Analysis of Behavioral Determinants of Covid-19 Incidents in Soppeng Regency

Anita Triani Karno1, Ridwan Amiruddin2, Andi Zulkifli Abdullah3,Ansariadi4 ,Syansiar S

Russeng5 ,Nurzakiah Hasan6

Hasanuddin University FETP Students 1,

Department of Epidemiology,Public Health Faculty of Hasanuddin University2,
Department of Epidemiology,Public Health Faculty of Hasanuddin University3
Department of Epidemiology,Public Health Faculty of Hasanuddin University4,
Departement of Occupational Health and Safety, Public Health Faculty of Hasanuddin University 5,
Departement of Nutrition, Public Health Faculty of Hasanuddin University 6

Abstract— Throughout the Covid-19 pandemic, have been three major waves
of increasing case incidents in Indonesia. Almost all regions experience it, including
Soppeng Regency, which rurals area with a low population density. This phenomenon
leaves questions if you look at the government's efforts to control it; especially in
enforcing PPKM rules. Various restrictions on PPKM have made this rule the most
popular in the community. Even so, there is no specific study that looks at success of
enforcing the rules risk factor for the occurrence of Covid-19. The aim of the research
is to see the magnitude risk of adherence to staying away from crowds, adherence to
washing hands when gathering, adherence using masks when gathering.
This study uses case control study design. The case population is individuals
who have been infected Covid-19 and the control population is those who have never
been infected with Covid-19. A sample of 55 cases and 55 controls, selected by
purposive sampling. Data analysis with univariate, bivariate and multivariate and odds
ratios through cross tabulation with logistic regression test.
Research results show. Bivariate analysis, compliance with staying away from
crowds (OR 58.75 CI95% 16.05 - 234.66), adherence to washing hands at parties (OR
104.125 CI95% 24.37-500.45), adherence to wearing masks (OR 29.26 CI95% 9.22 –
100.21), adherence to physical distancing (OR 32.31 CI95% 9.74 – 120.62), limiting
mobility (OR 47.97 CI95% 13.87-176.33). Multivariate analysis showed variabled most
at risk for the incidence of Covid-19 was limiting mobility when gathering with an OR
value of 3.871 (95%CI: 2.739-5.002).

Keywords: Covid-19, compliance, crowds, hand washing

1. Introduction
At the end of 2019, for the first time in Wuhan, China, a mysterious pneumonia
appeared. This disease was officially declared as Coronavirus Disease 2019 by the
World Health Organization (WHO). The disease is caused by the Severe Acute
Respiratory Syndrome Coronavirus-2 (SARS-Cov-2) virus. This is a new type of
coronavirus and has never been identified in humans.[1] Identified symptoms that arise
when infected include fever, tiredness, dry cough, and sometimes experience pain,
diarrhea, loss of smell, loss of sense of taste and rashes on the skin.[2]
1
March 11, 2020 WHO officially declared the corona virus outbreak a pandemic.
January 19, 2021 global Covid-19 cases reached 96 million.[3] The number of cases in
Indonesia at the same time reached 927,380. The cumulative number of deaths is
26,590 or equal to a CFR of 2.9%. This figure is greater than deaths from global Covid-
19, 2.1%.[4] The latest data release from the Ministry of Health on August 8 2022
stated that out of 104,536,662 samples examined in Indonesia, 6,249,403 were
confirmed positive, with 49,633 active cases. South Sulawesi Province alone
contributed 143,989 cases with a CFR of 1.7% of the total. [3]

Throughout 2019 to 2022 in Indonesia there have been 3 waves of cases. Overall
resulting in an increasing curve of cases throughout the country. This condition is not
only in urban areas but also in rural areas such as in Soppeng Regency. Data obtained
from the Soppeng District Health Office stated that as of August 31, 2022, the number
of patients confirmed positive for SARS CoV-2 was 3,234. The highest number was
found in 2021, where sufferers reached 2,247 patients with the number of deaths
reaching 33 people per 1,000 confirmed cases.

