"Hospitals can't cope now," said senior surgeon at the Shoalhaven District Hospital, Martin Jones. "And no matter what anybody says out loud from the government, we're not coping at all."

Prof Jones comments come the day before ISLHD chief executive Margot Mains said the district is prepared and would adapt its response to COVID-19 in line with case numbers as they rise and fall.

But hospitals are already under "remarkable pressure" and the federal government's response to Omicron has left health workers in the "firing line", according to Prof Jones.

He fears the change to the isolation period for frontline workers will contribute to the spread of the highly infectious variant in hospitals.

Read more: COVID spike: Illawarra Shoalhaven health chief says 'we're prepared'

NSW Health announced last Friday that in "exceptional circumstances", frontline workers who are asymptomatic close contacts will be exempt from having to self-isolate for seven days to avoid disruption to service delivery.

"Being pushed back into service quickly if you're a close contact certainly has put up a feeling of fear," said Prof Jones.

"That could be a problem across the whole of the health system, where close contacts are actually positive and infectious, and because of that definition, could cause spreading of the virus.

"It's really galling when we've been working so hard to keep everybody well, and the whole way this has changed, is putting us in the firing line a whole lot more than it was before."

Read more: Long delays for results being felt in Shoalhaven

He added that regional hospitals struggled with staff shortages and bed blocks prior to the pandemic and is worried about the impact the increase in hospitalisations due to Omicron could have.

As at 8pm Tuesday, January 4, there were 38 patients in hospital across the Illawarra Shoalhaven Local Health District as a result of COVID-19, an increase of 15 from the previous reporting period.

"I know people who are looking for staff all the time. It's almost impossible to get them," said Prof Jones.

"it's difficult because we're seeing that rise in hospitalisations in a time when normally we are quiet.

"There are equal the number of people in hospital at the moment than usual, and we're not even doing elective surgery.

"A problem in the Shoalhaven, as well as Gosford and Port Macquarie and all along the coast - is the fact we have a major influx of people at this time.

"One wonders what effect that will have with regard to COVID over the next few weeks."

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Prof Jones said elective surgery is beginning again next week and could add to the pressure.

"I worry about all the patients that we've got on the waiting list," he said.

"We've already got patients not coming into the hospital because they're worried about COVID.

"And when they come in, they're so much more ill than they should have been, making the treatment almost impossible.

"And that's putting extra pressure on the on the hospital itself because they are more likely to end up in intensive care, which of course has been struggling with the potential from COVID."

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