As physicians and healthcare providers in your communities, we have seen firsthand the devastating impact COVID-19 is having on our patients, hospitals, and health care workers. It is a battle we are fighting every day. In an effort to keep our communities healthy, we need your help to keep our students safe and healthy.

Hospitals throughout the country are seeing significantly more children who are sicker than at any other time during the pandemic. We want to encourage safe, common-sense strategies to prevent pediatric illnesses and hospitalizations while ensuring our children have the best opportunity to remain in school.

Due to the circulating and highly contagious Delta variant and rise in COVID-19 cases among young people, the Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP) recommends universal indoor masking by all students (age 2 and older), staff, teachers, and visitors to K-12 schools, regardless of vaccination status. For more in-depth information regarding K-12 school recommendations, view the CDC’s website.

Why are we recommending masking for ALL students and staff?

The Delta variant is more than twice as contagious as previous variants and hospitalizations of pediatric patients have increased.

Many North Dakota school systems are not performing adequate or timely COVID testing and are not recommending appropriate quarantine protocols creating confusion for parents and virus transmission within schools.

North Dakota’s vaccination rates are not sufficient to protect our children. We rank near the bottom of the United States.

Unvaccinated populations remain highly vulnerable to the Delta variant. In children, early observations show higher hospitalization rates and more severe illness.

Less than 30% of eligible school age adolescents have been vaccinated and represent a large potential for transmission and infection.

Elementary students are currently ineligible for vaccination, so their primary protection is masking and other mitigation measures. Some students with medical or developmental conditions are not able to mask consistently.

Local and state COVID-19 case rates are already far ahead of what they were last year and will continue to increase due to lack of masking and vaccination

Hospitals, including pediatric hospitals around the country, are reaching capacity and the peak of illness continues to be weeks away.

In-person school has clear educational, safety, physical and mental health benefits. Students and teachers are already getting sick. As you modify your schools COVID-19 safety plans, please require masking by all staff and students. Universal masking is the best and most effective strategy to create consistent messaging and expectations. We also strongly recommend COVID-19 vaccinations for your employees and community members especially those working directly with children in schools. The vaccines are highly effective and safe.

Safe and healthy school environments must be everyone’s responsibility, and these mitigation strategies are essential. Without these efforts children will get needlessly sick, there will be severe illness, and potentially even death.


Members of the North Dakota chapter of the American Academy of Pediatrics, North Dakota Medical Association and the North Dakota Academy of Family Physicians

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