NSW’s local COVID cases have bounced back up to 600 and 11 more people have died, in the state’s worst 24-hour tally in recent days.

There were 646 coronavirus cases reported to NSW Health in the 24 hours to 8pm.

It comes after a steady downward trend in daily case numbers, with new infections in the 500s for the past two days.

The state’s toll from its Delta outbreak has reached 414 with the deaths of two women and nine men, aged from their 50s to their 80s. Eight came from western or south-western Sydney, with the others from the city’s south-east, inner-city and lower north shore.

Tweet from @NSWHealth

In the 24 hours to 8pm on Thursday there were 103,388 tests and chief health officer Kerry Chant said it was critical that high testing rates continued.

“It’s an exciting time but I caution everyone to do everything safely,” she said on Friday.

The update came as doctors voiced concern that the accelerated NSW roadmap out of lockdown – announced by new Premier Dominic Perrottet on Thursday – could be going too far, too fast.

The Australian Medical Association of NSW said changes to the state’s plan to emerge from lockdown could overwhelm the hospital system and burn out healthcare workers.

“We’ve got a new Premier in the driver’s seat, but that’s not a good enough reason to deviate from the course previously set,” AMA NSW President Danielle McMullen said.

“Keeping people safe must be the Premier’s top priority.

“Relaxing restrictions too soon will not be a ‘popular’ decision if it means the number of people contracting the virus and ending up in hospital skyrockets.”

The NSW Doctors Reform Society questioned whether Mr Perrottet had listened to advice from chief health officer Dr Kerry Chant.

“Mr Perrottet’s proposals to increase the numbers of people in peoples homes and stop the use of masks in offices could risk much higher numbers of COVID infections and even increased deaths,” DRS president Con Costa said.

But Katherine Gibney from the Doherty Institute said that while virus case numbers would jump as restrictions loosened, easing out of lockdown was inevitable.

“Hopefully with high vaccination rates we’ll be protected against the more severe disease and those requiring hospitalisation and ICU. But we are expecting these to increase in the coming weeks and couple of months,” Dr Gibney told ABC TV on Friday.

“It has to be done. We can’t live in lockdown indefinitely.”

Mr Perrottet announced a revised strategy to reopen NSW on Thursday, with NSW to emerge from months of lockdown on Monday having reached its 70 per cent double-dose vaccination milestone.

Ten adult visitors will be allowed in homes, 30 people can gather outdoors and 100 guests can attend weddings and funerals.

Indoor swimming pools will be able to open and all school students will be back in the classroom by October 25. All teachers will have to be fully vaccinated by then.

From Monday people will be able to travel between Sydney, Shellharbour, Wollongong, the Blue Mountains and the Central Coast but not into other regions.

The United Workers Union, which represents many frontline and public-facing workers, is concerned members checking vaccination status could be put in unsafe situations.

“We want the NSW government and employers to ensure that we aren’t leaving the casually employed person, potentially in their teens or early 20s, bearing the brunt of any pushback that might arise from vaccination requirements for people wanting to enter venues again,” UWU National Secretary Tim Kennedy said on Friday.

The union wants the government to issue clear guidelines to protect public-facing workers, and penalties for non-compliance, as well as to implement a simple way to verify vaccination status.

The integrated Service NSW vaccine certificate or passport app is still not ready to be rolled out statewide. It is being trialled with 500 people in regional NSW.

Restrictions will ease further when 80 per cent of the adult population is fully jabbed, expected about October 25.

There are 856 COVID cases in NSW hospitals. They include 170 people in intensive care, 75 of whom require ventilation.

-with AAP