When a system is under stress – as our health services are now – cracks and strains become apparent that may otherwise have been easy to overlook. Australia's response to coronavirus is constrained by the fundamentals of our health system, which are hindering management of the pandemic.

Primary care in Australia, which should be the front line of any service response (in contrast to a quarantine or social-distancing response), is delivered via a 1950s-style, GP-centric, fee-for-service model. It is already widely regarded as not fit to respond to the changing epidemiology of the increased prevalence of chronic disease in Australia and our response to coronavirus shows it is not fit to respond to an infectious disease pandemic either.

A microscope image shows a sample of COVID-19 isolated from a patient. Credit:NIAID-RML

The initial advice from health authorities in Australia was that people who had travelled to certain countries and exhibited flu-like symptoms should seek testing from their GP. This advice reflects the GP-centricity of primary care in Australia, including that there is no systematic approach to paying for testing by any other provider.

The media over the past few weeks has been dominated by representatives of general practitioners and the broader medical profession bemoaning the lack of personal protective equipment, poor distribution of masks, and the failure of public health authorities to provide regular updates on the pandemic.