The reopening of schools will have an impact on infection rates that could affect the roadmap for lifting restrictions, Boris Johnson has warned as England’s deputy chief medical adviser said it was too soon to rule out a fourth wave taking off.

The comments sparked alarm from a number of Tory MPs, who insisted the government should remain open to an earlier lifting of lockdown measures.

Speaking after millions of pupils returned to schools across England on Monday, the prime minister said the number of people being admitted to hospital with Covid-19 each day was eight times higher than “the lows of last summer”, and reiterated that people must still follow the “stay at home” message.

“Of course, there will be a risk of increased transmission, that’s inevitable if you open up schools for millions of kids across the country. That is going to happen,” he told a Downing Street press conference.

Jenny Harries, the deputy chief medical adviser for England, said infection rates remained at the same levels as in late September, even without the effect of schools returning. That was the same period when government scientists became so concerned about infection rates that the government was advised to consider a two-week circuit-breaker lockdown.

Harries said although there was now a steep decline in cases and deaths, infections were still causing a “substantial strain on the NHS”.

“The case rate is still falling, it’s below 100 per 100,000 in every region across the country, but it’s not uniformly across the country,” she said. “You can see that the rate is now back where it was in the end of September. So, still quite a high level, this is a level which a new wave could easily take off again from.

“The number of people in hospital with Covid-19 [is] … back down to around 10,000 but this is still a substantial strain on the NHS … a good sign but there is still some way to go.”

Johnson said it was right that parents were sending their children back to school, and praised those who ran home-schooling, especially mothers.

“We all know that the education of our children is so important that the greater risk now is keeping them out of school for a day longer,” he said, speaking on International Women’s Day. “We all know that the burden has disproportionately fallen on women often holding down jobs and providing childcare at the same time.”

Although schools reopening was a “crucial first step on what we hope is our cautious but irreversible roadmap to freedom”, the government would need to monitor the effect of pupils’ return on the rest of the roadmap, the prime minister said.

Asked whether he would consider speeding up the easing of lockdown, Johnson said: “We have to look at the rates of infection. We have seen, alas, in other European countries that the curve is going up again, and we remember frankly what happened every time we’ve seen those upwards curves in our friends and neighbours that it is not too long after that that we see an increase in this country as well.

“I think people would really rather trade some urgency and some haste in favour of security and certainty about those dates that we have set out.”

Some MPs said there was growing discontent about the caution in the roadmap. Mark Harper, the chair of the Covid Recovery Group of lockdown-sceptic backbenchers, said: “We must be led by data, not dates. The data is outpacing [the government’s] pessimistic assumptions.”

Chris Green, the Conservative MP for Bolton West, said: “We are leaving rather than entering the respiratory virus season and vaccinations all mean that there is no equivalence between now and September. We need to return to normal.”

Another Tory MP signalled that internal anger was growing, saying: “International travel will remain a problem, but if the hospitalisation figures are going down rapidly I don’t see why we shouldn’t bring forward some dates – that would encourage people.”

Earlier, the government was forced to clarify growing confusion over Covid testing in secondary schools in England, after warnings that thousands of pupils and their families could end up having to self-isolate unnecessarily.

The latest muddle centred on testing at school versus testing at home. According to government guidance, pupils are required to have their first three lateral flow device (LFD) rapid tests in school over a two-week period. If they test positive they and their families must self-isolate, without confirmation from a more accurate polymerase chain reaction (PCR) test.

After the first three on-site tests, pupils will test themselves twice weekly at home using LFDs. If they receive a positive result they will be required to have a PCR test to confirm. If that test proves negative, it overrides the less accurate LFD test and the pupil can return to school without self-isolating.

The logic appears to be that testing at school by a trained operator will be more reliable than a test done at home, but headteachers said the situation was “absurd” and asked ministers to reconsider the rules.

Julie McCulloch, the director of policy at the Association of School and College Leaders (ASCL), said: “We are baffled by this difference, and concerned that it might lead to thousands of children needing to self-isolate unnecessarily when they should be able to return to school.”

Amid concerns about the uptake of Covid testing, which is voluntary, a snap survey of more than 700 secondary schools and colleges by ASCL found just over half reported take-up of on-site Covid tests of 90-100%. Just 6% of schools reported take-up below 60%.

Harries said she was “very optimistic” that children would not now need to spend long periods of time out of the classroom. “There may be a very short period at the start of this programme where everybody gets used to it and a larger number of children come out of school and then it will settle down,” she said.

This content first appear on the guardian

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