Health authorities and the Australian government are privately increasingly concerned about Japan's response to the coronavirus outbreak, citing the decision to let hundreds of passengers off the Diamond Princess cruise ship in Yokohama onto public transport despite confirmed cases spiking at more than 600 on the vessel on the day of their release. Australia has since confirmed seven further cases from the 169 evacuated from the cruise ship that were transported into quarantine in Darwin. The United States has confirmed 14. On Tuesday, a fourth cruise ship passenger died in Japan from the virus and the number of cases on the mainland rose to 147. In his first interview since the outbreak of the virus in December, Dr Hughes said human-to-human transmission of the flu-like disease in Japan was a "far from ideal" situation. "We will not have a vaccine for coronavirus before the Olympics," he told The Sydney Morning Herald and The Age. "We would need to be sure that it is safe to take athletes into Japan." The Olympics rings are reflected on the window of a hotel restaurant as a server with a mask sets up a table in the Odaiba section of Tokyo. Credit:AP

Dr Hughes said while coronavirus was a "significant challenge that we would rather not have", the team was proceeding on the basis the Games would go ahead as planned. The Japanese football league on Tuesday announced the postponement of all J-League cup matches until at least March 15 over coronavirus fears. Dr Hughes, who is also the chief medical officer at the Australian Institute of Sport, said "what is going on in Japan now is a key issue". "The next couple of weeks is going to be the real test in seeing whether this local transmission can be brought under control. "It's a far from ideal situation when we are preparing for an Olympics. All I can say is we certainly would prefer that there wasn't local transmission occurring in Japan.

David Hughes said coronavirus was a "significant challenge that we would rather not have". Credit:SMH "All sports will now be looking at pre-Tokyo preparation and ensuring that they do their training in a place that doesn't have active transmission for the coronavirus. "That in itself could become more difficult. We are seeing local transmission starting to occur in quite a few places." Dr Hughes said the coronavirus was a different challenge to the Zika virus outbreak in the lead-up to the Rio Games in 2016 because it is transmitted between humans, not by mosquitoes. "Having a lot of people together in a transmission zone is not ideal," he said. "We don't know what the transmission rates are going to be like in July. I am concerned about the coronavirus. We are certainly not complacent. It is a significant challenge that we would rather not have."

Chief Medical Officer Brendan Murphy said on Tuesday it was still too early to predict the impact of the virus on the Games. "Clearly, Japan has a significant outbreak and we still haven't seen the full impact of the Diamond Princess cruise ship outbreak," Professor Murphy said in Canberra. "The Japan health system is strong. They're working very hard to try and contain their outbreak at the moment and we'll be watching that situation closely." Loading Replay Replay video Play video Play video The virus has now killed 2469 people and infected 78,985. Up to 23,400 have recovered. Mainland China accounts for more than 76,000 of all cases. Its neighbour, South Korea, has the second-highest levels of infection, with more than 600 cases.

Loading South Korea and China are by far Japan's highest source of tourists, accounting for more than 14 million of the 40 million expected this year. Outside China, Japan and South Korea, the spread of coronavirus to Italy and Iran has prompted health authorities to warn the chances of a pandemic are "very high", rattling global investors and throwing events into chaos after a tumultuous past month. The 100,000-delegate Mobile World Congress in Barcelona scheduled for this week has been cancelled. The Shanghai Fashion week at the end of March was postponed, along with the Beijing Auto-Show. Chanel has delayed its May catwalk, and Armani revealed its Milan collection in an empty theatre on Monday. Global stock markets took another battering on Tuesday, with more than $1.5 trillion wiped off shares in the US, Europe and Asia. The Australian stock exchange dropped 2.35 per cent at the opening on Tuesday, shedding $47.3 billion in early trade after losing almost $50 billion on Monday.

With Rob Harris