This pandemic has had a very broad impact on people's lives. Millions and even all
people in the world are required to adapt new behaviors in everyday life. This condition
is the result of establishing a health protocol policy that must be enforced in all
lines/aspects of activity. Starting from limited social restrictions to a total lockdown
which resulted in the obstruction of some or all of community activities. These policies
by the government are aimed at reducing the rate of spread of the virus. Failures in
control are believed to have a snowball effect and potentially increase risks to the
world's health system. The negative impact will be wider including changes in the
global economy.[5]

Emergency committeeWHO states that the spread can be reduced if protection, early
detection, isolation, fast and appropriate treatment are applied. This integration is
useful for creating a strong system to stop the spread of Covid-19.[6]Efforts to limit the
spread of the virus can be achieved in several ways. Among other things, the
implementation of regional borders and restrictions on people's movements
(quarantine). This policy is popularly taken by leaders of countries in the world because
its effectiveness has been proven in history. The next step taken is to strengthen
human immunity against viruses by administering vaccines regularly. It is hoped that
this step will at some stage be able to form herd immunity or herd immunity so that the
transition from pandemic to endemic disease can be realized.[5]

As long as the spread of SARS CoV-2 remains high and herd immunity has not been
achieved, the threat of a pandemic is not over. Collaboration is needed between policy
makers, practitioners, academics, and all elements of society in disease control. The
main controls for disease prevention are quarantine efforts and behavior changes to
reduce the rate of spread of the virus.[7]SARS CoV-2 is transmitted directly and
indirectly (through contaminated objects or surfaces), close contact with an infected
person through mouth and nose secretions. These secretions include saliva,
respiratory secretions, or droplet (splash) secretions. Exposure to secretions of an
infected person who coughs, sneezes, talks or sings from a distance of less than 1
2
meter can enter and infect the body of a healthy person through the mouth, eyes and
inhalation. This fact is a benchmark that avoiding contact with sufferers can be done by
keeping a distance of at least 1 meter from other people, using a mask when doing
activities in public spaces, washing hands more often, and applying cough etiquette.[8]

The wave of increasing cases of Covid-19 that has occurred in the last three years has
not only hit cities. It also occurs in some rural areas. One of them is Soppeng Regency.
Rural areas with relatively low population density. The number of cases in this area is
relatively high when compared to Takalar Regency with 3004 cases and Barru
Regency with 2162 cases as of October 15 2022. Even though geographically these
two areas are closer to urban areas, namely Makassar City and Pare-pare City which
are areas with Covid-19 cases. 19th highest in South Sulawesi.[9]

The problem found in the initial survey was the behavior of residents gathering.
Collection in large numbers and come from many different areas. People are used to
celebrating with parties. This behavior is a major part of their socio-cultural life. The
obligation to attend weddings, aqiqah, circumcision, and visiting each other on religious
holidays is difficult to ignore.

During the Covid-19 pandemic, the government established PPKM with various binding
rules including gathering. The articles in it are very complete, detailing the number of
people allowed, the use of masks, the obligation to wash hands, the establishment of a
safe distance, limits on mobilization, and the obligation to vaccinate. Even so, the
phenomenon of an increase in the incidence of Covid-19 that is evenly distributed
throughout the region, including in sparsely populated areas such as Soppeng
Regency raises questions about this effort. Until now, there has been no specific study
or analysis that has looked at the success of enforcing the rules in terms of being a risk
factor for the occurrence of Covid-19. Departing from all that, the researchers were
interested in conducting research on the Behavioral Determinant Analysis of Covid-19
Incidents in Soppeng Regency.

