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NSW has reported 919 new local coronavirus cases on Wednesday, the highest daily number ever recorded in Australia.

Premier Gladys Berejiklian said there had been two deaths since yesterday’s update: Ianeta Isaako, aged in her 30s, whose death was reported yesterday afternoon and a man in his 80s who died at Hornsby Hospital after acquiring his infection at the Greenwood Aged Care facility at Normanhurst.

Ianeta Isaako, pictured with her husband, died after being diagnosed with COVID-19.

Ms Berejiklian maintained she will announce what additional freedoms will become available for fully vaccinated residents on Thursday or Friday this week. Up to 125,000 vaccine doses were administered yesterday, with nearly one-third of the NSW population fully vaccinated.

There are currently 645 COVID-19 cases admitted to hospital in NSW, including 113 people in intensive care. Forty of the intensive care cases require ventilation. Ninety-eight of the cases in intensive care had not been vaccinated.

“I don’t want to take away from the situation NSW is in … don’t get me wrong, every day we want to see case numbers go down,” Ms Berejiklian said.

“They will bounce around a little: could go up, could go down. We need people to focus on what you need to do to keep yourself and your family safe and what all of us can do to reduce spread.”

Ms Berejiklian said the areas of most concern in Greater Sydney and western Sydney remain Guildford, Auburn, Merrylands, Greystanes, Granville, Punchbowl, Yagoona, Blacktown and surrounding suburbs.

There also has been a significant increase in the number of local cases reported in western NSW today. Forty-nine new cases were reported in the Western NSW Local Health District and an additional seven in the Far West.

NSW Deputy Premier John Barilaro said the western region was “still of great concern”, adding that residents in the state’s south also had to be on alert after sewage detections at Merimbula. Other detections in areas with no known cases were at Toukley and another detection at Bateau Bay on the Central Coast.

NSW Health Minister Brad Hazzard said the hospital system was coping, but individual sites were coming under specific pressure.

Yesterday Westmead Hospital announced it would move to emergency operations, reducing its intake of COVID-19 patients and opening beds in the private hospital network due to a rapid increase in community cases.

Mr Hazzard said the situation at Westmead was “typical of the sorts of pressures you’d expect when you got a major hospital in the middle of the epicentre of the virus outbreak”.

He said Westmead staff were managing about 1500 COVID-19 patients in the community, including people in home care, and they only had 121 staff in their wards.

“I’ll stress that it isn’t easy,” he said. “Last week, Westmead Hospital had 280 patients who came in by ambulance with COVID.”

Western Sydney lung specialist Associate Professor Lucy Morgan said she had been treating a high number of younger patients in her work at Nepean and Concord hospitals.

“One of the things I’ve noticed in my most recent days in the hospital was the heartbreaking stories of patients who were very, very young,” Dr Morgan said.

“I’ve been looking after patients in their 20s, in their 30s and in their 40s. Many of whom have very young children, many of whom have partners who are in hospital or in other hospitals, dislocating their families.

“Many of these patients have children who have needed to be so that there is someone who can care for them safely. All of them have extended families who have been impact in many, many ways by the impact of COVID-19 illness.”

With issues being reported across hospitals in western Sydney, inundated with positive COVID-19 patients, NSW Health Chief Officer Kerry Chant was asked whether field hospitals should be considered. The Chief Health Officer said it was not.

“In general, field hospitals are really not what we need in Sydney,” Dr Chant said, adding that the public health system needed to treat patients in an environment with “copious oxygen supplies”.

“We need a safe environment, we need social distancing, we need beds, we need ability to feed, access to drugs, access to IV therapies and ICU,” she said.

“We do have a number of facilities and as [Health Minister Brad Hazzard] indicated we have got the capacity to work with our private hospitals, of which we have significant bed capacity.”

Meanwhile, the NSW branch of the Australian Medical Association said on Wednesday it does not support the easing of restrictions in the state “at any level”, as the fully vaccinated wait to hear what additional freedoms they may be granted after NSW hit its 6 million shots target.

AMA NSW President Danielle McMullen said although “people are tired, want to see their families, and are increasingly vaccinated … this is not the time to ease restrictions at any level”.

“We understand the desire for certainty, and we think discussion about modelling and vaccination rates is important,” she said. “However, NSW has not achieved the vaccination rates or lowered the case numbers significantly enough to make any changes to current restrictions. ”

COVID-19 cases have continued to close schools in NSW: Strathfield South High School and Lucas Gardens School, in Sydney’s inner west, Dee Why Public School, on the northern beaches, and Gorokan High School on the Central Coast all shut their doors today after infections in the community.

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