading health experts in the country recommend that schools be closed at a rate of 100/100k, which is 20% of the level of spread we are seeing right now.

As the delta variant spreads and cases mount, it is critical to utilize a layered approach to COVID-19 prevention. Thousands of Cobb students and staff have been exposed at school. Slowing the spread in schools is essential to slowing community spread.

Currently our hospitals, ICUs, and clinics are struggling to provide care for the whole community, and with the continued rise in cases our hospitals could become overburdened. When that happens, it puts everyone who may need medical care (regardless of condition) at risk.

Until K-12 schools meet a high enough threshold of vaccination for both students and staff, we must continue the layered approach that has been shown to keep school transmission rates low, including the use of face coverings, physical distancing, excellent ventilation, adherence to a strict quarantine policy, and a robust virtual option. Otherwise, more school outbreaks of COVID-19 are inevitable, leading to illness and subsequent disruptions to learning.

As it stands now, we see no evidence that you have followed public health guidelines and used proper mitigation strategies. Our students, staff and community deserve to be protected while they learn, yet your decisions have placed the majority of them at risk. You are directly accountable and in a position of power to provide our children with a safe learning environment.

We expect you to modify your 2021-2022 Public Health Protocols to adequately address the current severity of the pandemic and help to ensure a safe and healthy community.