2. Research Methods
a. Design, place, time and research sample
This research is an analytic observational study with a case control study design.
This study compares two groups (cases and controls) based on exposure status
through retrospective observation. The choice of case control design is based on
the consideration that the accuracy of the results of this study is better with lower
costs. The initial step of research is to determine the disease (outcome) first, then
identify the causes (risk factors). Exposure history in this study can be known
from medical registers or based on interviews with research respondents. The
research location is in the Salotungo, Sewo and Malaka Subdistricts, Lalabata
District, Soppeng Regency, the research time is November 2022 to January
2023.

b. Data collection
Data collection was based on inclusion criteria and exclusion criteria, namely
having been infected with Covid-19 as evidenced by medical records at the
puskesmas, never being infected with Covid-19, being able to communicate well,
aged under 15 years or over 65 years and not willing to participate in the study.
3
 Data collection for Covid-19 sufferers will be carried out at the puskesmas
accessing patient medical records, exclusions will be made for patients under 15
years of age and over 65 years and contacting sufferers who have been infected
with Covid-19 then providing a complete explanation of the research process and
ensuring willingness to participate in the study to the end and sign an informed
consent and complete the questionnaire by the respondents.

c. Processing and analysis of data

Data processing is done by doing Data Editing, Coding, Entry, and Cleaning. The
results of the questionnaire were then processed using the STATA -14 tool,
presented in the form of tables and narratives. Univariate analysis to see the
characteristics of respondents, bivariate and multivariate using odds ratios
through cross tabulation and logistic regression tests.

d. Research Ethics
This research was carried out using a questionnaire sheet which during its
implementation did not conflict with human values and the research code of
ethics. Prior to that, researchers conducted informed consent to patients for
consent as research subjects. This research permit was proposed to the Ethics
Committee of the Faculty of Public Health, Hasanuddin University with a
recommendation for ethical approval Number: 13977/UN4.14.1/TP.01.02/2022.

3. Results
Descriptive/univariate analysis was carried out to see the frequency distribution of each
variable, the distribution of frequency determinants of household and environmental
factors.

The general characteristics of the research include gender, age group, education level,
and type of work of the respondents. It can be seen in table 1 that the majority of
respondents were female consisting of 76.36% cases and 74.55% controls. The most
age who participated in the study were 19-29 years and 30-40 years, 27.27% of cases
and 27.27% controls. The education of the most respondents was S1 equivalent with
details of 40% of cases and 27.27% of controls and the occupation of the most
respondents was civil servants 38.18% of cases and 38.18% of controls.

Table 1. Respondent Demographics Based on Characteristics

Covid-19 events
Characteristics Case (55) Control (55)
n % n %
Gender
Man 13 23,64 14 25.45
Woman 42 76,36 41 74.55
Age
<18 years 1 1.82 1 1.82
19 – 29 Years 15 27,27 15 27,27
30 – 40 Years 15 27,27 15 27,27
41 – 50 Years 13 23,64 13 23,64

4
 Covid-19 events
Characteristics Case (55) Control (55)
n % n %
20.00
51 – 60 Years 11 20.00 11

Education (Graduated)
SD 1 1.82 3 5.45
Middle School & Equivalent 7 12.73 6 10.91
High School & Equivalent 9 16,36 12 21.82
D3 15 27,27 13 23,64
S1/D4 22 40.00 15 27,27
S2 1 1.82 6 10.91
Work
civil servant 21 38,18 21 38,18
Self-employed 11 20.00 11 20.00
Honorary 3 5.45 3 5.45
Farmer 1 1.82 1 1.82
IRT 9 16,36 9 16,36
Student 3 5.45 3 5.45
Student 4 7,27 4 7,27
Doesn't work 3 5.45 3 5.45
Source: Primary Data, 2022

Bivariate analysis aims to see the relationship between the risk factors for the
independent variables (adherence to staying away from crowds, adherence to washing
hands when gathering, adherence to wearing masks when gathering, adherence to
keeping distance when gathering, compliance with vaccinations) and the dependent
variable (Covid-19 incident).

