The Hunter has testing rates less than half of other areas with high COVID-19 case numbers, prompting a warning from the region's medical controller not to ignore mild symptoms.
Hunter New England Health reported 35 new COVID-19 cases on Tuesday, the lowest daily count since September 25. But the district has recorded just 183 tests for every 1000 people over the past four weeks, way below the 442 rate in South Western Sydney.
HNEH has recorded 1684 cases in the past month, behind only South Western Sydney (3831) and Western Sydney (2782) among NSW local health districts.
Western Sydney also has a much higher testing rate, 436 for every 1000 people, than Hunter New England.
Of the other districts with more than 1000 cases over the past month, Illawarra Shoalhaven has a testing rate of 324, South Eastern Sydney 322 and Sydney 365.
Newcastle council area has a test rate of 212 per 1000, Lake Macquarie 207, Maitland 277, Cessnock 215 and Port Stephens 147.
The number of tests in the Hunter has fallen from a peak of 79,608 in the week to August 15 to 40,194 last week.
HNEH medical controller Dr Paul Craven said the figures were concerning.
"We have testing rates half of other districts with the same amount of virus in the community," he said.
He said test rates could be lower in the Hunter than in Sydney and Wollongong because the region had encountered rising cases at a time when it also had relatively high vaccination rates.
"It's important that people still stay away from work and get tested when they have symptoms," he said.
"You may not realise you have COVID. For one person COVID can be a runny nose and for the next person it's being on a ventilator."
Full vaccination reduces infection and transmission but does not eliminate them.
NSW recorded 273 new cases and four deaths in the 24 hours to 8pm on Monday.
The Hunter and NSW case numbers are trending downwards since the state reached its first 70 per cent adult vaccination target and the government started reopening social and economic activity eight days ago.
NSW chief health officer Dr Kerry Chant said it was too early to conclude that the reopening had not affected case numbers.
"It does take a lag, so we wouldn't be expecting numbers to rise. In a two-week period we'll get a sense," she said. "Next week I'll be really interested in what our numbers are."
The fresh Hunter cases included 13 in Lake Macquarie local government area, five in Cessnock, four each in Maitland and Newcastle and one in Port Stephens at Raymond Terrace.
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