The death rate in Australian residential aged care for coronavirus is among the highest in the world, counsel assisting the aged care royal commission Paul Bolster said in his opening remarks in the three days of hearings on the impact of the pandemic on aged care.

"The aged care system we have in 2020 is not a system that is failing," Mr Bolster said in his damming opening comments. "It is the system operating as it was designed to operate. We should not be surprised at the results," he said.

As of Sunday, more than 68 per cent of all Australian COVID-19 deaths cases were in aged care.Credit:Virginia Star

Commenting on the unfolding disaster in Victoria, Mr Bolster said between July 8 and Sunday, more than 1000 residents had been diagnosed with COVID-19.

He said COVID-19 was the greatest challenge the Australian aged care sector has ever faced.

More than 68 per cent of all COVID-19 deaths cases were in aged care. As of Sunday, 203 deaths of the 290 were from COVID-19 were residents of aged care.

"This makes Australia one of the countries with the highest rates of deaths in residential care," Mr Bolster said.

He said it had "starkly exposed all of the flaws of the aged care sector which have been highlighted during this royal commission".

"It is hardly surprising that the aged care sector has struggled to respond to COVID-19," said Mr Rozen.

"For instance, the requirement for one registered nurse to be on duty in a home at all times was removed in 1998. As Professor Kathy Eagar, professor of health services research at the Wollongong University, has been quoted as saying, most people would be surprised to know that you don't have to have a nurse on the staff to run a nursing home," he said.

Royal commissioner Tony Pagone said the impact of the pandemic had been for people in aged care "tragic in ways that were unimagined a few months ago. The full impact is not yet known".

He extended his sympathy and understanding to "those who have not been able to spend time with their relatives or friends in aged care because of of the restrictions introduced to deal with the pandemic".

"We feel your losses and your absences deeply. We have heard many of your stories and have been moved by them," said Mr Pagone.

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