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On the day Sydneysiders should be coming out of lockdown, they're instead staring down the barrel of a still-worsening coronavirus outbreak.

There are fears today's New South Wales coronavirus case numbers will surge once again as a spike in testing reveals something closer to the true spread of the virus in south-western Sydney.

9News reporter Lauren Tomasi reported overnight that the testing clinic at Fairfield had already recorded five positive cases by 5pm, from about 2500 tests.

READ MORE: Sydney's COVID-19 exposure sites boom as focus shifts to growing cluster

https://twitter.com/LaurenTomasi/status/1413030226808905730

"Indicates another spike likely for (Friday's) numbers. Police will be on the beat here focusing on compliance (with lockdown rules) from 7am," Tomasi said.

Fairfield has been identified by authorities along with Canterbury-Bankstown and Liverpool as the areas of growing concern of fresh spread of COVID-19 from the current wave crippling Sydney that started in Bondi.

Millions of residents in greater Sydney were due to have restrictions eased today before lockdown was extended for at least an extra week.

Premier Gladys Berejiklian said NSW would "get to where we need to go" at the end of the three-week lockdown if "every single person does the right thing".

"Experts have told us it is achievable. If it was not achievable, we would not have provided those details to the community," Ms Berejiklian said.

READ MORE: Supermarkets, Kmarts, chemists, Bunnings added to exposure sites list

"That's assuming everybody does the right thing and we work together to make sure we stop the spread."

It was a warning bizarrely echoed by Western Australia Premier Mark McGowan, who called on "flippant" Sydneysiders to stick to the lockdown rules.

Hundreds of thousands more vaccines and even the police are being sent in to south-west Sydney to combat the pandemic in its new epicentre, where vaccinations rates among older people are worryingly low.

New South Wales yesterday recorded its highest single-day rise in COVID-19 cases in more than a year with 38 infections recorded to 8pm on Wednesday.

https://twitter.com/NSWHealth/status/1412939556286963713

"The situation is serious enough that, according to Nine newspapers, three senior NSW ministers are considering whether to abandon the state's goal of zero local transmission and accepting that the more contagious Delta variant will circulate in the community.

Australian Medical Association president Omar Khorshid was quick to rule out the suggestion of living with the virus, arguing, NSW must "continue lockdowns until the virus is eliminated" or risk "disaster".

"There's no alternative to elimination," he said, adding that "nowhere in the world has any community been able to live with Delta without very significant levels of vaccination".

"We would be talking about long-term significant restrictions on people's movements from going in and out of lockdown, hospitals filling up with extremely sick people, and a devastating economic impact, not just on NSW but the rest of the country.

"We would see permanently closed borders between most other states and NSW, which would have (a) devastating impact on many families and businesses."

Chief Health Officer Dr Kerry Chant has defended her health advice to extend the lockdown, saying everything she has advised the premier has also been shared publicly.

"The assessment was that we needed this lockdown," Dr Chant said.

"We had tried everything, and once we had a sense that we had missed some unrecognised chains, we acted to try and lock down the minimum number of people that we could with still a massive impact."

Dr Chant said NSW Health's vision was to have 80 per cent of the adult population vaccinated before talking about living with COVID-19 in the community.

Family restrictions clarified

Dr Chant asked NSW residents to redefine who they classify as family as household transmission continues to present an ongoing challenge for the state.

For the purposes of the lockdown, she said the family unit only applies to anyone who lives in your household.

A person should only visit another household to deliver needed care.

In terms of shopping, only essential visits should be made.

"If you are going shopping, think about what you absolutely need, do the list, get in and out. This is not the time for browsing," Dr Chant said.

"We are asking the community to only shop for those essential goods.

"The reason we haven't defined essential is because clearly, people may need blankets, rugs, school shoes, these are the sort of things that are defined as essential."

Vaccination plea

Ms Berejiklian called for all people in NSW over the age of 60 to ring their GP and get vaccinated.

"We can't pretend we're different in Australia, you can't live with the Delta variant unless you have a certain proportion of the population vaccinated. That is the bottom line," Ms Berejiklian said.

"If you have had the first jab of AstraZeneca, please go and get your second jab, and if you are younger than 60 and want the AstraZeneca, please go to your GP and get the advice. This is really important."

