Reopening schools could lead to coronavirus infections rising and force the reintroduction of some local lockdown measures, the UK’s most senior medical advisers have warned. In a joint statement on Saturday night, the chief and deputy chief medical officers from across the UK said while there were “no risk-free options”, further time out of the classroom would increase inequalities, reduce the life chances of children and could exacerbate physical and mental health issues. They said they were confident that there was an “exceptionally small risk of children of primary or secondary school age dying from Covid-19”. However, they added that it is “possible that opening schools will provide enough upward pressure on R that it goes above 1 having previously been below it, at least in some local areas”. They add: “This will require local action and could mean societal choices that weigh up the implications of imposing limitations on different parts of the community and the economy.” The R value reflects the average number of people a person infected with coronavirus passes the disease on to. When the figure is above 1, an outbreak can begin to grow exponentially. Chris Whitty, England’s chief medical officer, warned that Britain faced a “real problem” with coronavirus this winter and that it would remain a “serious challenge” for at least the next nine months. Asked about the potential for the return of lockdown measures, he said: “That is certainly possible and I don’t think that’s a controversial statement, I think that’s just a statement of reality. As I have said in various other situations, we are left with a large number of situations where we have to make really quite difficult choices. There are no easy choices in confronting coronavirus. “The fact of schools being open will probably lead to some increase in transmission but much of that is indirect, it’s not so much the children passing it on but the fact that schools are open allows more mixing of adults in the workplace and in other environments. “The result of that is that it will create some upward pressure on the R, it may increase it. The evidence from other parts of the world is that when schools have opened, this has not led to a sudden surge in transmission that looks as if it’s due to the schools opening and we are very confident this effect is not anywhere near as severe as it would be, for example, with flu where children and schools are a very large part of transmission. But it is likely to put some pressure upward on R and if that happens we will have to respond.” He added: “What we are trying to do is learn the lessons from the first wave of coronavirus to minimise the chance of significant impact in the medium to long term. But I do want to be really clear, even with all the information we have got now, even with all the tools we have at our disposal now, we have still got a really serious challenge of coronavirus for at least the next nine months. Going into winter, we’re going to have real problems with this virus and the information we have got on this virus will help us but it does not take away the fact this is a very very substantial challenge we are all collectively going to have to respond to.” In their joint statement, medical officers from across the four nations said the evidence that older children and teenagers are at lower risk of catching Covid-19 “is mixed”, adding: “Very few, if any, children or teenagers will come to long term harm from Covid-19 due solely to attending school. This has to be set against a certainty of long-term harm to many children and young people from not attending school.” They said that international evidence did not suggest school reopening was followed by a surge in infections, but added that this could not be concluded with confidence. “Early identification and quickly managing outbreaks of Covid-19 in schools is essential as part of a local response to Covid-19,” they stated. “Clear advice for pupils and staff not to attend school with symptoms, and prompt availability of testing, appropriate isolation advice, and careful public health surveillance and monitoring of educational establishments are key to support the safe return to schools.” They said that changes related to the reopening of schools could be “as important as what happens within the school”. They cited parents going back to work, meeting at the school gates, public transport and shared vehicles.