Despite nearly a dozen new cases in a week, Ballarat is still sheltered from the worst of the second wave with a ratio of active cases of one new case per 9700 people, seven times lower than the ratio of one case every 1410 people in Melbourne.

The broader picture is less reassuring with 23 active cases, including Moorabool and Golden Plains shires, in one of the higher concentrations in regional Victoria.

There were no new active cases in Ballarat on Friday despite it being another deadly day for Victoria and one patient remains in intensive care in a serious condition at Ballarat Health Services Base Hospital.

Now, the region's leaders and medical professionals want more contact tracing, better preparation plans and most of all, collective behaviour change to stop the trend growing worse and keep the deadly disease under control in the region.

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BHS chief Dale Fraser said we were starting to see the very real impact of COVID-19 in the community with active cases on par with Mitchell Shire and hospitalisations.

"There is evidence of community transmission in Ballarat, which means people are not doing the right thing and self-isolating while they have symptoms of COVID-19," Mr Fraser said. "It cannot be more clear - now is the time to make those integral sacrifices to protect yourself, your loved ones and the broader community."

BHS is conducting more than 100 checks daily on people isolating in the broader community on behalf of the health department.

It has been one week since the premier promised a dedicated public health team to tackle tracing for Ballarat. Geelong has one in action but the health department has not responded to multiple queries the past week for details on a Ballarat unit.

MORE must be done from the health department and by individuals at a community level to prevent COVID-19 taking hold of Ballarat, health leaders say. They reiterate lives were at stake.

UFS chief executive officer Lynne McLennan said the critical message to self-isolate was not getting through to people. Ms McLennan said people were not taking the threat seriously enough. Her staff, leading the Lucas fever clinic, repeatedly had cases of people booking a COVID-19 test about work.

"If you want to do the right thing, isolate. Do not work. If you get symptoms book a test and isolate. Don't self-diagnose that it's just a cold - you need to be tested," Ms McLennan said.

"What is a risk in Ballarat is people's behaviour and seeing people not doing the right thing...Isolating is hard and it's very inconvenient but if the alternative is people dying, then it should be no choice."

Ms McLennan said anecdotal reports from the Lucas clinic were those who tested positive tended to be visibly incredibly sick. Her concern was how long it might have taken them to get to that point - how long they might have been infected.

Ballarat being a small community organically helped contact tracing, Ms McLennan said with an understanding people testing positive were quick to let their close contacts know well before Department of Health and Human Services reached out.

City of Ballarat councillor Mark Harris, who is also an emergency doctor, said the Ballarat's case trajectory demanded a state response cognisant of results in the region. Eleven active cases had cropped up within City of Ballarat boundaries in the past week after two months without known cases.

Cr Harris said hospitalisations, of which there were now four cases, and deaths were slower to catch up.

"For any system that has exhausted contact tracing, the next and only thing to do is increase public health measures," Cr Harris said.

"I expect at a political level the state is balancing against economic causes...My view is just that seeing what's happening rurally, DHHS would be foolish not to call more stringent measures."

This comes after Cr Harris made a scathing report before council on Wednesday night on the deficient, over-stretched and disappointing DHHS support for regional health.

Cr Harris' report is as part of the city's emergency planning committee. He told The Courier DHHS was competent in contact tracing for infectious diseases but in this pandemic had been found lacking.

DHHS has not responded to The Courier's queries on contact tracing this week.

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