Donald Trump appeared restless, agitated and fed up. He gestured wildly, his arms repeatedly stretched to the side or aggressively in front of him as he stood behind the lectern Monday night in the sparsely populated White House briefing room. He was tired of precautions. It was time to follow the same instincts that put him there.

Gone was last week's measured and stoic president, replaced with the combative commander in chief persona that has defined his nearly five years as a professional politician. Gone was the CEO-in-chief who for five days delegated answers to technical questions to his public health experts, replaced by the chief executive with all the answers – based on his own hunches – that put his own re-election needs over cold, hard science.

"This is going away," the president declared boldly just hours after his hand-picked surgeon general told the country "this week, it's going to get bad."

"If you had a viable business in January, we are committed to ensuring the same is true in the coming weeks. In fact, we want to make it even better than it was before and we're doing things to help in that regard," Mr Trump said to the chagrin of many Democrats and public health experts. "America will again and soon be open for business. Very soon. A lot sooner than three or four months that somebody was suggesting. A lot sooner."

Mr Trump did not dispute what Navy Vice Admiral Jerome Adams said in terms of the number of confirmed virus cases continuing to tick upward. But the president revealed how he truly thinks about the pandemic during a wild Monday night press conference that spanned nearly two hours and stretched well into the prime time television block he absolutely covets.

He acknowledges many more people – thousands, probably – will become infected by the virus inside the United States.

Trump seems to have been listening to some of the data his senior public health advisers have been providing him – but selectively, and in ways that justify his often hardline instincts.

Of all those who have coronavirus-like symptoms, the "vast majority of people, they're not reporting. They're not calling the doctor," he said Monday night, almost imploring the 14 reporters in the 49-seat briefing room due to social distancing restrictions to just see it his way.

Deborah Birx, a physician detailed from the State Department to work on his coronavirus task force, was standing by him at the lectern. "Correct," she said softly.

"They're not calling it," he said. "They're just getting better."

As public health officials, along with state governors and local leaders, focus on stopping the spread of the highly contagious bug, the president of the United States spent two hours as the number of confirmed cases on his soil was approaching 46,000 and essentially asking: What is all this fuss about if the body count is lower than in other hard-hit countries?

Mr Trump has seen the numbers from around the globe. And he is fixated on one column: the death toll.

He knows that the United States, so far at least, has a remarkably low "mortality rate," as he and Dr Deborah Birx repeatedly referred to it Monday evening.

Take Italy and Spain, two Western and developed European countries. Italy has 63,927 confirmed cases and 6,077 deaths, according to The Johns Hopkins University. That translates into roughly 101 deaths per 1m citizens. Then there's Spain's 39,673 confirmed cases with 2,696 Covid-19 deaths – roughly 58 dead per 1m citizens.

But for the United States, Trump sees a much different situation: 46,450 confirmed cases – even though the onset of aggressive and widespread testing only began in recent days – with just 593 deaths. That's two deaths per 1m citizens. To Mr Trump, that means he's winning. And winning big.

Under questioning from a reporter about his justification for mulling, as he put it, a declaration that "America will again – and soon – be open for business," Mr Trump said flatly: "I think a big factor is the mortality rate."

"We're talking about the mortality rate. You know, when we first started, people were speaking about 3 per cent and 4 per cent, and now we're talking about a much lower number than that," he said. "I think it's a number that will be a lot different than people thought."

The president had long been banking on a strong economy to boost his re-election chances. He did little Monday night to mask his desire to get people back work, businesses open again and US stock market values pointed north again.

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In fact, the death toll-focused president went so far as to say that millions of Americans continuing to work from home would be more catastrophic than if millions more had flu-like symptoms for a few weeks -- even if some died.

"We're going to win the battle, but we also have, you know, you have tremendous responsibility. We have jobs, we have people get tremendous anxiety and depression and you have suicides over things like this when you have terrible economies," he said. "You have death probably in, I mean, it definitely would be in far greater numbers than the numbers that we're talking about with regard to the virus."

"So we have an obligation. We have a double obligation," the president said. "There is no country like it in the world and there's no economy like it in the world. I mean ... we were just blazing."

Social distancing and feeding the economic engine?

"We can do them both at the same time," the president said. To him, it's just that simple – just keep that body count low.

"I have got many, many people that now come to me and say, 'We get it. We think we can really do it now, and do it while we are open,'" he said without naming those alleged advisers. "So, at some point we will be setting some guidelines. We will be setting some date lines and we will be announcing them in the not too distant future."

Mr Trump's focus on the death rate drew some pushback. For instance, Matthew Gertz, a senior fellow at Media Matters for America, noted that "The notion that the mortality rate is low depends on functioning hospitals that can handle the caseload of the larger percentage that need ICU care. As hospitals get swamped, mortality rate rises."

Time will tell if Mr Gertz's point plays out and significantly changes the president's thinking. But, for now, Mr Trump is banking his re-election on a big gamble that the US health system can handle what his team predicts will be a major increase in cases, keeping the mortality rate relatively low compared to Italy and Spain.