Dr Anthony Fauci has warned that if the US moves too quickly to end stay-at-home orders there could be another surge in Covid-19 cases.

Speaking to ABC News, the director of the National Institute for Allergy and Infectious Diseases, a key member of the White House coronavirus taskforce, was much more cautious than Donald Trump, who has downplayed the outbreak and pushed to open the US quickly.

“If you jump the gun and go into a situation where you have a big spike, you’re gonna set yourself back,” Fauci said. “So as painful as it is to go by the careful guidelines of gradually phasing into a reopening, it’s going to backfire. That’s the problem.”

Fauci also warned: “Unless we get the virus under control, the real recovery economically is not going to happen.”

According to researchers at Johns Hopkins University, the US is approaching 800,000 confirmed coronavirus cases and has recorded more than 40,000 deaths. New York is by far the worst-hit state, with more than 18,000 deaths, while more than 4,000 have died in New Jersey and more than 2,000 in Michigan.

Trump remains keen to reopen the US economy as soon as possible, to the extent of tweeting and expressing support for protests organised in part by far-right groups and aimed at Democratic governors.

Fauci’s relationship with the president is relentlessly parsed in the media, amid rightwing pressure for Trump to fire the doctor, who has been in the post since 1984.

Recently, Derek Hodel, a senior program adviser at Physicians for Human Rights who worked with Fauci as an Aids activist and advocate in the 1990s, told the Guardian: “Decades ago, he said things that we didn’t want to hear.

“He said a lot of things we did want to hear as well, but he said a lot of things we didn’t want to hear.”

The White House has denied Trump is preparing to fire Fauci.