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Phlebotomist Warren Dawkins demonstrates drive-thru testing for coronavirus at Murphy Medical Associates in Greenwich, Conn. Monday, March 9, 2020.

Public Health Emergency Preparedness & Response Coordinator David Fraszka distributes COVID-19 test kits to Greenwich residents at Grass Island Park in Greenwich, Conn. Tuesday, Jan. 4, 2022. A total of 6,000 at-home COVID test kits were distributed to Greenwich residents at Grass Island Park and the Greenwich Senior Center.

Nurse Practitioners Heather Dawson, DNP and Julianna Barresi, APRN prepare to test Greenwich resident Walter Aucay, 36, with an oral swab for the COVID-19 Coronavirus at a testing site set up at the Family Center at Wilbur Peck Court in Greenwich, Connecticut on May 1, 2020. Approximately 60 Rapid Covid-19 test were performed, yeilding results in less than a day.

Laboratory technician Daphne Henri and office manager Javier Ortiz administer drive-thru COVID-19 tests outside The Doctors Office in the Cos Cob section of Greenwich, Conn. Tuesday, Nov. 17, 2020. The Doctors Office offers drive-thru COVID-19 nasal PCR tests during normal business hours.

GREENWICH — How many people are getting their noses swabbed at COVID-19 testing sites anymore? Not many.

Greenwich Hospital is conducting approximately 70 percent less molecular COVID-19 tests than it was a year ago, Dr. Kisha Mitchell Richards, director of pathology and clinical laboratory at Greenwich Hospital, said in an email.

Molecular tests, also called PCR tests, are sent to a laboratory for analysis. The other type of testing, antigen testing, can produce rapid results and is available in at-home kits that have been widely distributed.

Molecular tests are a patient’s best chance at identifying a COVID-19 infection early, Richards said. The at-home tests can give people a false sense of security who do not have a viral load high enough to react with the test strip.

According to state Department of Public Health data, testing outside of home hasn’t been this low since spring 2020 — when locations were sparse in Connecticut.

In April 2020, COVID testing in Greenwich, for example, was reserved for those with symptoms or a doctor’s order. But by the next month, CVS Health had started administering tests in Connecticut.

In May 2020, an average of 5,365 swabs were collected daily. In June 2020, the number rose to a daily average of 8,160 people taking advantage of test sites in Connecticut.

Currently, the rate falls in between May and June of 2020 with an average of 6,672 swabs collected each day this month.

Nowadays, tests are available to those with or without symptoms, but the number of testing sites has begun to diminish.

In June of this year, the federal government stopped funding COVID testing at health care systems, such as Greenwich Hospital. So, tests that were once free are now billed to insurance.

Free tests are still available at 20 state-supported sites, reduced from the previous 27 locations. The site closest to Greenwich is at Fairway Stamford.

The state Department of Health tracks the number of tests given at its state-supported sites. Testing dipped drastically in late January, corresponding with the availability of rapid kits shipped from the federal government beginning Jan. 19 and distribution events in communities. Other factors, such as waning cases after the holidays, likely contributed.

Public health officials and doctors have suggestions for consumers’ use of tests, acknowledging the usefulness of both at-home antigen tests and lab-based molecular tests.

“It is important to know that a home test is less accurate than a molecular test and early in the course of an infection, a home test is more likely to have a false negative result, sometimes more than once,” Richards said.

The U.S. Food and Drug Administration released guidance Aug. 11 recommending “serial testing” for those who have been exposed to COVID or who have symptoms and wish to use at-home antigen tests.

It recommended using at least two COVID-19 tests, administered 48 hours apart, for those with symptoms. Those that have been exposed to the virus but without symptoms should take a minimum of three tests, also administered 48 hours apart, it said.

The Centers for Disease Control and Prevention also state that “a single, negative antigen test result does not rule out infection.”

It says molecular tests are “typically the most reliable tests” but cautions that it detects genetic material that remains up to 90 days post-infection. So, those who have tested positive fewer than 90 days ago, should not use a PCR test, it says.

Because at-home tests are not reported to public health departments, municipalities measure the presence of COVID-19 in wastewater. The data is compiled by the CDC.