Ballarat has again broken its own record for the number of new COVID-19 cases in a day, prompting health experts to urge people to take serious precautions even though few enforced restrictions remain in place.

The city set a new daily record for the second day in a row, with a further 391 cases on Wednesday, more than the previous record high of 330 set on Tuesday.

The number of active cases has climbed to 1612, up from 1442 on Tuesday, and has averaged 200 per day for the last two weeks.

Leading epidemiologist Nancy Baxter, head of the school of public health at the University of Melbourne, said a convergence of factors including complacency since restrictions eased, waning immunity and the advent of winter were driving the surge in regional numbers.

Australia also had the second-highest number of new daily cases in the world but Professor Baxter said this ranking should be understood alongside our high testing ratio. However she said the death toll - Victoria recorded 17 and 18 deaths the last two days - was a clear indicator the virus was still a serious public health risk.

"COVID is on track to be one of the top killers of Australians this year, behind cancer. It's around the same as what the deaths are for cardiac disease - and that really is pretty shocking," Professor Baxter said. "I can understand why people don't want to hear it and don't want to focus on it, but I think in three-to-six months we will look back and wonder 'what happened' and whether there was anything we could have done to prevent that."

Professor Baxter said a COVID-weary public meant politicians in an election year were shying away from the urgency of the message to remain vigilant.

"A much more palatable message will be that 'the pandemic is over - go and have fun'. The problem is that COVID doesn't vote and COVID doesn't care."

Professor Baxter said a combination of fatigue and eagerness to get workplaces back to normal have potentially added to complacency.

She said the great unknown yet to be added to this surge and the pressure it would place on the health system, was the dangers of a higher winter flu season brought on by people mixing freely and indoors.

"So here we have two outbreaks at once and that is not good, even if you have a public health system that's got a lot of capacity - and we know that that's not necessarily the case in Australia."

Ballarat base hospital came out of a Code Yellow late last month, a situation where it had to limit access to the emergency department due to excessive pressure and while it has not yet had to upgrade its current normal status, the numbers are being watched carefully.

Grampians Public Health Unit medical director Rosemary Aldrich told The Courier this week they expected hospitalisations to increase for a week or two.

Professor Aldrich said it was critical anybody who had tested positive to let health authorities know if they had inadvertently visited a high risk setting, such as a nursing home.

"There's so much COVID in the community that we know many, many people have been exposed without knowing and we are trying to keep people as safe as possible especially in vulnerable settings."

Grampians Health have also reiterated for those not needing emergency treatment at the ED to seek alternative healthcare such as a GP or Nurse on Call.

Professor Baxter echoed the precaution for anybody who has has not yet had their third boosters along with a fourth shot for those eligible to act now, as the vaccines still provided the best protection from getting very sick from COVID.

"If you haven't been boosted, get boosted - that's number one, " she said.

"If you're in a higher risk group, getting that fourth winter dose is really important. It will protect you from getting really seriously ill from covid."

EARLIER

The number of new COVID cases in Ballarat continues to surge, with a new daily record set for the second day in a row.

Ballarat confirmed a further 391 cases on Wednesday, considerably more than the previous high of 330 set on Tuesday.

The number of active cases has climbed to 1612, up from 1442 yesterday.

Case numbers have climbed sharply this week, having averaged 200 per day for the previous two weeks.

In comparison, Geelong recorded 571 new cases (2827 active) and Bendigo confirmed 327 (1610 active).

Speaking to The Courier on Tuesday, Grampians Public Health Unit medical director Rosemary Aldrich said more than 80 per cent of current cases were coming from Rapid Antigen Tests.

"What this means, and this is good, is that people are reporting their RAT results which is very important and means if they become very unwell and need anti-viral therapy, the health authorities know who they are and can reach out and talk to them," she said.

Professor Aldrich said a "constellation of factors" had contributed to the COVID surge including a general increase in respiratory virus infections circulating in winter as people spend more time inside, the easing of restrictions and mask mandates, and immunity starting to wane in people who had their third doses early.

She urged people to wear masks, continue to practice social distancing, get their third vaccine dose if they had not already, or their fourth if eligible, and let health authorities know if they had inadvertently visited a high risk setting, such as a nursing home, before testing positive.

Ballarat has almost 80 per cent of eligible people having received three vaccinations.

"If you have visited anywhere we need to be concerned about, like a parent in an aged care facility, get in touch with us or the facility to let them know so we can hopefully help them put measures in place to keep people safe," Prof Aldrich said.

"There's so much COVID in the community that we know many, many people have been exposed without knowing and we are trying to keep people as safe as possible especially in vulnerable settings."

Prof Aldrich said she would not expect hospitalisations to increase for another week or two.

"We do know that vaccines are very effective in reducing the need for hospitalisation and severe disease and deaths, and the strength of our high vaccination rate continues however we have always known that even vaccinated people can spread the infection if they get COVID and that's what we are seeing now."

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