Bivariate analysis in table 2 shows the result that 90.91% of respondents who were
infected with Covid-19 did not adhere to staying away from crowds. Based on the
results of the analysis, the OR value is 58.75 with the lower limit and upper limit above
the number 1, namely 16.05-234.66. This means that adherence to staying away from
crowds is a significant risk factor for the occurrence of Covid-19. The conclusion is that
adherence to staying away from crowds is a risk factor for the occurrence of Covid-19.

Bivariate analysis on the handwashing compliance variable when gathering showed

that 89.09% of respondents who were infected with Covid-19 did not adhere to the
protocol. Based on the results of the analysis, the OR value was 104.125 with the
lower limit and upper limit being above number 1, namely 24.37-500.45. This means
that adherence to hand washing when gathering is a significant risk factor for the
incidence of Covid-19. The conclusion is that adherence to hand washing when
gathering is a risk factor for the occurrence of Covid-19.

Table 2. Distribution of Risk of Independent Variables for Covid-19 Incidents in

Soppeng Regency

Variable Covid-19 events OR 95% CI

5
 Independent Infected Not Infected
(n=55) (n=55)
n % n %
Obedience Staying
Away from the Crowd
Not obey 50 90,91 8 14.55 58.75 16.05-234.66
obey 5 9.09 47 85.45
Compliance with Hand
Washing at gatherings
Not obey 49 89.09 4 7,27 104,125 24.37-500.45
obey 6 10.91 51 92.73
Compliance Using
Masks when gathering
Not obey
obey 49 89.09 12 21.82 29,26 9.22–100.21
6 10.91 43 78,18
Compliance with
Maintaining Distance
when gathering
Not obey 42 76,36 5 9.09 32,31 9.74–120.62
obey 13 23,64 50 90,91
Limiting Mobility While
At the Gathering Place
Not obey
obey 47 85.45 6 10.91 47.97 13.87-176.33
8 14.55 49 89.09
Vaccination Status
Vaccine 0 0.00 4 7,27 0 0 – 0.923
No Vaccine 55 100 51 92.73
Source: Primary Data, 2022
Bivariate analysis on the variable compliance with wearing masks when gathering
showed that 89.09% of respondents who were infected with Covid-19 did not adhere to
the protocol. Based on the results of the analysis, the OR value is 29.26 with the lower
limit and upper limit above the number 1, which is 9.22–100.21. This means that
adherence to wearing a mask when gathering is a significant risk factor for the
incidence of Covid-19. The conclusion is that adherence to wearing a mask when
gathering is a risk factor for the Covid-19 incident.

Bivariate analysis on the variable adherence to keeping a distance when gathering

shows that 76.36% of respondents who were infected with Covid-19 did not adhere to
the protocol. Based on the results of the analysis, the OR value was 32.31 with the
lower limit and upper limit being above number 1, namely 9.74 – 120.62. This means
that adherence to social distancing is a significant risk factor for the occurrence of
Covid-19. The conclusion is that compliance with keeping a distance when gathering is
a risk factor for the Covid-19 incident.

Bivariate analysis on the compliance variable limiting mobility when gathering showed
that 85.45% of respondents who were infected with Covid-19 did not adhere to the
6
protocol. Based on the results of the analysis, the OR value was 47.97 with the lower
limit and upper limit being above number 1, namely 13.87-176.33. This means that
adherence to limiting mobility when gathering is a significant risk factor for the
incidence of Covid-19. The conclusion is that limiting mobility when gathering is a risk
factor for the occurrence of Covid-19.

Bivariate analysis on the variable of vaccination status showed that 0 respondents who
were infected with Covid-19 did not have the vaccine in carrying out the protocol or in
other words that all respondents who were infected with Covid-19 in this study had
received vaccinations. Based on the results of the analysis, the OR value is 0 with a
lower limit and an upper limit below the number 1, namely 0 - 0.923. This means that
vaccination status is a protective factor against the incidence of Covid-19. The
conclusion is that adherence to immunization is a protective factor against the Covid-
19 incident. To make it easier to read the test results, the following is a summary of the
results of the bivariate analysis of these variables presented in table 3.

