NSW has reported another 45,098 COVID-19 cases and nine deaths, while acknowledging case numbers are likely an underestimate.
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The record total comes weeks from the peak of the current Omicron outbreak, expected in mid-to-late January, according to recent NSW Health modelling.
The figures, announced on Saturday morning for the 24 hours to 8pm Friday, came from 116,915 tests, representing a positivity rate just short of two-in-five.
Hospital numbers increased 57, or 3.2 per cent, to 1795, including 145 in intensive care.
Immunisation levels barely budged, with the double-dose vaccination rate 93.7 per cent for residents aged 16 and over and 78.1 per cent for those aged 12 to 15.
Vaccinations for children aged five to 11 begins on Monday.
Dr Kerry Chant on Friday said current figures were an underestimate, given the high spread in the community, difficulty accessing rapid antigen tests and the expected number of asymptomatic cases,
Case totals in coming days are likely to only capture part of the story.
Symptomatic people or close contacts who test positive to rapid antigen tests from Saturday have been instructed to treat themselves as a case.
But a mechanism to report such cases through Service NSW is still being developed.
Victoria on Friday launched a web form to report positive RATs.
The current outbreak has led to a drop in spending in Sydney unlike any other time in the pandemic, the Tamworth Country Musical Festival to be delayed until April and non-urgent elective surgery to be halted for weeks.
From Saturday until at least January 27, singing and dancing in pubs and clubs is banned, except for weddings, performers or classes.
Premier Dominic Perrottet defended his decision to ease restrictions last month as the state's Omicron outbreak took hold.
Asked several times whether easing restrictions in December, only to reinstate many of them within a month, was the right call, Mr Perrottet said Omicron required a different response.
"It is much, much less severe, and the approach we've taken is the right approach," he said.
"Clearly in the middle of a pandemic, when cases arise, that will dampen confidence but ultimately, the alternative is to lock down."
But state opposition leader Chris Minns has criticised his comments.
"If that's his idea of success, I'd hate to hear what his idea of failure is," he told reporters on Friday.
"At the end of the day, the premier told the people of NSW who raised concerns about hospital overcrowding and rising case numbers that they were being alarmist or they were being bed wetters."
