COVID-19 is being spread in indoor settings like gyms and household gatherings in NSW and authorities say even the vaccinated need to remain vigilant.

NSW vaccination rates continue to improve, health authorities are warning even fully jabbed people can catch the virus after an outbreak at a Sydney gym.

NSW Health's Marianne Gale says everyone needs to remain vigilant by wearing masks, maintaining social distancing and washing their hands - particularly when gathering indoors.

"We are seeing transmission occurring in indoor settings including gyms and household gatherings - including in fully vaccinated people," she said on Thursday.

"You can still get COVID-19 even if you are vaccinated and you can still pass it on to other people," she said.

"Vaccination does lower this risk but it's not 100 per cent foolproof," she said.

NSW Health on Wednesday night issued a COVID alert for City Gym, at Darlinghurst in the inner city, where 15 cases have been confirmed.

The cases involve people who attended the gym while infectious or acquired their infection at the facility, the department said.

People who used the gym at certain times between October 18 and 23 or on the 25th are considered casual contacts and must get tested and self-isolate until a negative result is received.

NSW recorded 293 new local cases of COVID-19 and two deaths in the 24 hours to 8pm on Wednesday - 11 fewer new local cases than the previous day.

There are 381 COVID-19 patients in NSW hospitals - down by 37 from the previous day.

There are 82 COVID-19 patients intensive care - 15 fewer than the previous day - of whom 38 require ventilation.

Currently 93.3 per cent of people 16 and older have had one dose of a COVID-19 vaccine and 86 per cent of adults are fully jabbed.

In the 12-15 year old age group, 78.5 per cent have had their first dose and 54.8 per cent are fully vaccinated.

The death toll from the current outbreak, which began in mid-June, is 508.

A fully vaccinated woman in her 90s died at the Tarrawanna aged care facility, north of Wollongong, where she acquired her infection.

A man in his 70s from southwest Sydney died at St George Hospital. He had received one dose of a COVID-19 vaccine.

The cluster in the Hunter New England Local Health District continues to grow with 79 new cases taking the number of active cases there to 1089.

There were 51 cases in southwest Sydney and another 30 in the Murrumbidgee Local Health District which includes the town of Albury on the Victorian border.

NSW Health's ongoing sewage surveillance program has detected fragments of the virus in samples collected from across NSW, including Barraba, Moree and Uralla.

The highly anticipated move to unfettered travel to the regions is due to start on Monday after being delayed over lower vaccination rates outside Sydney.


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