An Open Letter to North Dakota School Boards Association and all School Boards in North Dakota

August 17, 2021

An Open Letter to North Dakota School Boards Association and all School Boards in North Dakota,

The following members of the North Dakota Chapter of the American Academy of Pediatrics (NDAAP) and our partner health care providers call on all school boards in North Dakota to adopt COVID policy consistent with the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC). We write this letter as North Dakota suffers a surge in COVID-19 cases as the virus’s highly contagious Delta variant makes its way across the country. Increases in infections, hospitalizations, and deaths have concerned medical and educational professionals, who wish to bring children back into classrooms while minimizing the risk of a COVID-19 outbreak.

The AAP and partnering organizations strongly recommend that all school plans for COVID-19 start with a goal of keeping students safe and physically present in school. The importance of in-person learning is well-documented, and there is substantial evidence of the negative mental and physical health impacts on children because of school closures in 2020.

To maintain in-person instruction while mitigating risks, the AAP and CDC urges schools to adopt the following clear recommendations:

• School districts be in close communication and coordinate with state and local public health authorities, school nurses, local pediatric practitioners, and other medical experts.
• All eligible individuals should receive the COVID-19 vaccine.
  • Only 26.2% of vaccine eligible adolescents in North Dakota have received partial vaccination and only 20.7% are fully vaccinated.
  • North Dakota as a whole has only 50.6% of the population partially vaccinated and 47.1% fully vaccinated.
• All students older than 2 years and all school staff should wear face masks at school (unless medical or developmental conditions prohibit use) for the following reasons:
  • A significant portion of the student population is not yet eligible for vaccination;
  • Protecting unvaccinated students from COVID-19 reduces transmission;
  • It is difficult for schools to monitor or enforce mask policies that are optional or exempt vaccinated persons; universal masking is the best and most effective strategy to create consistent messages, expectations, enforcement, and compliance;
  • As noted above, North Dakota has an extremely low vaccination rate, meaning many community members are not protected from COVID-19;
  • Universal masking from the 2020-21 school year meant a demonstrable decline in other respiratory illnesses that could take children away from school;
  • The Delta variant is more easily spread among children, adolescents, and adults.
• Adequate and timely COVID-19 testing resources must be available and accessible.

• Schools must continue to take a multi-pronged, layered approach to protect students, teachers, and staff. Combining these layers of protection will make in-person learning safe and possible.

It is critically important to develop strategies that can be revised and adapted depending on the viral transmission and test positivity rate throughout the community and schools. School policies should be adjusted to align with new information about the pandemic; administrators should refine approaches when specific policies are not working.

Schools have an obligation to keep children safe during the Delta variant surge and adopting the recommendations from the AAP and CDC is the best way to do this.

Sincerely,

Grant Syverson, MD, FAAP NDAAP Policy Chair

and

Tatsiana Aleksandrovich, MD Kathy Anderson, MD, FAAP Samuel Anim, MD

Stephanie Antony, MD, FAAP Rebecca Bakke, MD

Cody Baxter, PA-C

Ashley Benson, DNP, APRN, CNP Timothy Blaufuss, DO

Carrie Brower-Breitwieser, Ph.D., LP, BCBA-D Ann Cadwalader, MD, FAAP

Thomas Carver, DO, FAAP Kari Casas, MD

Melanie Chihak, DO Chris Cleveland, MD

Jordan Coauette, MD, FACOG Joan Connelle, MD, FAAP Christina daSilva, MD, FAAP Amanda Dahl, MD

Rachel Faleidi, DNP, FNP-C Jane Gaffrey, DO

Stephanie Hanson, MD, FAAP

Jaclyn Held, DO, FAAP

Caitlin Hemquist, APRN, CPNP Aubrey Hess, MPAS, PA-C Justin Horner, MD

Melissa Horner, MD, FAAP Alison Hornyak, DO, FAAP Julie Kenien, MD

Diane Kjelstrup, MD Parag Kumar, MD, FAAP Melissa Kunkel, MD Clifford Mauriello, MD

Tapati Mazumdar, PhD, MPH Stephen McDonough, MD, FAAP Brandon Meyer, MD, FAAP Hope Meyer, MD

Jagila Minso, MD, FAAP

Robert Montgomery, MD, FAAP Avish Nagpal, MD

Stephen Nelson, MD, FAAP David Newman, MD

Tracie Newman, MD, FAAP Amy Oksa, MD, FAAP Amanda Oney, CPNP

Koye Oyerinde, MD, FAAP Sarah Paur, APRN-CPNP Chris Pribula, MD

Myra Quanrud, MD, FAAP Carrie Ann Ranum, MD, FAAP Sara Reinke, MD, FAAP

Erica Sauer, MD

Melissa Seibel, MD, FAAP Arveity Setty, MD, FAAP Roopa Sharadanant, MD Parveen Suhara Wahab, MD Alex Thompson, MD

Brenda Thurlow, MD, FAAP Stephen Tinguely, MD, FAAP Chris Tiongson, MD, FAAP

Abigail Burkett Vetter, DNP, APRN, CPNP Berit Wallevand, PA-C

Jamie Zink, PA-C