The federal government is “holding back” 10,000 ventilators because it anticipates the breathing machines will be needed for an expected “surge” in coronavirus cases across the country, Donald Trump said Tuesday evening.

“I want all Americans to be prepared for the hard days that lie ahead. We’re going to go through a tough two weeks,” a serious president said. “This is going to be a very painful two weeks.”

His administration has said cases could soar between now and Easter Sunday (12 April), adding he has approved shipments of ventilators to Michigan, New York and Louisiana.

He said Americans need to respond to the coming situation with an “ironclad resolve,” predicting a “light” at the end of a proverbial tunnel following the coming surge.

The president, who weeks ago called Covid-19 “like the flu,” reversed himself yet again on Tuesday night: “This is not the flu. This is vicious.”

But Mr Trump was visibly shaken during the opening minutes of his daily coronavirus press conference. He spoke about a hospital in Queens, New York City, that is near his childhood home, his voice uncharacteristically breaking as he talked about “freezers” out back used for the deceased.

One of Mr Trump’s coronavirus response directors, Deborah Birx, displayed a set of ominous slides that showed what he described: a steep increase in cases around mid-April, then declining sharply by 1 May and even more by 1 June.

Anthony Fauci, Mr Trump’s top infectious disease official, predict the number of cases, which already has been climbing, is expected to do so more so in the next week. He called on Americans to “put your foot down on the accelerator,” meaning following the Centers for Disease Control and Prevention‘s guidelines for things like “social distancing” and rigorous hand-washing.

Mr Fauci and Vice President Mike Pence said there are signs those CDC measures are being followed and are working in places that are hardest hit, like New York City.

There have been 1.1m people tested inside the United States, Mr Pence said, noting the president has approved 29 federal disaster declarations for state and territories.

Ms Birx repeated Mr Fauci’s warning that 100,000 to 200,000 people in America could die from the virus because the rate of the spread is expected to slow slower than the rate of increases in infections.

Asked if Americans should prepare themselves for that many deaths, Mr Fauci said: “We need to prepare ourselves for that. ... It will be difficult.”