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A street in New York's Chinatown is empty, the result of citywide restrictions calling for people to stay indoors and maintain social distancing in an effort to curb the spread of COVID-19, Saturday March 28, 2020, in New York.

The Associated Press

Bracing the country for a grim death toll, U.S. President Donald Trump on Sunday extended the voluntary national shutdown for a month, bowing to public-health experts who told him the coronavirus pandemic could claim more than 100,000 lives in the United States, perhaps significantly more, if not enough is done to fight it.

It was a stark shift in tone by the President, who only days ago mused about the country reopening in a few weeks. From the Rose Garden, he said his Easter revival hopes had only been “aspirational.”

The initial 15-day period of social distancing urged by the federal government expires Monday and Mr. Trump had expressed interest in relaxing the national guidelines at least in parts of the country less afflicted by the pandemic. But instead he decided to extend them through April 30, a tacit acknowledgment he’d been too optimistic. Many states and local governments have stiffer controls in place on mobility and gatherings.

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Mr. Trump’s impulse to restore normalcy met a sober reality check Sunday from Anthony Fauci, the government’s top infectious disease expert, who said the U.S. could experience more than 100,000 deaths and millions of infections from the pandemic. Mr. Trump’s decision to extend the guidelines reflected a recognition that the struggle will take place over the longer haul and the risk of deaths spiralling into the hundreds of thousands is real.

“I want our life back again,” the President told reporters in the Rose Garden.

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

President Donald Trump is extending the voluntary national shutdown for a month as sickness and death from the coronavirus pandemic rise in the U.S. The Associated Press

“It’s a horrible number,” Mr. Trump said, but added: “We all together have done a very good job.”

Brought forward by Mr. Trump at the outdoor briefing, Dr. Fauci said his projection of a potential 100,000 to 200,000 deaths is “entirely conceivable” if not enough is done to mitigate the crisis. He said that helped shape the extension of the guidelines, “a wise and prudent decision.”

The federal guidelines recommend against large group gatherings 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.

The extension would leave the federal recommendations in place beyond Easter, April 12, by which time Trump had hoped the country and its economy could start to rev up again. Alarmed public-health officials said Easter was sure to be too soon.

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The U.S. had more than 139,000 COVID-19 cases reported by Sunday evening, with more than 2,400 deaths. During the course of the Rose Garden briefing, reported deaths grew by several dozen and the number of cases by several thousand.

One in 3 Americans remain under state or local government orders to stay at home to slow the spread of the virus, with schools and businesses closed and public life upended.

Deborah Birx, head of the White House coronavirus task force, said parts of the country with few cases so far must prepare for what’s to come. “No state, no metro area, will be spared,” she said on NBC’s Meet the Press.

Most people who contract COVID-19 have mild or moderate symptoms, which can include fever and cough but also milder cases of pneumonia, sometimes requiring hospitalization. The risk of death is greater for older adults and people with other health problems. Hospitals in the most afflicted areas are straining to handle patients and some are short of critical supplies.

Dr. Fauci’s prediction would take the death toll well past that of the average seasonal flu. Mr. Trump repeatedly cited the flu’s comparatively much higher cost in lives in playing down the severity of this pandemic.

Mr. Trump had eyed a “reopening” of the U.S. economy by Easter, but in recent days medical professionals warned that would be far too soon for the country’s heavily affected urban areas.

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Just on Saturday, Mr. Trump was discussing tightening restrictions, suggesting then backing away from an “enforceable” quarantine of hard-hit New York State, Connecticut and New Jersey. Instead, the White House task force recommended a travel advisory for residents of those states to limit non-essential travel to slow the spread of the virus to other parts of the U.S.

House Speaker Nancy Pelosi suggested that Mr. Trump shouldn’t be so quick to reverse the social-distancing guidelines, saying more testing needs to be in place to determine whether areas currently showing fewer infections are truly at lower risk.

Mr. Trump’s “denial” in the crisis was “deadly,” she told CNN.

“As the President fiddles, people are dying, and we have to take every precaution,” she said. She promised a congressional investigation once the pandemic is over to determine whether Mr. Trump heeded advice from scientific experts and to answer the question that resonates through U.S. political scandals: “What did he know and when did he know it?”

Mr. Trump minimized the gravity of the pandemic for weeks. Asked whether she is saying that attitude cost American lives, Ms. Pelosi said: “Yes, I am. I’m saying that.”

It put Ms. Pelosi out of lockstep with former vice-president Joe Biden, the likely Democratic presidential nominee, who said he wouldn’t go so far as to lay the blame for deaths on the President. “I think that’s a little too harsh,” he told NBC.

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Mr. Biden faulted Mr. Trump for holding back on using his full powers under the recently invoked Defense Production Act to spur the manufacture of the full range of needed medical supplies – and for making erratic statements about the pandemic.

“He should stop thinking out loud and start thinking deeply,” Mr. Biden said.

Meanwhile, governors in other hot spots across the country were raising alarm that the spread of the virus was threatening their health-care systems.

“We remain on a trajectory, really, to overwhelm our capacity to deliver health care,” Louisiana Governor John Bel Edwards said on ABC’s This Week. “By the end of the first week in April, we think the first real issue is going to be ventilators. And we think it’s about the fourth or fifth of April before, down in the New Orleans area, we’re unable to put people on ventilators who need them. And then several days later, we will be out of beds.”

He said officials have orders out for more than 12,000 ventilators through the national stockpile and private vendors, but so far have only been able to get 192.

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