Tens of thousands of NSW school students have started the school year after undergoing the first of many rapid antigen tests in a bid to keep a lid on an anticipated spike in COVID-19 cases as classes resume.

NSW Premier Dominic Perrottet says there will be bumps along the way and "it won't be all smooth-sailing" but "there's northing more important" than getting children back in classrooms.

"I know that many parents are anxious ... but the alternative is to have schools closed and ... it's not the outcome that's best for our kids," he said on Tuesday.

Catholic schools resumed on Monday but most state pupils started on Tuesday, testing the government's new COVID-19 protocols for face-to-face teaching.

Teachers and students are required to test for COVID-19 twice weekly, year groups will be segregated, ventilation has been improved, children have been getting vaccinated and high school students and teachers must wear masks.

Education Minister Sarah Mitchell acknowledged that adding a RAT to a family's morning routine was a big ask but said it was important to keep children, their classmates and teachers safe.

The premier also announced that from Monday, private hospitals, and public hospitals in regional and rural areas, would begin a staged return to resume non-urgent elective surgery.

"We thought that ... we could bring that back in mid-February but we've been able to bring that forward," he said.

"I think (that) is a testament to the strength of our health system."

Opposition leader Chris Minns says the government needs to reduce elective surgery backlogs in Sydney public hospitals when surgeries resume there, where a long waiting list for treatment has only increased during the Omicron wave.

"You're talking about 100,000 people, many of them are in severe pain and need this surgery to get their life back on track," Mr Minns said.

Health Minister Brad Hazzard says the focus for metropolitan hospitals will remain on caring for COVID-19 patients and elective surgeries will not resume until they can be conducted without compromising that care.

Australian Medical Association NSW President Danielle McMullen says the government needs to provide more certainty to patients that surgery won't be cancelled again by planning better for future outbreaks and not "use elective surgery as a lever to fix workforce resourcing problems".

"We need better planning and better solutions, for our patients' sake.

"Suspending elective surgery should only be a last resort and a local decision based on capacity," Dr McMullen said.

State and federal governments need to prioritise "appropriate funding of general practice to provide alternatives to hospital care", she said.

NSW Health reported 12,818 new cases of COVID-19 and 30 deaths in the 24 hours to 8pm on Monday.

The seven-day average for new cases has fallen to 14,914, from 38,725 two weeks ago.

However, the government has previously warned a resurgent spike in cases is likely as children return to school.

There are 2749 people with COVID in hospital, 184 of them in ICU and 70 are ventilated.

More than 78 per cent of students aged 12-15 have had two doses of a COVID-19 vaccine while nearly 40 per cent of children aged 5-11 have had one dose.

Some 44.7 per cent of eligible people in NSW have had a booster shot.

"I would love that pace to pick up," Chief Health Officer Kerry Chant said.