NSW will likely keep periodically inoculating its residents against COVID-19 for years to come, the state's top doctor says, as daily infections hit another high and the nation records its first Indigenous virus death.
A record 1290 new locally acquired COVID-19 cases were detected in NSW in the 24 hours to 8pm on Sunday, and another four deaths recorded.
A man in his 50s in Dubbo, two men in their 70s and a woman in her 60s take the death toll from the current outbreak to 93, with the national toll for the entire pandemic surpassing 1000.
The Western NSW Local Health District on Monday confirmed the Dubbo man - who was not vaccinated - was Aboriginal.
He is the first Indigenous person to die with COVID-19 in Australia since the pandemic began.
Chief Health Officer Dr Kerry Chant said health authorities would likely vaccinate NSW residents on a regular basis in the long term, or until vaccines are developed which provided more permanent COVID-19 immunity.
"We need to get used to being vaccinated with COVID vaccines for the future ... I can't say COVID is not going to be with us forever," Dr Chant told reporters on Monday.
"As a public health doctor we always want to have diseases go, to be totally eliminated, but that is not on the horizon in the near future.
"Booster doses and repeat doses will be part of that."
The state government on Sunday committed to restoring personal freedoms to fully vaccinated residents once the state hits 70 per cent double-dose coverage, regardless of COVID-19 case numbers.
About 36 per cent of the state residents have been fully vaccinated so far, with the 70 per cent threshold expected to be reached in mid-October.
But, unlike other jurisdictions such as the UK, Premier Gladys Berejiklian again made clear that reaching 70 and 80 per cent NSW vaccination coverage would not prompt a widespread "freedom day".
QR code check-ins, yet-to-be-developed vaccination passports, density requirements and mask use would be long-term suppression tools.
It comes as the number of COVID-19 patients in NSW hospitals nears 850, with 137 patients in intensive care and 48 ventilated.
While NSW has a surge capacity of about 2000 intensive care beds and an equivalent number of ventilators, unions have expressed concern the quality of patient care in such a scenario would be greatly diluted.
Ms Berejiklian said the rate of hospitalisations per COVID-19 infection would continue to fall as more NSW residents are vaccinated, but the overall number of hospitalisations was likely to rise as infections increase.
October is likely to be the worst month for the NSW health system due to the accumulation of COVID-19 infections from the preceding weeks.
"Every day we get closer to hitting those vaccination targets, meaning the pressure on our hospital system, on our ICU will decline over time, and that is what we need to manage," Ms Berejiklian said.
"We are going to see more cases but if the majority of the population is vaccinated, the majority of those cases will not need to be in hospital.
"The health system is prepared, but will it stretch? Absolutely."
Education Minister Sarah Mitchell said she was confident rising vaccination rates would also ensure a staggered return to school from October 25, building to a full return from November 8.
A survey of 50,000 public school teachers found about 70 per cent had one vaccination and 40 per cent were double vaccinated.
Authorities on Sunday also revealed a COVID-19 outbreak at Parklea prison in Sydney's northwest has reached at least 31 cases.
A Corrective Services NSW spokeswoman said extra precautions including rapid antigen testing had been introduced, after inmates who may have been exposed to the virus were recently transferred out of the Parklea jail.