Determinants of risk factors for COVID-19 transmission in densely populated areas: Insights from the first wave of the pandemic

Introduction: COVID-19 spreads quickly, especially in densely populated countries like Indonesia. Understanding transmission factors can support in reducing transmission rates. The purpose of this study is to analyze the various factors that may contribute to the transmission of COVID-19 in Indonesia, especially in the first wave of pandemic. Methods: This was a cross sectional study design. The sample was selected from the new all record data or the database for recording COVID-19 cases at the health office at the research location by online system. The research was conducted in seven districts and cities across three provinces to obtain an overview of transmission in each regional characteristic. The number of samples was as high as 2,010, with confirmed cases and close contacts in Banda Aceh City, Aceh Besar District, Semarang City, Magelang District, Ternate City, South Halmahera District, and Tidore Islands City. Data analysis was done descriptively and were analyzed using Chi-square and logistic regression with SPSS software. Results: The multivariate analysis shows that five dominant factors the risk of COVID-19 transmission, there are, age, employment status, activities outside the home, medical history, and vaccination status. Age group of 20-39 years (odds ratio [OR]=1.6-1.7; 95% confidence interval [CI] 1.07-2.71), working of employment status (OR=1.51; 95% CI 1.10-2.07), have a comorbid in medical history (OR=2.39; 95% CI 1.67-3.4), have activities outside home (OR=1.82, 95% CI 1.39-2.39), and have not been vaccinated of COVID-19 (OR=3.03; 95% CI 3.37-3.87) were significantly related with an increased risk of COVID-19 transmission. Conclusions: productive age, work and activities outside the home, having comorbidities, and not having received COVID-19 vaccination are all risk factors for COVID-19 exposure. Eliminating all of these factors at the same time will undoubtedly be difficult. As a result, cross-sectoral collaboration is needed to control the spread of COVID-19 at the community and individual levels, as well as to support policy interventions to accelerate the elimination of COVID-19 cases.