The chief executives of aged care facilities in the Hunter have told the Newcastle Herald they have had staff - who have not had the benefits of working from home or taking leave during the pandemic -in tears due to the unrelenting stress of being short staffed.

But the current outbreak of COVID cases in the region had exacerbated the already stretched workforce with staff needing to isolate either with the virus, or as a close contact.

"It is definitely the worst I have seen it," Frank Price, of Royal Freemasons' Benevolent Institution - which runs several aged care facilities at various sites across the Hunter, said.

Federal figures show a dramatic impact. The latest available, for Thursday, show 3653 aged-care residents with COVID nationally, with 1733 of these in NSW. A week before, the national tally was 1370 active resident cases and 1835 cases involving staff, and 495 facilities with current outbreaks.

Providers say between five and 40 per cent of staff are furloughed due to COVID-19, flagging rising concerns that residents would suffer without sufficient the staff to care for them 24/7.

Letters to the Minister for senior Australians and aged services - written by Mr Price and signed by 12 other providers in September - proposed adding aged care workers as a skilled occupation on the migration list for the next four years, paying staff a wage in line with hospital and disability sectors, and providing incentives for students to become nurses.

"If you can create a visa for fruit pickers, why can't you create a visa for aged care workers? Is aged care not as important as the need to pick fruit?" Mr Price said.

"But the solutions we proposed were ignored because the government believed that the situation would improve once border restrictions relaxed.

"Unfortunately, the situation has only deteriorated. We need more people on the floor right now. To achieve that we need to be able to bring people in. But we need a sustainable workforce, so it can't be exclusively immigration."

Newcastle Anglican Bishop Peter Stuart, of Anglican Care, said since the current outbreak began, seven of their aged care sites had been directly affected by COVID-19. Two residents, both fully vaccinated, had died after contracting the virus at the organisation's Kilpatrick Court facility in Toronto.

"We currently have four in full or partial lockdown, which means that there are significant restrictions on the visitors to the site," Bishop Stuart said.

"We have three of our supported independent living sites, which are home for people living with a disability, in lockdown. There are incredible demands placed on management and staff when there is a lockdown.

"There are increased requirements for care and testing. There is reduced availability of staff if they are isolating because of a positive test or being a closed contact to someone with COVID.

"In ordinary times, if a service has a medical incident, such as an outbreak of gastro, then you can draw support from other services and from agency staff. All of these resources are equally stretched meaning there isn't relief available."

Bishop Stuart criticises the NSW government's decision to open up in December.

"The maintenance of masks, QR codes and expectations of social distancing would have reinforced to the community that we continue to be in a pandemic," he said.

"We all would have been helped by earlier decisions around the provision of rapid antigen testing. It is now difficult to obtain RATs, meaning we are having to risk assess our response where we cannot ascertain the health situation of asymptomatic people who could spread COVID."

Bishop Stuart said governments appeared to have moved to a "tough it out approach" at the cost of the ordinary citizen.

"I am seeing the fatigue in staff who have been working tirelessly across long days to provide a sustained response," he said.

Maroba nursing home CEO Viv Allanson said the Waratah operation had been relatively fortunate to date, although 40 or so staff had been furloughed from mid-December with COVID-19 illness or close contact exposures.

Ms Allanson said Maroba had organised its own vaccine booster clinic for residents after becoming tired of waiting for the Commonwealth government to provide the in-reach service. They had taken to attempting their own contact tracing before test results had been confirmed, just in case. Staff had been doing rapid antigen tests before every shift - with a number of positive cases caught at the door.

Ms Allanson said allied health staff including physiotherapists, occupational therapists and speech therapists and the "activities team" had "eyes" on the residents watching for any changes and monitoring their wellbeing: things the care team could potentially miss with reduced, fatigued staff.

"I think every aged care manager must have ulcers by now," she said. "We have also had negative RATs, but by that night they go and have a PCR test and they are positive."

Ms Allanson said she had also proposed a new category of support worker for aged care to the federal government that had been ignored thus far. These workers could offer nurturing tasks such as help residents ring or Facetime their family members, or help them get set up for dinner.

"The government ignored that opportunity too," she said. "Now we are seeing aged care providers and residents suffering across many organisations. Our staff have worked a lot of overtime. They are tired. They are in full PPE. I'm sick of hearing, 'We want to thank our health workers', because: that is hollow. If they were really appreciative of the health workers, they would have done something to prevent this happening, they'd fund proper wages. If they want to thank aged care workers, give them a 25 per cent pay rise to bring them in line with hospital staff.

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