Table 3. Summary of Bivariate Analysis Results of Independent Variables

Covid-19 incident in Soppeng Regency

95% CI
No Research variable OR value
(LL-UL)
1 Obedience away from the crowd 58.75 16.05-234.66 0.000
2 Compliance with hand washing in the party
104,125 24.37-500.45 0.000
venue
3 Compliance with wearing masks 29,26 9.22 – 100.21 0.000
4 Distancing compliance 32,31 9.74 – 120.62 0.000
5 Limit mobility 47.97 13.87-176.33 0.000
6 Vaccination status 0 0 – 0.923 0.042
Source: Primary Data, 2022

Multivariate analysis was carried out to identify the factors most at risk for the
occurrence of Covid-19. The variables included in the multivariate analysis are those
that have a p value <0.05 and the results are as follows:

Table 4. Summary of Independent Variable Multivariate Analysis Results

Against the Covid-19 Incident in Soppeng Regency
Research 95% CI
No Coef. SE value OR
variable LL ul
1 Obedience Staying 4,595 5,054 0.165 4,595 0.532 39,664
Away from the Crowd
2 Compliance with 21,667 37,411 0.075 21,667 0.734 638.94
Washing Hands When
Gathering
3 Compliance with Using 0.205 0.298 0.276 0.205 0.012 3,545
Masks When
Gathering
4 Compliance with 1.285 1,589 0.839 1.285 0.114 14,494
Maintaining Distance
When Assembling
5 Limiting mobility When 11.013 11,829 0.026 11.013 1,341 90.404
Assembling
6 Vaccination Status 1 Omitted 0.000 1 0.031 0.246
7
 Table 4. Summary of Independent Variable Multivariate Analysis Results
Against the Covid-19 Incident in Soppeng Regency
Research 95% CI
No Coef. SE value OR
variable LL ul

Constant -1,812
Source: Primary Data, 2022

After carrying out the regression test, it was found that variables that had a p value
<0.05 only limited mobility when gathering and adherence to vaccinations (table 4).
therefore, further analysis is only the two variables. The analysis uses the backward
stepwise (LR) method and the results can be seen in table 5 below:
Table 5. Results of Multivariate Analysis of Independent Variables on Events
Covid-19 in Soppeng Regency

95% CI
No Research variable Coef. SE value OR
LL ul
1 Limit mobility 3,871 0.577 0.00 3,871 2,739 5,002

Constant -1,812
Source: Primary Data, 2022

The results in table 5 show that the variable most at risk for the incidence of Covid-19
is limiting mobility when gathering with an OR value of 3.871 (95% CI: 2.739-5.002). It
can be seen from the statistical test values that limit mobility when gathering,
Covid-19 Event Logit = -1,812 + 3,871 (limiting mobilization)
y= Constant + a1x1
y= -1.812 + 3.871
y= 2.059
The interpretation of the logistical equation for the Covid-19 event is that in a condition
where there is no effect of limiting mobilization and paying attention to negative
constant values, it means that without the influence of these risk factors, the risk of
Covid-19 events will decrease by 2.059 times. However, if you take into account the
constant value by adding these risk factors, the risk of a Covid-19 event will also
increase. For example, to increase the value of limiting mobilization by 2, it will
increase the risk of Covid-19 events by 4,118 times. The results of these values when
added to the constant value will show a straight comparison, that is, the greater the
value of the independent variable, the greater the risk of experiencing a Covid-19
incident.
The probability value of people experiencing a Covid-19 event because it does not limit
mobility in Soppeng Regency is as follows:
1
P=
1+𝑒 −𝑦
1
P=
1+2,72(−2,059)
P= 0.22 or 22%
Information:
8
 = Probability of the occurrence of an event
y= Constant +𝑎1 𝑥 1
e= Natural Number (2.72)
So it can be stated that the probability of someone experiencing a Covid-19 event if
they do not comply with limiting mobility when in a crowd is 22%.

