Special "fever clinics" could soon be established, retired doctors asked to return to work, and non-urgent surgeries cancelled as the Federal Government shifts into the next phase of its response to the coronavirus outbreak.

Key points: More than 80,000 people have been struck down by coronavirus COVID-19

More than 80,000 people have been struck down by coronavirus COVID-19 The next phase of Australia's emergency plan has been activated

The next phase of Australia's emergency plan has been activated Doctors say the health system is already stretched and will struggle to cope with a likely pandemic

Emergency doctors warn hospitals are already regularly operating at or beyond capacity, and could be completely overwhelmed by the huge wave of patients that a pandemic could bring.

GPs also say they are ill-equipped to deal with a pandemic, and are urgently calling for more access to protective equipment.

The Federal Government on Thursday activated its emergency plan and is now operating on the basis the virus is a pandemic.

"We have accepted the very strong likelihood that we will get further cases and some further transmission of this virus in Australia, given the international situation," chief medical officer Brendan Murphy said today.

"I do want to reiterate though that, at this stage, we are still contained in Australia.

"No-one should go around wearing and wasting face masks please."

Health Minister Greg Hunt today met with his state and territory counterparts at a special COAG pandemic meeting.

"My judgement coming out of the meeting with the states and territories today is that we were better prepared, they were more advanced, than I had previously known," he said after the meeting.

Fears emergency departments cannot take on much more

Simon Judkins, the former president of the Australasian College for Emergency Medicine, said the Government's emergency plan was robust and rightly focused on prevention and preparation.

But he warned even a bad flu season could stretch Australia's healthcare systems to the limit — so a coronavirus pandemic could completely overwhelm them.

"We do operate most of our hospitals either at or over capacity — that's why we have ambulances ramping out the front of hospitals and patients spending a lot of time in emergency departments," Dr Judkins said.

Space to play or pause, M to mute, left and right arrows to seek, up and down arrows for volume. Watch Duration: 1 minute 9 seconds 1 m 9 s PM says Australia is well prepared for looming COVID-19 pandemic

He said hospitals would be looking to develop fever clinics outside their buildings, cancel non-urgent elective surgeries or move them into the private sector, and set up clinics in outpatient departments in order to create capacity for a large influx of patients.

"There is not a lot of additional capacity in our system as it is, so it's not like we can just open up new wards and get new staff — we need to work out how to most effectively use the resources that we've actually got available," Dr Judkins said.

But Professor Murphy said hospitals had shown in the past they could step up capacity.

"There is a lot of elective work that hospitals do, there is a lot of diversion work that hospitals can do," he said.

More than 82,000 people have been struck down by the virus worldwide, and more than 2,800 have died — though more cases are likely to have gone undetected or unreported.

As of lunchtime Friday, it had reached 49 countries, and every continent except Antarctica.



GPs call for protective measures

The president of the Royal Australian College of GPs, Harry Nespolon, said GPs urgently needed more protective equipment — including masks, goggles and protective suits — so they could safely assess people who might have coronavirus.

"If there's going to be up to 40 per cent of Australians affected by coronavirus, giving each surgery a few masks is not going to work," he said.

"We don't want a large number of GPs to get sick."

Dr Nespolon is also calling on the Federal Government to introduce a short-term Medicare rebate for telephone or telehealth consultations to cover doctors' time spent assessing possible coronavirus patients.

"Patients could then stay at home and be assessed," he said.

"We need these practical measures set up now, rather than waiting until there is a pandemic."

Dr Nespolon said many GPs felt left out of preparation and planning for the outbreak.

"We need to know what practical role the Government wants GPs to play and to have that role properly resourced," he said.

GPs also want more practical guidance on how to deal with at-risk groups, such as people in aged care facilities and Indigenous populations, who are more likely to suffer complications from the virus.

After the COAG meeting, Mr Hunt said the chief medical officer would hold a roundtable with the general practice community.

He said masks had been provided to primary health networks when they had asked for them.

