COVID virus detection in sewage at three sites in Port Macquarie-Hastings is a red flag for Mid North Coast Local Health District (MNCLHD) officials.
Similarly, it is the third instance where samples have yielded positive results at the Bonny Hills wastewater treatment plant, prompting urgent calls for people living in the area to come forward for testing.
While there have been no new cases on the Mid North Coast in the 14 days since two people tested positive at South Kempsey, the message remains clear, and simple - stay committed to the current public health orders, get tested even if you have the mildest of symptoms, and get vaccinated.
MNCLHD chief executive Stewart Dowrick said the COVID testing regime at these facilities is conducted daily and is so sensitive, the detection of virus fragments could be the result of just one person who does not know they have the virus, or who has not yet been tested.
But as the nation has seen in Greater Sydney, just one person unaware they have contracted COVID who is still moving about in the community can have catastrophic consequences.
"It does concern us that we've had three positive cases in the last few days," Mr Dowrick said.
"All we can ask people to do in the Port Macquarie and Laurieton areas is to come out and get tested if you have any symptoms.
"The sewage detection is very sensitive but it is not the only tool we use. The most important tool we have is COVID testing, and it yes, can be just one person, it is that sensitive.
"It could suggest there are people in the communities of the Mid North Coast, particularly Port Macquarie, Laurieton, Camden Haven areas who may have COVID.
"It could relate to someone who has come through and is on the road and is just passing as we noticed when we had a detection at Nambucca and Kempsey when we had an interstate truck driver going between Sydney and Queensland."
Detection of virus fragments in sewage can also be due to shedding of the virus by someone who may have previously had the illness and may no longer be infectious. It can also be the result of a person with COVID-19 who may have visited the community and has since left the area.
As well as being present in stools, viral fragments can enter the sewer when washed off hands and bodies through sinks and showers.
The Port Macquarie sewage treatment plant serves around 54,000 residents of Port Macquarie, Sovereign Hills, Thrumster, Sancrox, North Shore and Settlement Point in the Port Macquarie-Hastings local government area.
The Bonny Hills sewage treatment plant serves around 7000 residents of Lake Cathie and Bonny Hills.
The Dunbogan sewage treatment plant serves around 8500 residents of Dunbogan, Laurieton, Lakewood, West Haven, Camden Head and North Haven.
The turn-around time for sewage testing is usually two to three days, Mr Dowrick said, but samples will be taken daily. Sewage testing has expanded across the region to Bellingen and Kempsey.
"The community has been wonderful across the Mid North Coast over the last few months in coming out in droves to get tested," Mr Dowrick said.
He added that the Mid North Coast has worked hard during the lockdown to keep the region safe.
"The last six weeks, because of these incidents, we've had record numbers in our testing facilities," he said.
Mr Dowrick said most importantly, people need to come forward and get vaccinated and talk to their local GP about which vaccine works for them.
"It's the most important thing we can do as a community. Both vaccines (Pfizer and Astra Zeneca) are both very effective ... this is our way out of this," he said.
The Moderna vaccine is expected to become available in coming weeks to complement the current vaccine rollout.
Today, NSW reported a further 1116 cases and the 100th death since the outbreak began in Sydney in June.
The region, along with the rest of regional NSW, remains in lockdown under stay-at-home orders until September 10 when it will be reviewed based on case numbers.
There are COVID-19 testing clinics located across the Mid North Coast LHD at Bellingen, Coffs Harbour, Kempsey, Macksville, Nambucca Heads, Port Macquarie, South West Rocks, Wauchope and Woolgoolga.
A full list of clinic locations and opening hours are listed on the NSW government website at: www.nsw.gov.au/covid-19/how-to-protect-yourself-and-others/clinics.
There is a drive-through testing site at Kempsey's Riverside Park reserve at the Austral St boat ramp which is open 8am-6pm weekdays and 8am-4pm on weekends.
MNCLHD urges anyone feeling unwell with even with the mildest of symptoms to come forward for testing.
To find a testing clinic near you, visit the NSW Government website www.nsw.gov.au/covid-19/health-and-wellbeing/clinics
Go to the online COVID-19 vaccine eligibility checker to find out when and where you can receive a COVID-19 vaccine.
You can also speak with your local participating pharmacist or GP about the vaccine that is right for you.
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