4. Discussion
Coronavirus Disease-2019 (COVID-19)is a disease caused by a virusSARS CoV-2
(Severe Acute Respiratory Syndrome Coronavirus 2) which is another type of the
coronavirus family that caused SARS in 2003.[10] This disease is a new type of
pneumonia that was first discovered in Wuhan, Hubei Province. Infected people will
suffer symptoms similar to SARS. The spread of Covid-19 is classified as massive with
a fatality rate below 5%.[11]

Research conducted in Soppeng Regency focused on risk factors for Covid-19 events
and assessed the independent variables that had the greatest contribution to the
incidence of Covid-19 in the area. The analysis using the odds ratio (OR) is in line with
the design used, namely the case control study, adjusting to the research objectives. A
complete discussion of each variable will be described based on the results of the data
analysis that has been carried out.

1. Compliance Risk Factors Staying Away from the Crowd

Covid-19 is a disease caused by a virus whose transmission can occur directly to
humans via droplets. The virus is transmitted when a symptomatic patient coughs,
sneezes or talks.[12] Based on the results of this study, staying away from crowds is
highly emphasized in preventing the spread of Covid-19. It is hoped that by not
crowding, the spread through droplets can be suppressed.

This study found that 90.91% (50 people) of respondents who had been infected with
Covid-19 and did not adhere to staying away from crowds. The results of the Odds
Ratio (OR) test for adherence to staying away from crowds show that the risk of Covid-
19 events is OR = 58.75 with a significance = 0.000. From these results it can be
interpreted that people who do not obey staying away from crowds have a 58.75 times
the risk of being infected with Covid-19 compared to those who obey.

A quantitative study that assessed people's behavior in preventing Covid-19 in 2021

reported that there was a relationship between people's negative behavior (including
ignoring the prohibition on gatherings) and the incidence of Covid-19 of 69.2% with a p
value of 0.023.[13] Nonetheless sanother study assessing the behavior of staying
away from crowds during the Covid-19 pandemic in 2021 stated that, on average,
public awareness increased by 50% compared to before the pandemic.[14]

The risk of the occurrence of Covid-19 does not stand alone but is multifactorial.
Caused by several interactions of risk factors. The deeper the risk factors are studied,
the clearer the sequence of causes can be found. Thus follow-up in solving the
problem can be done appropriately. In behavioral theory, individual attitudes are
formed by internal and external factors. Knowledge, education, culture, and
environment are the biggest internal individual factors.[15] By looking at these factors,
intervention is not only limited to making suggestions and enforcing rules. Rather, it is
9
carrying out interventions to increase public knowledge to provide an understanding of
the causes, risks and how to avoid the spread of Covid-19.

2. Risk Factors Compliance Hand washing when gathering

Hand washing is the easiest and cheapest way to prevent transmission of viruses and
bacteria. Research has proven that washing hands properly can prevent transmission
of the corona virus.[16] Another article states that hand washing behavior is also
effective in reducing the transmission of respiratory viruses by 45-55%. The same
opinion on the results of research on prevention of transmission of the H1N1 virus
states that 38% of transmission of the H1N1 virus can be prevented by washing
hands.[17]

This researchfindthat respondents who had been infected with Covid-19 and did not
comply with the hand washing health protocolgathering time 89.09 (49 people). The
results of the Odds Ratio (OR) test for adherence to staying away from crowds show
that the high risk of Covid-19 events is OR = 104.125 with a significance = 0.000. From
these results it can be interpreted that people who do not comply with the hand
washing protocolwhen they get togetherhave a risk of being infected with Covid-19 as
much as 104.125 times compared to adherents.

