The "floodgates have finally opened" on COVID-19, but a Newcastle virus expert says the nation is well placed to deal with tens of thousands of cases emerging every day.
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NSW recorded 21,151 cases on Friday, almost double the record 12,226 confirmed infections the day before.
The official case load is doubling every four days, meaning the daily count in NSW alone could be as high as 160,000 in two weeks.
The Hunter New England Health district registered 1983 new cases, more than double the previous daily record, including 730 in Newcastle local government area, 480 in Lake Macquarie, 245 in Maitland, 138 in Port Stephens and 120 in Cessnock.
A double-vaccinated man from Kilpatrick Court nursing home in Toronto died in John Hunter Hospital. The man was in his 70s and had other health conditions.
"The floodgates have finally opened," University of Newcastle viral immunologist associate professor Nathan Bartlett said on Friday.
"It was bound to happen in Australia. Now it's happening. We've been preparing for it for almost two years."
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The official case count is likely to be a fraction of true infections. Some people will be infected and never know while others have started giving themselves rapid antigen tests at home and not figuring in the official statistics by confirming their positivity with a PCR test.
Hospital COVID admissions jumped again in NSW from 746 to 832 and grew by 10 in the HNEH district to 35.
Sixty-nine people are in intensive care, including 39 who are unvaccinated.
Dr Bartlett was hopeful Australia was well prepared for the omicron onslaught.
"Hopefully, all the hardship and effort people have done in terms of lockdowns and putting up with financial hardship, everyone getting vaccinated, pays off and we can manage this outbreak in Australia and it's going to be minimally impactful on the population," he said.
Premier Dominic Perrottet confirmed that NSW would adopt the new rules for isolation and close contacts outlined on Thursday by Prime Minister Scott Morrison.
The changes include limiting the definition of close contacts to household members and reducing isolation periods to seven days.
Mr Morrison said on Friday that state leaders had agreed to drop the previously announced requirement for COVID-positive people to return a negative rapid antigen test on day six of their confinement before leaving the next day.
Anyone who has COVID and still has symptoms is not allowed to leave isolation on day seven.
University of Newcastle Laureate Professor Nick Talley, a staff specialist at the John Hunter, 2018 NSW Scientist of the Year and editor-in-chief of the Medical Journal of Australia, said the new definition of close contacts was "delusional".
Labor's shadow health minister, Mark Butler, said Mr Morrison had "decided to let it rip" without giving Hunter people the "tools they need to protect themselves".
"People have been spending hours upon hours in testing queues right around the Hunter, and rapid antigen tests are as rare as hen's teeth on local shelves," he said.
"This is sheer neglect and a failure by Scott Morrison to do his job as Prime Minister."
Two weeks ago, the NSW government cited modelling that pointed to 25,000 cases a day by the end of January, but the state has almost hit this mark 30 days early.
In response to questions on where case numbers could be in a month, chief health officer Dr Kerry Chant said: "I think many people in the community can do [calculate] what that looks like."
Dr Chant said the high case count "reflects the international experience with omicron where we're seeing a rapid doubling rate".
"I think it would be sensible to slow the spread of the disease through the community so we can keep our health services functioning and our critical services functioning," she said.
NSW COVID hospital admissions have increased 118 per cent in a week, from 382 to 832, but Dr Chant said this figure could include some patients who were in hospital for other reasons.
Mr Perrottet again declared NSW and its health system to be in a "strong position", though Health Minister Brad Hazzard admitted hospitals and the ambulance service were under "massive pressure" dealing with rising cases and missing staff.
St Vincent's Hospital executive director Kevin Luong reportedly wrote an email to staff on Thursday saying the hospital was "extremely vulnerable" to an expected rush of emergency department activity in the next few days and "beginning to run out of options to maintain safe nursing staffing levels".
Mr Perrottet said omicron was testing health systems around the world.
"People are anxious, but we will get through this challenge," he said.
He said state-run vaccination centres would start delivering 300,000 booster shots a week in January.
Mr Morrison said on Thursday that the states would not hand out free rapid antigen tests other than to eligible people at testing sites.
Mr Perrottet said NSW had ordered 50 million RATs and was "working though" how and to whom it would distribute them.
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