US president Donald Trump has defended his decision to extend restrictive social-distancing guidelines until the end of April, while bracing the nation for a coronavirus death toll that could exceed 100,000 people.

“The worst that could happen is you do it too early and all of a sudden it comes back,” Mr Trump said during a nearly hour-long call-in interview with Fox & Friends as members of his coronavirus task force fanned out across other media outlets to warn the virus’ spread was only just beginning.

The comments came a day after Mr Trump made a dramatic course reversal and announced that he would not be moving to ease the guidelines and get the economy back up and running by Easter, as he said last week he hoped to do.

In the face of stark projections from his team and searing images of overwhelmed hospitals in his native New York City, Mr Trump instead extended to April 30 the social-distancing guidelines, which had been set to expire on Monday.

Many states and local governments already have stiffer controls in place on mobility and gatherings.

On Sunday, Dr Anthony Fauci, the government’s top infectious disease expert, said the US could experience between 100,000-200,000 deaths and millions of infections from the pandemic.

That warning hardened a recognition in Washington that the struggle against the coronavirus will not be resolved quickly even as Mr Trump expressed a longing for normalcy.

“It would not have been a good idea to pull back at a time when you really need to be pressing your foot on the pedal as opposed to on the brakes,” Dr Fauci said on CNN on Monday, describing how he and Dr Deborah Birx, the coronavirus task force coordinator, had convinced Mr Trump to reconsider.

“We showed him the data. He looked at the data. He got it right away,” Dr Fauci said. “It was a pretty clear picture. Dr Debbie Birx and I went in to the Oval Office and leaned over the desk and said, ‘Here are the data. Take a look’. He just shook his head and said, ‘I guess we got to do it’.”

Americans are now being asked to prepare for at least another 30 days of severe economic and social disruption, with schools and businesses closed and public life is upended.

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One in three Americans remain under state or local government orders to stay at home to slow the spread of the virus, and employment claims have already skyrocketed.

The federal guidelines recommend against group gatherings larger than 10 and urge older people and anyone with existing health problems to stay home.

People are urged to work at home when possible and avoid restaurants, bars, non-essential travel and shopping trips.

For more than a week, Mr Trump had been bombarded by calls from outside business leaders who urged him to begin reopening the nation’s economy, at least in places with low infection rates, and warned of catastrophic consequences that could damage his reelection chances if it remained shuttered for much longer.

Mr Trump told Fox & Friends that “nobody” was “more worried” about the economic impact on the country than he was. But he said, “We want to do something where we have the least death.”

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Dr Deborah Birx, White House coronavirus response coordinator, speaks during a coronavirus task force briefing as Donald Trump and Dr Anthony Fauci listen (Patrick Semansky/AP)

Mr Trump, who has largely avoided talk of potential death and infection rates, cited projection models on Sunday that said 2.2 million people or more could have died had social-distancing measures not been put in place. And he said the country would be doing well if it “can hold” the number of deaths “down to 100,000″.

In addition to the numbers, Mr Trump said he was moved by harrowing scenes from New York, particularly hard-hit Elmhurst Hospital in his native Queens.

He described the images he had seen on television with “body bags all over, in hallways. I’ve been watching them bring in trailer trucks — freezer trucks… because they can’t handle the bodies, there are so many of them…. I’ve seen things that I’ve never seen before.”

But experts warn that those scenes could play out across the country, as the virus spreads.

Dr Birx and Dr Fauci said even areas that have so far been spared must prepare for the eventuality that they, too, will become hot spots, with undetected cases likely in existence now.

“It’s critical that even if you don’t see it, it could be circulating in your community,” Dr Birx told CBS This Morning on Monday.

Dr Fauci said on ABC’s Good Morning America that smaller US cities are now ripe for the kind of acceleration that has occurred in New York.

“If you look throughout the country there are a number of smaller cities that are sort of percolating along,” Dr Fauci said. “It looks like it’s low level, it starts to accelerate, then it goes way up.”

The US had more than 140,000 Covid-19 cases reported by Monday morning, with more than 2,500 deaths, according to data compiled by Johns Hopkins.