US President Donald Trump is extending the voluntary national shutdown for a month as sickness and death from the coronavirus pandemic rise across the country.

The initial 15-day period of social distancing urged by the federal government expires on Monday (Tuesday NZ time) and 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 to April 30, a tacit acknowledgment he’d been too optimistic. Many states and local governments have stiffer controls in place on mobility and gatherings.

Trump’s impulse to restore normalcy met a sober reality check Sunday from Dr Anthony Fauci, the government’s top infectious disease expert, who said the US could experience more than 100,000 deaths and millions of infections from the pandemic.

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Trump’s decision to extend the guidelines reflected a recognition that the struggle will take place over the longer haul.

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 on April 12, by which time Trump had hoped the country and its economy could start to rev up again.

The US had more than 137,000 Covid-19 cases reported by late Sunday afternoon, with more than 2400 deaths.

Fauci, speaking on CNN’s State of the Union on Sunday, offered his prognosis on the US’s Covid-19 situation. 

“I would say between 100,000 and 200,000 cases,” he said, correcting himself to say he meant deaths. “We’re going to have millions of cases.”

But, he added, “I don’t want to be held to that” because the pandemic is “such a moving target”.

Dr 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.

On Saturday, Trump was discussing tightening restrictions, suggesting then backing away from an “enforceable” quarantine of hard-hit New York, 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 US. 

Meanwhile, governors in other hot spots across the country have been raising the alarm that the spread of the virus is threatening their healthcare 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.