Research conducted in a crowd, taking a sample of TNI units conducting combat

training analyzing the determinants of the Covid-19 incident found that 25.6% of health
protocol behaviors including hand washing which was only carried out soberly caused
the transmission of Covid-19.[18] A collection of similar facts then has a major role in
encouraging handwashing compliance in the community in addition to enforcement of
policies by the government.[19]On the other hand, non-compliance is caused by a lack
of knowledge and hand washing facilities available in public spaces, including a lack of
access to clean water.[20]

One of the health protocols being promoted by the government is washing hands with
soap by implementing the 6 correct steps according to WHO recommendations. Apart
from soap, hand washing can also be done using 70% alcohol. Even so, the use of
soap is highly emphasized. This is because soap can destroy the lipid membrane of
Covid-19 so that it cannot multiply and infect.[2] Given the importance of washing
hands with soap in preventing Covid-19 and other diseases caused by viruses and
bacteria, it is highly recommended to procure complete facilities and infrastructure.[19]

3. Compliance Risk Factors Using Masks When Gathering

Covid-19 is known to be transmitted directly or indirectly. Transmission occurs when
close contact with sufferers or people who are infected. The virus is transmitted
through oral and nasal secretions including saliva, respiratory secretions and droplets.
Exposure occurs when sufferers cough, sneeze, talk or sing. This is the reason why
the use of masks is highly emphasized in public spaces.[17]

This study found that respondents who had been infected with Covid-19 and did not
comply with wearing masks when gathering were 89.09 (49 people). The results of the
Odds Ratio (OR) test for compliance with wearing a mask when gathering show that
the risk for the occurrence of Covid-19 is OR = 29.26 with a significance = 0.000. From
these results it can be interpreted that people who do not adhere to the protocol of
10
wearing a mask while at an event have a risk of being infected with Covid-19 as much
as 29.26 times compared to those who comply.

A study that examinesthe determinants of Covid-19 transmission among health

workers found that the use of good and appropriate personal protective equipment can
reduce the transmission of Covid-19 to health workers, especially those in emergency
rooms and medical wards.[21] As with other protocols, compliance with wearing masks
is also affected by enforcementpolicies by the government.[22] Even so, in certain
areas there is still neglect of government policies and is often found in spacepublic.

One of the health protocols being promoted by the government is washing hands with
soap by implementing the 6 correct steps according to WHO recommendations. Apart
from soap, hand washing can also be done using 70% alcohol. Even so, the use of
soap is highly emphasized. This is because soap can destroy the lipid membrane of
Covid-19 so that it cannot multiply and infect.[23]

4. Compliance Risk Factors Maintain Distance When Gathering

Physical distancingis the activity of maintaining a minimum distance of six feet
(approximately one meter) from one another. This is done as a form of protection in
avoiding transmission of disease through droplets, as is the case with Covid-19.
StudyEpidemiology suggests that physical distancing has been proven to be able to
reduce the probability of being infected with viruses that are transmitted by droplets
such as H1N1. Even so, it still requires further study in relation to the spread of SARS
CoV-2.[24]

This study found that respondents who had been infected with Covid-19 and did not
adhere to keeping their distance when gathering were 76.36 (42 people). The results of
the Odds Ratio (OR) test for adherence to staying away from crowds show that the
high risk of Covid-19 events is OR = 32.31 with a significance = 0.000. From these
results it can be interpreted that people who do not adhere to keeping their distance
when gathering have a risk of being infected with Covid-19 as much as 32.31 times
compared to those who obey.

