The new case is a close contact of an earlier case diagnosed in Coffs Harbour on the weekend. The person has been isolating since Saturday and was not infectious in the community.

Related content: 11 more deaths, 1000+ COVID cases reported in NSW

There have been 12 cases reported in the MNCLHD since the beginning of the current NSW outbreak.There are now four positive cases in Coffs Harbour and two cases in Kempsey.

The two cases in Kempsey are household contacts.

NSW Health's ongoing sewage surveillance program has detected fragments of the virus that causes COVID-19 at the West Kempsey treatment plant from samples taken on September 21.

The West Kempsey sewage treatment plant serves around 5,900 residents in areas north of the Macleay River including Kempsey, West Kempsey, Greenhill, Yarravel and Aldavilla.

Testing sewage can help provide early warning of undetected infections in an area. Detection of virus fragments in sewage can also be due to shedding of the virus by someone who may have previously had the illness and may no longer be infectious.

It can also be the result of a person with COVID-19 who may have visited the community and has since left the area.

MNCLHD chief executive Stewart Dowrick is urging residents to get tested if they develop symptoms.

"We are urging everyone to monitor for the onset of symptoms, and if they appear, to immediately be tested and isolate until a negative result is received," he said.

All residents in the Kempsey LGA must stay at home unless it is for an essential reason, which includes:

People who are fully vaccinated can attend an outdoor gathering of up to five people for exercise or outdoor recreation, as long as all of those aged 16 or older are fully vaccinated.

To determine the extent of the risk and detect any further potential COVID-19 cases in the area, the MNCLHD is calling on the communities to come forward for testing in large numbers.

A full list of COVID-19 testing clinic locations and opening hours are listed on the NSW Government website at https://www.nsw.gov.au/covid-19/health-and-wellbeing/clinics

There were 1043 new locally-acquired cases of COVID-19 across NSW in the past 24-hour reporting period and 11 further deaths.

There have been 277 COVID-19 related deaths in the state since mid-June and 333 in total since the pandemic began.

There are 1186 COVID-19 cases admitted to hospital, with 232 people in intensive care, 110 on ventilators, which is a slight decrease on yesterday's numbers.

The breakdown of the 1043 locally acquired cases is: