![Annette Wetherspoon, who is a recovering breast cancer patient, at Goulburn Medical Centre for her fifth COVID-19 vaccine. She is pictured with Dr Isabella Hawke. Photo supplied. Annette Wetherspoon, who is a recovering breast cancer patient, at Goulburn Medical Centre for her fifth COVID-19 vaccine. She is pictured with Dr Isabella Hawke. Photo supplied.](/images/transform/v1/crop/frm/190291005/ee914c1f-7fbf-48e7-b312-33ccc85e5e14.JPG/r68_49_1080_1368_w1200_h678_fmax.jpg)
Dr Isabella Hawke at Goulburn Medical Centre is warning residents "as strongly as I can" to not be complacent about COVID-19.
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Her voice is just one from the medical community spanning the Southern Tablelands, Highlands, Shoalhaven and Eurobodalla, warning people to take care at social gatherings over the Christmas period.
To 4pm on Thursday, December 8 there was 734 cases of COVID-19 recorded in the South NSW Health District, 2753 in the Illawarra Shoalhaven Health District and, 4827 cases in the South Western Sydney Health District.
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By local government area that was 133 cases in the Eurobodalla, 94 in Goulburn Mulwaree, 999 in the Shoalhaven and 621 in the Wingecarribee.
However, Dr Hawke said these numbers were "grossly underestimated".
"There's definitely another surge at the moment," she said.
"I think that it could easily be even five times higher than the actual figures. A lot of people aren't reporting or registering their positive [rapid antigen tests]."
There are reports circulating that COVID-19 has changed since the start of the pandemic and people have less to fear from the current strain. However, Dr Hawke said this is false.
"Yes, in general these strains are less dangerous than the initial Delta strain. However, we are still seeing large numbers of people hospitalised across the state, and in large numbers of people COVID-19 is contributing to their deaths."
Dr Hawke said vulnerable people are aged over 65 years, particularly those with pre-existing health conditions.
"People who are frail and in nursing homes, who are elderly and frail in general, and people who have multiple co-existing medical problems," she said.
"To a certain extent vaccination protects them but not entirely, so it's unpredictable."
People cannot afford to be complacent, according to Dr Hawke.
"Just as how this COVID-19 has morphed into less serious varieties it could just as easily morph into more deadly varieties in time for Autumn so we need to be vigilant to maintain protective measures and to uphold our vaccine status," she said.
"There are still people out there that are not vaccinated at all or who are under vaccinated or who haven't come forward for their boosters. The immunity does wain and it's my experience with COVID-19 that it's very unpredictable."
Those planning for social gatherings over the Christmas period need to also be up to date with their booster shots, and it's not too late to get a booster shot before gathering socially over the Christmas period.
"My message to everybody would be, as strongly as I can, not to be complacent. I think that we need to revisit minimising socialisation, particularly coming up to Christmas," Dr Hawke said.
"Wearing masks in public spaces, minimising unnecessary outings, and reviewing your vaccines urgently. My warning is very clear about having safe contact with family members over Christmas."
Dr Hawke and her peers across the region want people to consider outdoor lunches and picnics.
"The danger is not over," Dr Hawke said.
"People need to be wearing masks in the supermarket and when the are out and about as much as possible."
That people have been vaccinated is the reason why most people are okay, according to Dr Hawke.
"But a vaccination doesn't stop you from getting the disease, it stops you being seriously ill, hospitalised, and it reduces your risk of dying," she said.
At the height of the vaccine program, Dr Hawke was seeing 120 people a week in her vaccine clinics.
That's dropped to half a dozen and yet Dr Hawke said there were still people coming forward who haven't had any vaccine.
"I've been a doctor for 32 years. I'm a senior GP in Goulburn and I'm a senior lecturer at the ANU Medical School. I'm very experienced and well qualified with vaccines and I'm obviously a qualified COVID-19 vaccinator," Dr Hawke said.
"In my whole career as a doctor I've never known such opposition to preventative treatment and preventative measures and I think the Internet has got a lot to do with that."
Dr Hawke related this to misinformation about vaccines and a bad start to the program rollout.
"With unfortunately several people dying, and there's no doubt that that did happen, however we have to look at how the vaccine program actually saved countless lives, we will never know how many," Dr Hawke said.
She says it's not too late for people to review their vaccine boosters in time for Christmas.
"Certainly if people haven't had their third shot they definitely need to, and people over 30 should consider a fourth shot," Dr Hawke said.
Dr Hawke said Pfizer and the new Moderna multi-strain vaccine are the only two vaccines that can be used for boosters, at this time.
"AstraZeneca is not suitable and it's not available, and the Novavax is not available," she said.
Dr Hawke said that for the moment the focus is on adults.
"We're not vaccinating children anymore because there's been practically zero interest in children's vaccines," she said.
"Very, very low vaccine rates in children and I think that's because vaccines started at the beginning of school and then they all went to school and got COVID-19, so it's not really been a serious issue."
She was the focus on adults and on people who haven't been vaccinated.
"People who - and particularly the older patients - haven't had a fourth shot," she said.
"I'm not so concerned about the people in their 30s, people in their 30s who have had three shots and had COVID-19, I think that's reasonable. But anybody with underlying medical issues who are aged over 30 certainly should have their fourth shot."
Dr Hawke also stressed that it was important that all people have a COVID-19 treatment plan in place.
"People should be aware that there is easier access to antiviral drugs," Dr Hawke said.
"The criteria for that is people over 70 with any comorbidities [with symptoms]. Over 50 [years] if they have at least two medical conditions, such as hypertension, diabetes, asthma, COPD [Chronic obstructive pulmonary disease], or cancer. Indigenous patients over 30 with [symptoms] can access antivirals as well."
Of the vaccine program, Dr Hawke said stressed that anybody who is immunocompromised should have a fifth dose.
That group includes people with bone marrow diseases, blood cancers or cancers in the last five years to 12 months.
"People who are about to, or who have been through chemotherapy, should have a fifth dose," Dr Hawke said.
"I'm identifying lots of people that haven't had their fifth dose because they were unaware of it. A fifth dose is really important for the immunocompromised and with diseases such as leukemias, bone marrow diseases, severe auto-immune diseases, and people who are on immunosuppressive medications. If they're in doubt they should discuss it with their doctor."
Dr Hawke said people who do have COVID-19 need to seek a phone consultation with their doctor to clarify if they need or should have the antiviral treatment.
She holds a vaccine clinic at Goulburn Medical Centre on Tuesday and Thursday afternoons.