Rail services to both Armidale and Moree have been put on hold as a result of a COVID-19 scare among the state's rural train drivers.
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More than 130 TransLink regional rail staff have been forced into isolation after being in contact with a contractor who tested positive for coronavirus.
The Sydney to Armidale, Sydney to Moree, Armidale to Sydney and Narrabri to Sydney services have all been affected by a shortage of train drivers.
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Cancer Council Accommodation and Support Services Coordinator Shaen Fraser said a patient at the North West Cancer Centre who uses the train to get to medical appointments had been caught up in the failure.
Patients often spend as long as eight weeks at the centre, using the train to travel home on weekends.
Most patients are staying put during the state's COVID-19 lockdown in order to minimise their risk of infection anyway, she said.
"We've had one lady that's staying here from Glen Innes, her daughter was trying to go home to other family," she said.
"We haven't had anyone in particular not be able to get to treatment, just family that are with them wanting to go home and their only method was train and bus to Armidale and Glen Innes, that's the only impact we've had at this stage."
If the staff shortfall persists for weeks, the problem may escalate, she said.
Tamworth patients who use the railway to travel to Newcastle for higher-level care may be inconvenienced, she said.
A Transport for NSW spokeswoman confirmed the services would be cancelled and said the number of train drivers thought to be at risk was initially thought to be 260.
"Most booked regional train services were cancelled over the weekend and this week, due to staffing arrangements," she said.
"Patronage is down approximately 93 per cent on our regional booked services compared to 2019, however booked customers will be contacted directly and we are working closely with them to limit impacts."
The spokeswoman apologised to customers for any inconvenience.
"TFNSW is like any other workplace, where they are essential workers coming to work. Our priority is keeping our staff and customers safe, while continuing to provide transport services that are necessary for the functioning of the community," she said.
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