Study of Factors Associated with the Rate of COVID-19 Infection

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Introduction
COVID-19 is a new contagious disease caused by the latest discovered coronavirus. This new type of virus and disease was entirely unknown before it began to spread in China, around December 2019. At present, COVID-19 has widely spread, causing significant impacts on public health and the economies of nearly every country worldwide up to the present day (https://www.bangkoklife.com/th/articles/49/87). COVID-19 is transmitted from person to person through respiratory droplets such as from the nose or saliva, which are expelled when a COVID-19 patient coughs, sneezes, or talks. These droplets are relatively heavy, do not travel far, and quickly fall onto the ground. Thus, it is necessary to maintain a distance of at least 1 meter from others. These droplets can also fall onto objects and surfaces like phones, tables, door handles, railings, etc. When someone touches these surfaces and then touches their eyes, nose, or mouth, they can contract the virus. This can be prevented by frequently washing hands with soap and water or using alcohol gel before and after touching surfaces. Many COVID-19 patients have only mild symptoms, particularly at the beginning, so it's possible that we can get infected by COVID-19 from those who only have a slight cough and do not feel sick at all. Even scarier, asymptomatic patients can also spread the virus.
The most common symptoms of COVID-19 patients I have encountered are fever (temperature above 37.5 degrees Celsius), cough, and fatigue. Other symptoms include body aches, sore throat, loss of smell, loss of taste, nasal congestion, runny nose, diarrhea, or skin rashes, or changes in skin color on fingers or toes. These symptoms are often mild and gradually appear. Some people get infected but have mild symptoms. Most patients (80%) can recover without needing to be hospitalized. The latest research also suggests that those who cannot smell and cannot taste have a more than 10 times higher risk of being infected with COVID-19 than symptoms of fever, cough, and sneezing. Infected individuals may still be able to distinguish some tastes, such as salty or sweet, but they cannot identify flavors clearly. And people who lose the ability to smell often lose the ability to taste as well. About 1 in 5 COVID-19 patients who have severe symptoms and difficulty breathing are typically older and have underlying health conditions, such as heart disease, diabetes, high blood pressure, or cancer. These individuals tend to have a higher tendency to become severely ill than others. However, anyone can catch COVID-19, and there is a chance they can develop severe symptoms too. If you suspect you have symptoms, consult a doctor immediately. Importantly, prevention involves always wearing a mask when going out in public or in a place where people gather, maintain a distance of at least 1 meter from others to avoid close contact with anyone who is coughing or sneezing. Some infected people may not show symptoms, and it's not yet certain how long people can continue to spread the virus after they recover. Therefore, recommendations for self-isolation should be followed strictly. However, the key point is to prevent infection. We need to understand what factors contribute to the likelihood of contracting COVID-19 and what they are related to. If we can understand these relationships, we can design plans or policies to reduce infections. Researchers are thus interested in studying the factors associated with COVID-19 infections, which will benefit the planning of relevant agencies in the future.

Objective
The objectives of this research are to study the relationship between gender, age, occupation, congenital disease, vaccination and the number of vaccination needles received with the rate of infection with COVID-19.

Population and Samples
The population used in the research consists of patients with respiratory system-related diseases who received treatment at Phonthong Hospital, Phonthong District, Roi Et Province, in March 2022. The total number of individuals is 10,850.
The sample group used in the research consists of patients with a history of receiving treatment at the respiratory disease clinic of Phonthong Hospital, Phonthong District, Roi Et Province, in March 2022. The sample size is 597 individuals.

Research Instruments
The tools used for research in this study are questionnaires that investigate the factors related to the COVID-19 infection among patients at Phonthong Hospital, Phonthong District, Roi Et Province. The study is divided into three parts as follows Part 1 Information about the patient's general status, such as age, occupation, marital status, congenital disease a history of drug allergies History of smoking and drinking alcohol. Part 2: Information about your vaccination history and the number of doses received. Part 3: Information about COVID-19 infection during non-vaccination or vaccination, including the name of the injected vaccine, symptoms, patient level day/month/year of onset, type of patient (Dividing outpatients, how many days do they have home isolation, if they are inpatients, do they have inpatient treatment? Date/Month/Year of onset of illness) and the researcher will not bring these data publicly.