The physical distancing policy is used as a way to limit close interaction (contact)
between individuals when in public spaces. Every individual is required to maintain a
distance when in public spaces or interact with other people who are not the same
age.[25]Nonetheless, prevention by keeping a safe distance does not stand alone. In a
study, it was stated that if individuals comply with wearing masks, adhere to the
protocol of washing hands using soap and adhere to maintaining a safe distance, then
the possibility of contracting Covid-19 is getting smaller.[26] Other studies also
emphasize a similar point, stating that69.2% sufferersCovid-19 does not comply with
health protocols including maintaining physical distance.[13]

5. Risk Factors Limiting Mobility When Assembling

The behavior of limiting mobility, keeping distance (physical distancing), and staying
away from crowds is a series of Covid-19 prevention protocols that cannot be
separated from one another. Individuals who obey stay away from the crowd
automatically maintain their mobility. This behavior is not only a matter of knowledge

11
but more on public awareness and monitoring and enforcement of policies related to
sanctions by the government.[13]

This research focuses on looking at how individuals mobilize when they are in a
gathering place. Results obtainedIn this study, there were 85.45 respondents (47
people) who had been infected with Covid-19 and did not limit their mobility while at the
event/party venue. The results of the Odds Ratio (OR) test for the variable limiting
mobility while at the event/party show that the risk for the occurrence of Covid-19 is OR
= 47.97 with a significance = 0.000. From these results it can be interpreted that
people who do not limit their mobility while at an event have a 32.31 times the risk of
being infected with Covid-19 compared to those who comply.

6. Risk Factors Vaccination Status

Vaccination is immunization aimed at stimulating active human immunity. Application is
carried out by insertionmicroorganismsor a virus that is weakened/inactivated into the
body of a healthy individual in the hope that the body will be able to develop its ability
to protect against the disease. The end result expected from an immunization
movement is the immunity of a population against a particular disease.[7]

This study found that all respondents who had been infected with Covid-19 had been
vaccinated. It was found that the results of the Odds Ratio (OR) test = 0 with a
significance = 0.042. From these results it can be interpreted that this variable is a
protective variable and is not significant in the case of Covid-19.Evaluation of vaccine
effectiveness has been widely studied and is believed to be the most effective method
of preventing infectious diseases. This study has proven in eradicationvariola,
elimination of diseasepoliomyelitisAndtetanus. Nonetheless, historical writings make it
clear that no pandemic has been able to end with the success of a vaccine. His
discovery came decades after the end of the pandemic. It's different with SARS CoV-2.
Vaccines found in the middle of an emergency the rate of increase in cases. Changes
in the scientific approach change the old paradigm of making vaccines.[7]The success
of this breakthrough raises some doubts about the success of a vaccine to help control
SARS CoV-2. Nevertheless, the results of this study do not make absolute of these
doubts. There are many things that need to be analyzed. Returning to further research
in the future, including controlling the counter-factor of Covid-19 so that we can better
see the effectiveness of the vaccine.

5. Research Limitations
There is no authentic evidence in the form of certificates from education and SK from
the respondent's job, this study uses a retrospective research designso it is very
possible that there are answers that do not represent the actual condition of the limited
memory of the respondent about the incident. It is possible that there is a discrepancy
between the facts and the respondent's answer to a question due to a change in
knowledge or in an attempt to hide a situation due to embarrassment or fear.

6. Conclusion
The variable adherence to staying away from crowds is a risk factor for the occurrence
of Covid-19 in Soppeng Regency. Individuals who do not obey stay away from the
crowd are 58.75 times more at risk compared to those who obey. Compliance with
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washing hands when gathering is a risk factor for the occurrence of Covid-19.
Individuals who do not comply with washing their hands when gathering are at risk
104.125 times compared to those who comply. Compliance with wearing masks when
gathering is a risk factor for the occurrence of Covid-19 in Soppeng Regency.
Individuals who do not adhere to wearing masks when gathering are 29.26 times more
at risk compared to those who comply. Compliance with maintaining distance when
gathering is a risk factor for the occurrence of Covid-19 in Soppeng Regency.
Individuals who do not comply with keeping their distance when gathering are 32.31
times more at risk compared to those who comply. High mobility when gathering is a
risk factor for the occurrence of Covid-19 in Soppeng Regency. Individuals with high
mobility when gathering are 47.97 times more at risk than those with low mobility.
Compliance with vaccination is not a risk factor for the occurrence of Covid-19 in
Soppeng Regency.

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