A coronavirus-free tropical island nestled in the northern Pacific may seem the perfect place to ride out a pandemic -- but residents on Palau say life right now is far from idyllic.

The microstate of 18,000 people is among a dwindling number of places on Earth that still report zero cases of COVID-19 as figures mount daily elsewhere.

The disparate group also includes Samoa, Turkmenistan, North Korea and bases on the frozen continent of Antarctica.

A dot in the ocean hundreds of kilometres from its nearest neighbours, Palau is surrounded by the vast Pacific, which has acted as a buffer against the virus.

Along with strict travel restrictions, this seems to have kept infections at bay for a number of nations including Tonga, the Solomons Islands, the Marshall Islands and Micronesia.

But remoteness is not certain to stop the relentless march of the new disease. The Northern Mariana Islands confirmed its first cases over the weekend, followed by a suspected death on Monday.

Klamiokl Tulop, a 28-year-old artist and single mum, is hopeful Palau can avoid the fate of Wuhan, New York or Madrid -- where better-resourced health services were overrun.

But she describes a growing sense of dread, a fear that the virus is coming or could already be on the island undetected.

"You can feel a rising tension and anxiety just shopping," she told AFP. "Stores are crowded even more during non-payday weeks."

There have been several scares on Palau, including a potential case that saw one person placed into quarantine this week as authorities await test results.

- Antarctic seclusion -

Inside Australia's four remote Antarctic research bases, around 90 people have found themselves ensconced on the only virus-free continent as they watch their old home transform beyond recognition.

There is no need for social distancing in the tundra.

"They're probably the only Australians at the moment that can have a large dinner together or have the bar still open or the gym still open," Antarctic Division Operations manager Robb Clifton told AFP.

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The bases are now isolated until November, so the group is safe, but Clifton admits "the main thing that's on the mind of expeditioners is how their loved ones are going back home."

In some places, reporting no cases does not always mean there are no cases to report.

North Korea has portrayed emergency measures as an unqualified success in keeping COVID-19 out, despite sustained epidemics in neighbouring China and South Korea.

But state media also appears to have doctored images to give ordinary North Koreans face masks -- handing sceptics reason to believe the world's most secretive government may not be telling the whole truth.

- 'Waiting for the inevitable?' -

While Palau has no confirmed cases, it has still been gripped by the society-altering fears and economic paralysis that have affected the rest of the world.

Supermarket aisles in the country's largest town Koror have seen panic buying and there are shortages of hand sanitisers, masks and alcohol.

The islands depend heavily on goods being shipped or flown in, meaning supplies can quickly run low.

United Airlines used to fly six times a week from nearby Guam -- which has seen more than 50 cases -- but now there is just one flight a week.

"Look at how bad we coped when shipments were late before this pandemic happened," Tulop said. "Everyone was practically in uproar."

Residents have been practising social distancing. Doctors are waiting for test kits to arrive from Taiwan. The government is building five isolation rooms that will be able to hold up to 14 patients.

It all feels like waiting for the inevitable.

"I would like to be optimistic we won't get the virus," Tulop said. "But Palau would most definitely get it. We rely heavily on tourism and most of us even need to travel for work."

Rondy Ronny's job is to host big tourist events, but work has already dried up, and he admits to being "very anxious".

"I have loans and bills and payments due," he said. "This will definitely put me back, I hope the government will do something about our economy too, to help it recover."

Palau's biggest test may yet come with the first positive case.

But even in the most remote corners of the world, the impact of this truly global pandemic is already being felt.

Nowhere, it seems, is truly virus-free.