That was perhaps understandable in recent days, particularly with bigger matters at hand. Sydney remains embroiled in a stubborn outbreak that will keep it locked down until at least the end of the month, so of course it has been the focus of the public health response.

In comparison, and beyond mandatory mask rules, most of regional NSW remained fairly free. That is no longer certain to be the case given the detection of a "very heavy viral load" in refuse at Burwood, Belmont and Shortland waste water plants.

The danger sign comes just days after vaccines were seconded from Lake Macquarie for Sydney Year 12 students.

The state's leaders were quick to sidestep accountability for the worst-case scenario many fear is unfolding in the region now. It was exactly what Shannon Bailey, who has reduced lung function and had his Belmont vaccine appointment cancelled by text message on Saturday, had feared.

"If I end up on a ventilator, that's on NSW Health," Mr Bailey warned on Sunday.

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Asked about the decision at the same Wednesday press conference where chief health officer Dr Kerry Chant said she was "extremely concerned" at the sewage indicating the virus was present, NSW Health Minister Brad Hazzard demurred.

"As for Pfizer, I think we've talked about that until the cows come home so we won't go into that again," Mr Hazzard said, urging people to get tested.

Recent days have been filled with discussion of incentives to halt vaccine hesitancy.

Respectfully, reluctance to be vaccinated is not the only problem this region faces when state leaders are deaf to valid questions about how taxpayer-funded health resources are deployed.

Wednesday's announcement has left much of NSW's second-largest city staring down the barrel of a possible outbreak after what amounts to a Macquarie Street raid on its defences. It is frankly obscene for the man responsible for that exact portfolio to refuse answers to those who say they are "terrified" by the consequences of that decision.

While Sydney's outbreak has been a priority to this point, that will be no justification if Newcastle finds itself in a similar predicament in days to come.

For now we must listen to experts like Hunter New England Health public health physician Dr David Durrheim, who urges testing at the smallest sign of infection.

Happily, the Hunter has escaped past sewage positives without COVID outbreaks. But it appears that caution and its cost will once again become the responsibility of this region's people, its front-line health workers and its businesses. They are entitled to expect their leaders to care, to be proactive, and to support them through a difficult time.

Anything else is just idle talk.

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