Chief health officers pushed to the fore during the pandemic should use their elevated visibility to prepare the health system which has "totally neglected" climate change.
A new report has warned an onslaught of extreme weather will fill-up emergency departments and cost lives, calling on states and territories to fix the system now.
Co-author Stephen Duckett said emergency department presentations spiked during last summer's bushfires, with the effects of smoke alone causing 400 deaths.
"So climate change for the health system, was no longer 'we're worried about sea levels rising', for the health system it is very clearly impacting right now," He said.
The Grattan Institute report has made seven recommendations to prepare the sector for more frequent and intense disasters, including targeting safety and weather warnings and improving acute and long-term mental health care.
He said state and territory governments "couldn't afford not to" put climate change at the fore of immediate and long-term planning, or risk costing more lives and dollars.
"It is being totally neglected. Governments across Australia have not overtly taken it into account," he said.
"It's not as if climate change is a once-off event and we don't have to worry about it. There's going to be more frequent extreme weather."
When Canberra's air quality plummeted in January, emergency department presentations rose up to 70 per cent, the report found.
About 11 million Australians reported some exposure to smoke caused by the Black Summer fires. A NSW survey found most of the state experienced at least a minor symptom of the chocking haze.
More than half of adults felt anxious or worried about the blazes, with the long-term mental health impacts still unknown.
The report stated protocols should be in place to quickly mobilise healthcare workers to attend a disaster, arrange general practitioners to work in evacuation centres to ease hospital demand and have contingency plans to ensure access to long-term physical and mental health treatment.
"We have to recognise we're one country and we have to take national action, even if the Commonwealth doesn't," Dr Duckett said.
It also called for a uniform approach to create targeted warning systems.
"Not just relying on old communication styles where you might put something on the radio or newspapers," Dr Duckett said.
He said registration systems could be set-up to specify which locations, or groups would be at highest risk when a warning is issued.
For example, Dr Duckett said Canberrans should be able to sign-up to receive alerts via text or an app when a thunderstorm asthma event warning is issued, to spread the message further and to those who need it most.
After air quality dropped to dangerous levels in Canberra this summer, ACT Health has updated its air-quality alert system to include more distinctions when pollution is high.
Dr Duckett said the "best practice" should be copied by other governments.
Prior to the change he said the system had "failed to recognise things had got much worse".
Dr Duckett said the Australian Health Protection Principal Committee should take the lead, leveraging off public health's new visibility.
The report recommended an AHPPC committee be created to focus solely on the effect of the climate crisis on health.
"Right across the country ... you know now who your chief public health officer is," he said.
"We've now got very visible people ... and we can now trust these people.
"They can use this status to actually lead the public and lead government into actually doing something about climate change."
The report also recommended state health sectors have a plan to achieve net-zero emissions in place by 2023. Dr Duckett said ideally this would be achieved before the states' goal of 2050.
The ACT government has a target of zero emissions across their operations by 2040.
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