Local Doctors Sign Letter to Ragsdale and Cobb County School Board about COVID-19 protocols

coronavirus image -- a white sphere with red corona spikes emanating outwardThis illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. (public domain image)

The following letter was sent to the Cobb County School Superintendent Chris Ragsdale and the Cobb County Board of Education signed by 240 local doctors raising concerns about the Cobb County School District’s protocols for COVID-19, which ignore CDC recommendations:

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 2021-22 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 CDC guidelines. CCSD’s recently released Public Health Protocols for 2021-2022 do not comply with the most recent guidance from the CDC, AAP and CDPH 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 GA AAP (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 August 13, 2021, 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. Memark 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.

Karen Thrower, MDPediatrics
Laura Verigan, MDPediatrics
Sadia AliFoot and Ankle Surgery
Timothy LinPulmonary/Critical Care
Tejas MehtaPediatric Gastroenterology
Saira Adeel, MD, FACEEndocrinology
Maren Bear MD MPHPediatrics
Mona MegahedPediatrics
Sujatha HariharanHematology/Oncology
Dimple Shahinternal medicine
Joanna Kerr, CPNPPediatrics
Sadaria KishorInternal Medicine
Laura Badwan, MDPediatrics
Ahmad Khaldi, MDNeurosurgery
Ashleigh Clark, FNP-COB-GYN
Jonathan ChenPulmonary/Critical Care
Gautham Viswanathan, MDNephrology
Malar Ramasamy, MDNephrology
Vineet Reddy, MDPulmonary/Critical Care
Tammy Williams, MDPediatrics
Kumuda Ranjan, MDFamily Medicine
LaToya Oglesby MDPediatric Hospitalist
Usha Anand, MDHospitalist
Patrick Parkman AGACNP-BCCritical Care
Hiren V Patel, MDPulmonary/Critical Care
Sunitha Girish MDEndocrinology
Nana Arthur, MDHospitalist
Meena Visvanathan MDInternal Medicine
Marcus Goodman, DODermatology
Lindsay Green, MDPediatrics
Avanthi Doppalapudi, MDInfectious Disease
Alsadek Sultan, MDHospitalist
Monika KarakattuFamily Medicine
Annie Tang, MDEmergency Medicine
Pooja Bardhan MD MPHHematology-Oncology
Shaji J Puthuvel MDPsychiatry
Akhil Vallabhaneni, MDPulmonary and Critical Care
Shelly NorrisAnesthesiology
Amyn Hirani MDPulmonary and Critical Care
Neelima Kothari MDPulmonary and Critical Care
Andrew HelmsThoracic surgery
Ragheed AlturkmaniPulmonary Critical care
Zenobia JonesFosterHospitalist
Kathleen Empen MDPediatrics
Jocelyn Joseph MDFamily medicine
Frank Italiano MDPulmonary/Critical Care
Priya Behari MDInfectious Disease
Nirupama Natarajan MDChild and Adult Psychiatrist
Huda Sayed, MDPalliative Care
Joanna Dolgoff MDPediatrics
Prashant Patil, MDInternal Medicine
Arpita SrivastavaHospitalist
Satyen Mehta MDHematology/Oncology
Nikita Rangwalla MDPediatric Emergency Med
Saadia Ilyas MDFamily Medicine
Abdul SheikhCardiology
Anjali KhakhariaGeriatrics
Sheetal Desai, DOHospitalist
Faresa WeragodaCardiologist
Raj Valvani, DOPhysiatrist
Sarvenaz Danesh, MDintensivist