Steps for Constructing and Evaluating the Quality of the Questionnaire
1) Determine the purpose of creating the questionnaire. 2) Study concepts, theories and related research to define the operational definition 3) From the operational definition used to create a questionnaire 4) The researcher led the questionnaire to check the validity of the content by finding the Index of Concordance (IOC) by 5 experts. 5) Summarize opinions of 5 experts and select questions with a consistency index of 0.50 or higher. It is found that the IOC values meet all criteria. 6) Publish the questionnaire for further data collection.

Data Collection
The researcher took the completed modified questionnaire to record baseline data and Vaccination data of patients in Phon Thong Hospital, Phon Thong District, Roi Et Province by collecting data. According to information from patients of Phon Thong Hospital Roi Et Province All data were collected for a period of 5 days, receiving 597 responses via Google form, representing 100%.

Result
The analysis results of factors related to COVID-19 infection are shown in Tables 1-6. From Table 2, it was found that age is significantly correlated with COVID-19 infection at a statistically significant at the .05 level. The group of individuals aged 61-80 years has a lower tendency to be infected with COVID-19 compared to other age groups. From Table 3, it was found that the occupation of the patients is not correlated with COVID-19 infection.  From Table 5, it was found that the history of receiving COVID-19 vaccination is significantly correlated with COVID-19 infection at a statistically significant level of .05. The group that received the vaccine has a lower tendency to be infected with COVID-19 compared to the group that did not receive the vaccine. From Table 6, it was found that the number of vaccine doses received and the history of COVID-19 infection are significantly correlated at a statistically significant level of .05. The group of individuals who received multiple doses of the COVID-19 vaccine has a lower chance of being infected with COVID-19 compared to those who did not receive the vaccine or received a smaller quantity.

Conclusion
The research findings indicate that certain factors do not have an impact on the rate of COVID-19 infection, such as gender, occupation, and underlying health conditions. On the other hand, factors that do affect the rate of COVID-19 infection include age, vaccination status, and the number of vaccine doses received. The group of individuals aged 61-80 years has shown a lower tendency to contract COVID-19 compared to other age groups. Additionally, the group that has received the COVID-19 vaccine demonstrates a lower likelihood of infection compared to the group that has not received the vaccine. Moreover, the number of vaccine doses received also influences the likelihood of COVID-19 infection, with a lower risk observed when comparing individuals who have received more doses to those who have received fewer doses or have not been vaccinated at all.

