Hunter contact tracers, sewage surveillance and residents heeding public health advice helped keep a lid on COVID-19 in the region

Our community followed the rules, the advice and the guidance closely - and often more conservatively than the public health orders required - Dr David Durrheim said.

That response, alongside the work of contact tracers and the Hunter's health workers, has helped stamp out any COVID-19 fires before they had a chance to burn.

"In regional NSW there has been an appropriate level of gravity," the public health controller said.

"We have had four deaths in the region, which is terrible for those that have been affected.

"We have all seen how serious it can be, and now, as we look at the northern hemisphere and the chaos we are seeing, I think we can all be grateful that we took it more seriously, and acted responsibly and appropriately earlier."

Dr Durrheim said that of the region's 310 cases to date, 239 were acquired outside of Hunter New England - generally overseas or interstate.

"Thirty five acquired it within the region, and 31 were secondary cases," he said. "Often those people had been in isolation, and hadn't spread it to anyone else.

"Only five tertiary cases had spread from a secondary case, which probably speaks to the quality of the case and contact tracing."

The Hunter's contact tracing team had gotten to know each and every local person inadvertently infected with the virus to identify potential exposures.

Diaries, calendars, and credit card trails helped piece the puzzle together so the public health team could prompt people at risk to get tested for the virus.

Prior to Christmas, there had been close to 370,000 tests - a figure that was still climbing following the Avalon outbreak - in Hunter New England.

In Newcastle, there had been about 89,000 tests. In Lake Macquarie, more than 90,100.

There were almost 30,000 tests in Port Stephens, almost 41,000 in Maitland, more than 16,300 in Cessnock, and about 4200 in the Upper Hunter.

"Our public health team has been fantastic, and that includes our communications team and local media who have been so supportive getting the right messages out and getting people to do the right thing," Dr Durrheim said.

"What we have done, with excellence, is the case and contact tracing - which is why we have made our resources available to other areas. When Victoria was really under the pump, we provided support there, we did it with the recent Adelaide cases, as we are now with our colleagues in Sydney.

"We are all in this together. We need to make sure we suppress the virus effectively to avoid cases, horrible outcomes, and deaths until we have everybody vaccinated."

Sewage surveillance has also become a fundamental part of monitoring communities for traces of COVID-19, and the first sites processing the samples in real time were via Hunter Water, Dr Durrheim said.

"We saw it's value when we had the Newcastle cluster in August, and it does give you great reassurance that you have interrupted transmission," he said.

"It is a great additional weapon in our armoury."

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