Seema Lee, MDHospitalist
Nasira Hussain, MDHospitalist
Katherine Gartin, MDPediatric Emergency
Amaka AwoniyiHospitalist
M. Ali Al-Azem, MDPulmonary Critical care
Raja Sappati MDGastroenterology & Hepatology
Smitha Battula MDChild & Adolescent Psychiatry
Frini Shah, MDPediatrics
Meaghan McKennapediatrics
Ritesh Shah, MDGastroenterology
Porsche Patil, NP
Martha Aguilera MD FACSHospitalist
Shelley Anderson, PAPulmonary Critical Care
Crain GarrotHematology/oncology
Varsha Patel, MDPalliative Medicine
Amanda McGahee, MD, FAAPPediatrics
Martha Aguilera MD FACSGeneral Surgery
Jyoti SharmaNephrology
Tracy Barr, MDPediatrics
Ebonique B. Moment MDAnesthesiologist
Remmya Nair, MDFamily medicine
Madhuri Meka MDGastroenterology
William T Dowdell MDPulmonary Critical Care
Aamer RahmanPulmonary/critical care
Anitha Nagappan MDInternal Medicine
Surya PalakuruPulmonary Critical Care
Sudhir Belagaje MDOrthopedic Surgery
Padma Iyengar MDPediatrics
Julie Patel, MDFamily Medicine
Kailash Kulkarni,MDInternal Medicine
Vaishanavi Laiwala,MDInternal Medicine
Sridevi AgasthiInternal medicine
Erik Trosclair, MDEmergency Medicine
Sadeka ShahaniEndocrinologist
Medel Reyes MDPulmonary Critical Care MED
Hina Hussain MDFamily Medicine
Adrienne Jordan, DOPhysical Medicine and Rehabilitation
Abdalsamih Taeb MDPulmonary and critical care
Jennifer Headrick, MDInternal Medicine
Anamika Khatri-DuaPediatrics
Vineet DuaCardiology
Edward StettnerEmergency Medicine
Anupama RavikanthInternal Medicine
Jordana Heaven, MDPediatrics
Joanna Miragaya MDEndocrinology
Alexis Ahonen, WHNPOBGYN and Infectious Disease Research
Mofolasade Adeyi, MD MPHFamily Medicine
Adriana Rzeznik MDPediatrics
Marvin Eric Nix, MDEmergency Medicine
Fonda D. Martin, MDObstetrics and Gynecology
Daquesha CheverFamily Med/ urgent cares
Margaux Charbonnet, MDPediatrics
Shailesh Malla MD FACCCardiologist
Namita Rajouria Malla MD FAPAChild Psychiatry
Sharon Sonenshine PNPPediatrics
Amit ThakralPediatric rheumatology
Shany Cohen-Sadan MDFamily medicine
Robert Stoltz, MD, PhDOphthalmology
Shivam Patel, MDEndocrinology
Dipika Sharma, MDPediatrics
Nirav Patel, MDPediatric Gastroenterology
Ashleigh El Sakr, MDPediatrics
Mohammad KamranRheumatology
Sydney Wang, PA-CPhysical Medicine and Rehabilitation
Menelaos Demestihas, MDEmergency Medicine
Ami Dalsania, DOPediatrics
Ofer Sadan, MDIntensivist
Aadil Vora DOEmergency Medicine
Jordan Howard, MDPsychiatry
Shital Popat, MDInternal Medicine
Adetolu Odufuye, MDEmergency Medicine
Tam Le, MDPediatrics
Jamie Weisman, M.D.Dermatology
Patricia Wolfe, DOPediatrics
Melani Cornelius-Sanders MDOB/GYN
Erica Judge Edwards, MDFamily Medicine
Janelle Williams Holder, MDPalliative and Hospice
Andre HolderCritical Care Medicine
Aerica Summers, MD, MPH, FAAFPFamily Medicine
Mohan Punja, MDEmergency Medicine
Shalabh “Mickey” Bansal, MDPediatrics
Claire K. Bush, MDPediatrics
Tina Vothang, MDPediatrics
Sharvari Rangnekar MDEndocrinology
Harini Chittineninephrology
Stanton StebbinsPediatrics
Hang Shi MDNeurology
Nicholas Chiera, DOOB/GYN
Francheska Alcide, MDFamily
