Pandemic plan activated as coronavirus spreads and an impact on Australia becomes likely

Prime Minister Scott Morrison activated the national pandemic plan on Thursday as the coronavirus spreads to 42 countries and Australia looks increasingly likely to be impacted.

Health Minister Greg Hunt: The government is now preparing for a pandemic. Picture: Sitthixay Ditthavong

Health Minister Greg Hunt: The government is now preparing for a pandemic. Picture: Sitthixay Ditthavong

The nation's health ministers will meet on Friday as authorities move to ensure the states are ready to cope with a surge in cases in preparation for what Health Minister Greg Hunt described as "a much more significant event".

"We're effectively operating on the basis that there is a pandemic," Mr Morrison said.

"The expert medical advice we have received there is every indication that the world will soon enter a pandemic phase of the coronavirus, and as a result we have agreed today and initiated the information of the coronavirus and emergency response plan," Mr Morrison said.

"While the WHO is yet to declare the nature of the coronavirus and its move towards a pandemic phase, we believe the risk of a global pandemic is very much upon us and as a result is a government we need to take the steps necessary to prepare for such a pandemic."

The government has not extended its travel ban beyond China, despite the global spread of the virus. But the ban for China remains in place, including for students.

Authorities are looking to plug gaps in medical supplies and the stockpile of masks and other protective equipment, and to make plans to keep people away from emergency departments, ensure safety in aged care centres giving the higher death rate among older people, and make plans for school closures where necessary.

They were surveying the national medical stockpile, especially in light of the reliance on China for medicines, masks and medical devices.

"We're doing all of that work across medical stockpile, personal protective equipment, the supply chain, in particular personnel," Mr Hunt said. "One of the things we're most focused on is to make sure we have the personnel capacity if there is a surge within our hospitals and medical system.

Mr Hunt said it was likely that cases would make it to Australia, as the virus became "a truly global event".

"In the event of a pandemic, the goal is to slow its spread if it gets to Australia. But with the number of countries that are now affected, we have to be realistic about the likelihood of containment strategies into the weeks ahead."

He told Parliament earlier that more than 81,300 cases had been recorded worldwide, with 2770 deaths. Algeria, Brazil, Greece and Pakistan had confirmed their first cases in the previous 24 hours, with more new cases outside China than in. Algeria is the first African region country to report a case.

"We have Africa, South America, West Asia and Europe, all with new countries with their first case," Mr Hunt said. "What this says is that the arc of the virus continues to expand, that we are seeing more countries and more diagnoses, particularly outside of China. And against that background, the very clear message for Australians is that we are not immune."

In the United States the Centres for Disease Control reported the first case of a suspected community transmission, with a person in California testing positive without having travelled to a relevant country or having a known exposure to someone with the virus.

But Mr Morrison stressed that people should not make drastic changes in their lives.

"There is no need for us to be moving to having mass gatherings," he said. "You can still go to the football, you can still go to the cricket, you can still go and play with your friends down the street, you can go off to the concert and you can go out for a Chinese meal."

Chief Health Officer Paul Kelly stressed that for 80 per cent of people coronavirus was a mild illness. the focus now was to limit the number of cases arriving and slow the spread, to relieve pressure on the health system.

Universities Australia Chief Executive Catriona Jackson said universities were well prepared for the extension of travel restrictions for another week.

"The decision announced by the government this afternoon is based on expert medical advice. Universities will continue to adhere to that advice," she said.

"The priority of every university is the health, safety and welfare of their students and staff both overseas and in Australia."

ACT Chief Health Officer Dr Kerryn Coleman said locations had been identified across the ACT for respiratory assessment centres if required, and emergency management plans were in place in case of a major outbreak.

The current advice for Canberra doctors was to test for COVID-19 in patients with fever or respiratory symptoms who had travelled to or transited through mainland China in the 14 days before the onset of illness, and consider testing in patients with a clinically compatible illness who had travelled to Hong Kong, Indonesia, Iran, Japan, South Korea, Singapore or Thailand. They must notify suspected cases and isolate and apply infection control precautions.

"The ACT Health Directorate is also working closely with our public hospitals, as well as general practitioners and other primary health care providers, to ensure relevant health workers have the information they need to identify cases and put appropriate infection control measures in place," she said.

By lunchtime on Thursday 101 people had been tested in Canberra, all negative. Australia had 23 cases, eight from the Diamond Princess cruise ship.

The pandemic plan says the virus has the potential to cause high levels of morbidity and mortality and to disrupt the community socially and economically. It may well test the Australian health system, which already reaches capacity during severe flu seasons.

With no effective anti-virals and no vaccine, hand hygiene, isolation and social distancing would influence the spread of the disease. As the virus was new, there was no immunity in the community as there was with flu, making the population more vulnerable.

The plan sets out who is responsible for different parts of the response to a pandemic and describes the risks.

It sets out three scenarios. The low severity scenario would be similar to the 2009 H1N1 pandemic, with most cases mild to moderate other than in at-risk groups. People are risk - older people, infants, indigenous people and people with compromised immune systems or underlying illness - would need to be identified. Hospital and GP services dealing with respiratory illnesses and intensive care could become stretched.

In a moderate-severity scenario hospitals would be under severe pressure. Non-urgent medical procedure would be scaled back. Surge staffing and flu clinics might be needed and healthcare staff themselves might become infected. Emergency laws might be needed.

In a high-severity scenario, GPs, acute care, aged care and pharmacies would be stretched to capacity and mortuary services would be under pressure. The capacity of the health system would be challenged, including blood services and diagnostic services. This scenario could be similar to the 1918 Spanish flu.

A pandemic would increase demand for intensive care, pediatric care and respiratory care, and for specialised equipment and laboratory services. It would increase demand for "management of the diseased". The need for prompt diagnosis, minimising transmission opportunities and in building community confidence would also increase.