1)
Research findings indicate that the elderly population has a lower rate of infection than other age groups. The primary reason for this relates to the government's policy of prioritizing and vaccinating the elderly before other groups. The Thai government has placed importance on the elderly in formulating a COVID-19 management plan and prevention of the disease spread. Disease monitoring reports suggest that the elderly are a group at risk of contracting COVID-19 and if infected, they are more likely to experience severe symptoms than other age groups.  Vol. 15, No. 8;2023 This aligns with Calder (2020), who suggests that the immune system functions decrease with age, making the elderly more susceptible to infections. This also corresponds with Bunpot (2021) who states that the spread of the coronavirus disease (COVID-19) 2019 has impacted elderly care, which is a high-risk group for severe symptoms. Therefore, the Thai government prioritized vaccinating the elderly population, leading to a lower infection rate than other occupational groups. This aligns with Özdil, Bulucu Büyüksoy, and Çatıker (2021), who argue that promoting the mental health of the elderly, from the impact of the COVID-19 situation, is essential and highly necessary to maintain their robust physical and mental health, enabling them to adapt to various situations. This requires awareness and cooperation from the elderly themselves, people around them, and the community to jointly take responsibility and care for each other.
2) According to research findings, the group that received the vaccine showed a lower tendency to contract COVID-19 compared to the group that did not receive the vaccine. This indicates that vaccines can generate immunity and prevent the aforementioned infection. In the process of vaccine production, research and experimentation are conducted to ensure that they are effective in preventing COVID-19. The group that received the vaccine has a lower likelihood of contracting COVID-19 than the group that did not receive the vaccine. The reasons for this can be explained as fllows: a) Immune System Boost: Vaccination stimulates our immune system to produce antibodies against the SARS-CoV-2 virus, which is the cause of COVID-19. Therefore, the group that received the vaccine has a stronger immune response compared to the group that did not receive the vaccine. This allows them to fight the virus better and reduces the chances of infection. c) Reduction in Transmission: Vaccination helps decrease the spread of the SARS-CoV-2 virus in society. Although vaccines may not provide 100% protection against infection, the vaccinated group has a lower likelihood of getting infected and transmitting the virus to others compared to the group that did not receive the disease. d) Facilitating Immunity in Other Groups: Vaccination in high-risk groups also benefits low-risk groups. Building immunity in high-risk groups helps prevent the spread of the infection more effectively. This leads to a reduction in infections and outbreaks of the disease in the wider community. However, the decision to receive the vaccine depends on various factors. A study by Almaghaslah et al. (2021) found that the decision to receive the COVID-19 vaccine depends on whether it is a government policy and the perceived efficacy and safety of the vaccine.
3) According to research findings, the number of vaccine doses received has an impact on COVID-19 infection. Individuals who receive multiple vaccine doses have a lower tendency to contract COVID-19 compared to those who are unvaccinated or receive fewer doses. This may be due to the varying duration of protection provided by each vaccine dose, as exceeding the recommended intervals between doses may increase the risk of infection. Therefore, it is necessary to administer booster shots in order to maintain maximum vaccine effectiveness. However, the decision to receive vaccines depends on various factors. For instance, a study by Desye (2022) found that there are several factors associated with accepting the COVID-19 vaccine, one of which is considering the vaccine's efficacy. Nonetheless, vaccination may not have a significant impact on certain groups as a whole, necessitating widespread vaccination campaigns to prevent the spread of the virus. This aligns with Randolph & Barreiro's (2020) assertion that controlling the COVID-19 pandemic through vaccination requires a sufficient number of vaccinated individuals to achieve herd immunity and prevent outbreaks, particularly in highly susceptible environments like schools. Consequently, several countries have issued orders to close schools to reduce the transmission of the virus, in line with Abdulamir and Hafidh's (2020) statement that school closures are the most important step taken to prevent the spread of COVID-19. Therefore, schools must design appropriate teaching and learning methods, such as remote learning utilizing various media, as suggested by Bozkurt and Sharma (2020), and Mısırlı and Ergüleç (2021). Remote learning provides an alternative learning environment that offers flexibility in terms of time and location, responding to the COVID-19 pandemic and addressing the needs of both students and teachers. However, online learning management to reduce the spread of the disease may face several challenges, such as issues with parent-child relationships, installation of technological devices, and difficulties in adhering to the rules and regulations of online learning (Haekkilae et al., 2020). This aligns with Janssen (2020) and Schleicher's (2020) statements that the COVID-19 crisis has highlighted social inequality in many countries, such as the lack of access to computers and the internet. Furthermore, Wan (2020) mentioned that students whose parents have a lower level of education may have limited support for digital learning, which affects their education. Therefore, countries that efficiently manage vaccine distribution and prepare for the impact of government policies to prevent COVID-19 infections can minimize the adverse effects of various challenges.

These are the Suggestions from the Study
There should be a concerted effort to ensure systematic and continuous administration of COVID-19 vaccination. Relevant organizations should have accurate and comprehensive data on COVID-19 patients in order to facilitate systematic vaccine management and administration.

Future Research Recommendation
There should be research conducted to develop systematic approaches/models to promote COVID-19 vaccination.
There should be studies conducted to explore the long-term impacts of COVID-19 vaccination. There should be studies conducted to investigate the correlation between vaccination and the severity of symptoms in individuals infected with COVID-19, emphasizing the use of qualitative data that can provide in-depth explanations.