Doctor fatigue a looming challenge

Mary-Louise McLaws, an infectious disease expert from the University of New South Wales, said a coronavirus pandemic would cause major stress for doctors and nurses and it was vital they were properly supported.

"The level of anxiety can't be underestimated," she said.

Face masks are now a common sight in parts of Asia, but authorities say there is still no need to start wearing them in Australia. ( Reuters: Tyrone Siu )

Professor McLaws said Australia needed to heed lessons from the 2003 SARS epidemic, which killed hundreds in mainland China and Hong Kong. She reviewed the outbreak, particularly how it affected healthcare workers, in conjunction with Chinese authorities.

"If there is one thing I would advise, that is to put in place some pastoral care and mental health care of the healthcare workers while they're undergoing this enormous surge of capacity," she said.

"And also to remove them from clinical care after working four or five hours at the coalface, because wearing personal protective equipment causes a lot of fatigue, but also working with a novel virus causes a lot of emotional and energy fatigue."

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She said professionals from other parts of the healthcare system could be redeployed in emergency departments and hospitals to help manage demand, and retired doctors and nurses asked to return to work.

But many of those working on the frontline would not want to go home after work and place their families at risk, she said, so accommodation would need to be arranged for them.

'Guarantee' not everyone will contract virus

Australia's deputy chief medical officer Paul Kelly rejected reports the illness could infect everyone in Australia but said authorities were preparing for a range of scenarios.

"That's one of them, that the virus will indeed become like the common cold or a flu virus in terms of continuing to come perhaps in the winter months," he said.

"So that may happen, it may be a one-off wave that comes through and infects a certain wave of the population.

"It won't be everybody, I can absolutely guarantee that — or it won't come at all."

Iran has been particularly hard hit by the virus. ( AP: Ebrahim Noroozi )

Professor Kelly said he was surprised the World Health Organisation (WHO) had not yet declared a pandemic.

"When you look at their own definition of what a pandemic is it doesn't actually bring in an issue of severity but rather spread," he said.

"And so their own definition says if it's spreading … in more than one country, in more than one region of the world then that's when they start to move towards that definition."

Planning for the worst

The Government's emergency response plan for the healthcare sector acknowledges that the "health system already reaches capacity at peak times, such as during severe influenza seasons".

The plan outlines responses to three levels of outbreak severity — low, moderate and high — and says a high-severity scenario could have a similar impact to the Spanish flu pandemic in 1918, which is believed to have killed 50-100 million people worldwide.

Such an outbreak would require "heavy prioritisation" within hospitals, with primary and acute care, pharmacies, nurses and aged care services all "stretched to capacity".

Mortuary services would also come under pressure, and blood and diagnostic services would struggle just to maintain essential services.

Professor Murphy said he did not want to make any predictions about how the virus could affect Australia. "We made them in the swine flu pandemic and we got them wrong," he said.

But under the plan, a worst-case scenario outbreak would see:

Large gatherings cancelled

Large gatherings cancelled People having to work from home

People having to work from home Mortuary services prioritised

Mortuary services prioritised Aged care homes locked down

Aged care homes locked down Childcare centres closed

Kids could be 'less susceptible'

A travel ban, yesterday extended until March 7, means foreign nationals will not be allowed in Australia if they have spent any time in China in the previous 14 days.

Australian citizens and permanent residents are able to enter Australia, but need to isolate themselves for a fortnight.

No human-to-human transmission has yet been recorded in Australia.

"The great majority of people infected with this virus have a very, very mild disease — more than 80 per cent of people," Professor Murphy said.

He said one of the surprising features of the disease was how few children were getting sick.

"We don't yet know whether it's because children might be getting the disease, but it's so mild that it's not picked up … or whether they are somehow less susceptible," Professor Murphy said.

"That will be an important thing to find out.

"Whatever the reason, the fact that we're not seeing lots of children getting sick in China and other parts of the world is a great thing."