In response to a question about supply issues, Ms Berejiklian said NSW does not have control over the supply of vaccinations from the Commonwealth.

"We have always argued for extra supply of vaccinations, and that is the one thing the NSW Government can't control," Ms Berejiklian said.

"And we have always had a sense of urgency NSW about the vaccine."

Higher testing rates needed

Dr Chant again noted several suburbs in Sydney's south-west which are of particular concern.

The number of local cases in those communities continues to grow with authorities now focusing their attention on the areas of Fairfield, Canterbury, Bankstown and Liverpool.

Increasing rates of household transmission and lower testing numbers have prompted warnings from health officials for residents in those areas to reduce their contact with others and follow restrictions.

READ MORE: Aim to get all NSW students back in classrooms from July 19

The state tested more than 39,000 people for the virus during the last reporting period, sustaining strong testing levels.

However recent data has shown certain government areas are falling behind with 14,000 people tested in two weeks in the eastern suburb of Bondi compared with fewer than 2000 in Fairfield.

Dr Chant emphasised that while residents in those communities should be on high alert, other suburbs around Sydney should not become complacent.

"It doesn't mean if you are in a different suburb you don't have to be worried," she said.

"It is critical that everyone sees themselves at risk."

READ MORE: How to claim the COVID-19 Disaster Payment

Linda Burns received her AstraZeneca COVID-19 vaccine early last month.

Not long after, she began feeling ill with a nose bleed, sore throat, cough and headache. Her GP told her to go to hospital.

Three days later she was admitted to St John of God in Midland then transferred to Royal Perth where she suffered a brain bleed.

READ MORE: Vaccine boost for Sydney suburbs at risk of COVID-19

The Therapeutic Goods Administration today confirmed her death was "likely linked to the vaccine".

"This was based on the lack of strong evidence for other causes and the occurrence of the event being within a plausible time period after vaccination," the TGA said.

"While the woman had experienced a recent viral illness that could have theoretically caused ITP, the panel felt that the unusual severity of the event suggested that vaccination was a more likely cause."

READ MORE: 'No alternative' to NSW eliminating Delta, says top medical body

Dr Andrew Miller from the Australian Medical Association said Ms Burns' death following the vaccine was "an incredibly rare event".

"It's incredibly sad of course for those involved," Dr Miller said.

The 61-year-old's death is the third across the country connected to the vaccine. Five million doses of AstraZeneca have been administered.

But Ms Burns did not develop the same blood clotting disorder that claimed two other lives.

Instead, she had a severe case of immune thrombocytopenia or ITP – a rare bleeding disorder.

The health regulator estimates the risk of ITP is just one case per 100,000 AstraZeneca doses.

Doctors say the danger of COVID-19 is far greater than any risks from vaccines.

"The risk of COVID getting into the community is very real," Dr Miller said.

Investigations underway

Experts have repeatedly told Australians that the possibility of developing any life-threatening reaction to the vaccine is vanishingly small.

Immune thrombocytopenia (ITP) is a rare bleeding disorder that occurs when the immune system mistakenly destroys platelets, which helps the blood to clot.

It can occur after the immune system is activated, for example by a viral infection or vaccination, and has been reported with other vaccines for hepatitis B, measles, mumps, rubella and influenza.

Up to a third of people with ITP will have no symptoms at all, or have only minor bruising. However, about five percent develop severe bleeding.

The risk of ITP associated with the AstraZeneca vaccine is still being investigated and characterised, the TGA said.

Preliminary findings from a recent Scottish study estimate the risk of ITP to be about one case per 100,000 AstraZeneca doses.

To July 4, 2021, the TGA has received 36 reports of suspected ITP.

"We encourage people to seek medical attention if they experience signs and symptoms that could suggest ITP, such as unusual skin bruising or clusters of small red or purple spots that do not lose their colour when pressed," the TGA said.

"Unusual bleeding is another sign, for example bleeding from the nose or mouth that is hard to stop, or blood in the urine or stools."

In the past week, three confirmed incidents of the rare blood clotting condition TTS have been linked to the AstraZeneca vaccine, along with four classed as "probable".