Amber Driskell, MDInternal Medicine
Caroline Kemp,PA-CPulmonary Medicine
Nidhi G. Huff, MDPulmonary/ Critical Care
Thomas Sheftel, MDInfectious Disease
Brandy Blackwell-Ford,MDpediatrics
Josh HargravesEmergency Medicine
Prashant Mishra, MDInternal Medicine
Gagandeep Joshi, MDCardiology
Sivan Hines, MDPediatrics
Marisa Gadea, MDPediatrics
Jasmine Kearse, MDPsychiatry
Melanie Coon, CPNPPediatrics
Evelyn A Reynolds, MDGynecologic Oncology
Cynthia Colquhoun, MDPediatrics
Rohit PanchalPulmonary /critical care
Annisha Ellis, MDPediatrics
Vaishali ShahInternal medicine
Sahir ShroffSurgical oncology
Alexandra Vatzakas, MSN, AGACNP-BCPulmonary/ Critical Care
Belinda Graham,MDAllergy, Asthma & Immunology
Ashima Bharara, MDEmergency Medicine
Aashish Bharara, MDPain management
Bryan Kumiga D.O.Physiatrist
Wendy Book MDCardiology
Michael Piansky, MDInternal Medicine
Tariq Noohani, DOEmergency Medicine
Jody Hughes, MD, FCCPPulmonary/Critical Care
Sarah Bentley PA-CPulmonary/Critical Care
Angela R. McMichael, AGACNPCritical Care Medicine
Shaynah GoldfineAnkle & Foot specialist
Sohail Asfandiyar MDGastroenterology
Nitin Mayur, MDEndocrinology
Melissa Kinnebrew, MDDermatology
Katrice Larece, DOOB/GYN
Kylie Little, PA-CEmergency Medicine
Saima Hussain MDPediatrics
Anish Desai, MDGastroenterology
Eleza Golden, MDRadiology
Mary E. Coon, MDEmergency Medicine
Asif A. Saberi, MDPulmonary and Critical Care
Jennifer Giuseffi MDCardiology
Lyudmila TavrovskyInternal Medicine
Kelly Weselman, MDRheumatology
Dilani Weerasuriya, MDEmergency Medicine
Tracy Thomas, PA-CPediatric Pulmonology
Shreedhar Nagnur, MDInternal Medicine
Madhavi Siddhanthirheumatology
Justin Alexander, MDPM&R
Jay Desai, MDRadiology
Meagan Griffith, ACNPCardiac Surgery
Karim Ali, MDEmergency Medicine
Jacqueline W. GreenNeurology
Chirag Popat, MDPulmonary/Critical Care
Michael Lava, MDPulmonary/Critical Care
Melissa Boekhaus, MDPediatrics
Audrey Nuccio, MDNeurology
Heather Shields, NP-CInfectious Disease
Sajin Karakattu, MDPulmonary/Critical Care
Nicholas Irwin, MDEmergency Medicine
Anand Shah, MDOphthalmology
Nauman Rashid, MDEmergency Medicine
Joshua Davis, MDEmergency Medicine
Asif Choudhary M.D.C & A Psychiatry
Monica W Best, MDOb/Gyn
Reshma ShahEndocrinology
Humza Ilyas, MDDermatology
Yasamin Alwan Ilyas, DOPediatrics
Stacey Malstrom, NPCardiology
Anita Shetty, MDDermatology
Yasmeen Fareeduddin, DOChild & Adolescent Psychiatry
Habibur Rahman, MDPediatrics
Monica Bratton, MDOphthalmology
Amirah Brown-Johnson MDPediatrics
Margaret Omatsone MDInfectious diseases
Juron Foreman, MDEmergency Medicine
Rachel Swerdlin, CPNPPediatrics
Christopher Chan, DOPulmonary Critical Care
Juan C ArmstrongPulmonary Critical Care
Deepa Narang, MDPediatrics
Lubaina Rangwala, MDOphthalmology
Bradley Gaydos, MSN, FNP-CFamily Medicine
Nisha Ali FNP-CCardiology
Elizabeth BlackwoodPulmonary and Critical Care
Michael Nitzken, MD FACEPEmergency Medicine
Jenny E. Han, MD, MScPulmonary and Critical care
Matthew Whitley, MDPediatric ENT
Anand Mehta, MDPrimary Care
Vijay Nath, MDNephrology
Daniel N. SaadePediatrics