NSW is "pretty close" to letting COVID-19 rip through the community as the public health response of testing and tracing breaks down.
The state recorded more than 6000 cases on Tuesday for the fourth day in a row, but testing numbers have dropped from a high of 164,000 on Thursday to 93,000 on Monday. More than 6 per cent of tests are coming back positive.
The Hunter region recorded 409 new cases on Tuesday, down from a peak of 976 on Thursday, but most of the region's testing clinics were closed for part or all of the Christmas long weekend and will shut again this weekend, leaving many unable to confirm if they have COVID.
Data issued on Tuesday also show testing numbers fell off a cliff in the Hunter in the days leading up to Christmas.
Waiting times for results have blown out to almost a week in some cases, and health experts and politicians warn the virus is spreading undetected.
NSW Health has started focusing its overwhelmed tracing efforts on people who live with a confirmed COVID case rather than social, work and school contacts.
Premier Dominic Perrottet declared on Tuesday that "our plan is working" and NSW would "lead the nation out of this pandemic".
"We're in a strong position and learning to live alongside the virus," he said, while describing the current outbreak as a "transition period".
Laureate Professor Nick Talley, a researcher from University of Newcastle medical school and a staff specialist at John Hunter Hospital, said the government's response to omicron was "pretty close" to letting it rip.
The NSW Scientist of the Year in 2018 and editor in chief of the Medical Journal of Australia was critical of the decision to remove QR codes and mask mandates on December 15, saying the government should have known enough about Omicron by then to keep them in place.
"It really was a ridiculous change to make with a new variant that was clearly going to be problematic," he said.
"This was all predictable, which is what upsets me as a health professional. To let things go, we knew there'd be a big surge. To do that just before Christmas for an economic reason, and not to plan really carefully for the health and societal impacts, I'm flabbergasted."
He said retaining public health measures would have helped flatten the curve and ease the strain on the community and health system over the Christmas and new year period.
That pressure was evident late Monday night when Newcastle MP Tim Crakanthorp wrote on Facebook about the abuse his staff had suffered while trying to help people chase up test results.
"If my staff and I ... have spent the day being called some combination of f---ing idiot, dumb c--- or stupid sl*t then I can only imagine what kind of abuse people working on the frontlines of our health and pathology services are experiencing," he wrote.
The Labor MP laid the blame for testing delays at the feet of the government.
"The management of this outbreak has been an absolute sh*t show," he said.
"Rather than use a time of lower case numbers to learn from mistakes or develop a system to cope with a surge, the government rested on its laurels. Rather than boosting testing resources, the government has thrown its hands up. Rather than reassure the community that public health is being prioritised, we're told to just accept that we'll probably all get COVID."
Mr Crakanthorp said some people were waiting 150 hours for results and others had tested positive but could not contact anyone to discuss their co-morbidities.
Mr Perrottet said on Tuesday that the testing system was "at capacity" and the government was doing what it could to alleviate pressure on pathology labs, including lobbying other states to drop PCR test requirements for cross-border travel.
He said NSW test numbers of about 150,000 a day were "well up" on the spring delta outbreak, though records show daily tests exceeded 150,000 on 13 occasions in August and September.
Asked why the government had not delayed relaxing public health measures in the face of omicron, he said the government had made a "pact" with the people of NSW that getting vaccinated would mean a return to "normal society".
The Premier again urged the public to focus on hospital and intensive care admissions instead of case numbers, but Professor Talley and Port Stephens MP Kate Washington said this thinking ignored the wider social and economic impact of having tens of thousands of people in forced or self-enforced isolation.
"It was predictable that the economy would have a problem because people would become very, very worried when their relatives, friends and colleagues become infected," Professor Talley said.
"I believe the experts would have been telling government this was the case, and clearly other considerations took precedence.
"All of us, everyone I know, has relatives, friends and colleagues who are isolating. It's just remarkable. I think that's the big change."
The government has emphasised that local and overseas evidence shows omicron causes less severe disease, but Professor Talley was concerned hospitals would still be overwhelmed in January due to the sheer weight of case numbers.
NSW hospital admissions jumped again on Tuesday, from 521 to 557, and the number of COVID patients in ICUs rose from 55 to 60. The number of hospital admissions is almost halfway to the 1268 peak of the delta outbreak in September.
Hunter New England Health district hospital admissions were up from 22 to 27 on Tuesday, close to the delta peak of 30 on October 8.
Professor Talley said the percentage of tests coming back positive was rising, which suggested the virus was spreading undetected.
"How much exactly nobody knows. Three- to five-fold perhaps, but that's a guess. I suspect people are not going to get tested now because of the line-ups."
He said there was no way to control Omicron now it was "out and circulating", but the government should move quickly to give booster shots.
"It's a very difficult situation we've got ourselves into, not that we could have stopped it necessarily.
"People really needed to take the public health advice much more seriously and aggressively and we probably wouldn't have had the Christmas crunch that we've got and the new year crunch to come.
"The real issue is you need to get the booster program maximised. There was data today I saw that three doses definitely reduces symptomatic illness of Omicron.
"And getting children vaccinated. To me, these are priorities you'd want to get in place before you let it rip. And we have just ignored this. We've missed the boat."
NSW Health said on Monday that two-thirds of COVID patients in ICU were unvaccinated, but Ms Washington said that meant a significant number of vulnerable vaccinated people were still at risk from omicron.
She said the government's booster program must target older people and vulnerable people with a disability.