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NSW Covid update: record high 919 cases and two deaths as infections continue to rise

New South Wales has hit another grim milestone with a record 919 new Covid cases announced on Wednesday and predictions those numbers would continue to rise.

Two deaths were reported, including a woman in her 30s from Sydney’s west who died at home and whose death was revealed on Tuesday afternoon. A man in his 80s who caught Covid at Greenwood aged care in Normanhurst died at Hornsby Ku-ring-gai hospital.

Despite the rising Covid case numbers, the state government is expected to outline a roadmap on Thursday for a return to classroom learning for schools and the premier, Gladys Berejiklian, again insisted there would be some minor relaxation of restrictions for fully vaccinated people.

However the deputy premier, John Barilaro, all but confirmed the lockdown in rural NSW would be extended for several weeks after Saturday amid rising cases in regional areas, particularly in the west of the state.

Related: Facing a hospitals crisis, Gladys Berejiklian is finally getting tough on Covid | Anne Davies

The government is still insisting that despite rising case numbers, the NSW health system, though under stress, is coping.

Westmead hospital, in the epicentre of the breakout, went into emergency response mode on Tuesday night amid reports of ambulances waiting hours to admit Covid-positive patients through emergency.

Westmead staff are managing about 1,500 Covid patients in the community and 121 patients in their wards. There are 23 currently in ICU, the health minister, Brad Hazzard, said.

“You have to understand that the individual hospitals from time to time will all be under some sort of stress, especially in the epicentre of the breakout which is in western and south-western Sydney,” he said.

“NSW Health system is probably the best in the world. All the information given to me from the doctors and nurses and our public health staff is that the system is coping,” he said.

Urgent steps are now being taken to expand capacity at Westmead.

Beds are being made available for urgent cases in Westmead private hospital, patients are being transferred to other hospitals and a new short stay emergency department is being established for the less unwell, to avoid “ramping” – when ambulances are forced to queue to admit patients.

On average Westmead is getting 121 Covid patients a day, and Blacktown 15, while the number of cases being managed at home is increasing by 200 a day. Patients admitted to hospital with Covid stay much longer than those with other illnesses.

Westmead hospital in Sydney has gone into went into emergency response mode.
Westmead hospital in Sydney has gone into emergency response mode. Photograph: Bianca de Marchi/AAP

After the death of a 30-year-old woman at home on Tuesday, Berejiklian invited Dr Lucy Morgan, respiratory specialist at Concord and Nepean hospitals, to explain the symptoms of Covid.

Morgan said symptoms during the early infectious stage are very mild and similar to ordinary cold and flu symptoms and can include headache, sore throat and a slight cough. Some people have muscle aches and fever in those early days.

“But some people become breathless and dizzy – these are the sorts of symptoms that need urgent medical assistance,” Morgan said.

“If you have Covid-19, and you feel breathless, you have trouble breathing, and you are feeling dizzy, you need to call an ambulance.

“The patients I am treating have symptoms including a really severe headache, not just a little bit of a headache, but a really severe migraine-like headache that makes you sensitive to light, a stiff neck and takes more than just Panadol to relieve it.

Related: Only one in five aged care homes close to vaccinating all staff against Covid as deadline looms

“Many of my patients have a terrible cough, the sort of cough that leaves you breathless and they can’t move or speak without the cough becoming really terrible. Lots of patients have diarrhoea. Lots of patients have nausea. They just can’t eat or drink anything. And people feel so overwhelmingly fatigue, or they can do is lie on the bed.”

She said some patients become increasingly breathless so they cannot walk or even talk, and these patients need urgent care.

Morgan said no one she had treated with severe respiratory illness over the last few days was fully vaccinated and she implored the community to roll up their sleeves.

Hazzard confirmed the government’s modelling showed that the so-called “R effective rate” of the virus is still at 1.3 despite the harsher lockdowns, and that for every 10 people to get the virus, they will infect another 13.

“It will grow but the one way to stop growing and to stop you ending up in intensive care or hospitals is to get the vaccine,” he said.

The chief health officer, Dr Kerry Chant, was more explicit: “Just to be clear, this is a public health intervention in vaccinating the 16-to-39 age group [in the 12 hotspot LGAs] and getting the authorised workers.

“The modelling suggests if we can get the group vaccinated, we will break the transmission chain. It will take a while … but the solution is in our hands..

“If we get those high levels, the modelling shows that we will change the R effective and a decline in cases will occur. We have a choice,” she said.