Influence of the Peltzman effect on the recurrent COVID-19 waves in Europe



Epidemiologists report there is no precise definition for what is or is not an epidemic wave. ‘Waves’ are a phenomenon of infections that can develop during a pandemic. A wave implies a rising number of sick patients, a characteristic peak of illness and then a dramatic or sustained decline of infections reaching a baseline.1 Previous experiences with the Spanish influenza pandemic (1918) and seasonal influenza epidemics suggest further waves of COVID-19 are inevitable.2 The UK has endured the first two waves of the COVID-19 pandemic with widespread socioeconomic consequences and mortality.3 The WHO regional office for Europe has recently reported that incidence, hospitalisations and deaths in Central Europe, the Balkans and the Baltic states are among the highest globally suggesting a third wave of COVID-19.4 The reason for this third wave in Europe and anticipated further waves in countries with vaccine roll-out including the UK could be due to the Peltzman effect.

The Peltzman effect is named after Sam Peltzman, professor of economics at the University of Chicago Booth School of Business. It describes the concept of ‘Risk Compensation’.5 In this concept, it is argued that highway safety regulations were not reducing highway deaths. ‘Risk compensation’ is a theory that suggests that people typically adjust their behaviour in response to perceived levels of risk. It postulates that people become more careful where they sense greater risk and lesser careful if they feel more protected. Peltzman theorised that though the introduction of safety devices, like seat belts or air bags, reduced the ratio of fatalities to accidents, the rate of accidents was found to have risen enough to offset the decreased fatality rate. He proposed that though people felt safer driving with a seat belt, it probably led to a phenomenon of driving with less attentiveness or higher speed causing an increased risk of run-off-road crashes or similar accidents.


COVID-19 vaccination triggering Peltzman effect—An analysis of Peltzman effect reveals four main factors contributing to risk compensation, all of which appear to be present in the current COVID-19 pandemic. To initiate an increase in risky behaviour, a measurable benefit must be ‘visible’, a criterion that COVID-19 vaccines meet. This is supported by the decreasing number of infections in vaccinated populations.7 Risk compensation is more likely to occur if people have a ‘motivation’ to take on a risky behaviour and if it is within their ‘control’ to do so. With the COVID-19 pandemic these two factors seem to have manifested as ‘pandemic fatigue’ with decreasing adherence to risk reduction strategies of social distancing, face coverings and hand washing in the population. Such behaviours of risk compensation have raised concerns about threat to global public health efforts to control the pandemic.8 The final factor, the overall effectiveness of the intervention, in this case of the COVID-19 vaccine, is being increasingly recognised worldwide.9 This is highly desirable, increasing the likelihood of vaccine-acquired ‘herd immunity’. However, for the Peltzman effect, this high efficacy is likely to reduce adherence to other safety precautions. Vaccination drives in most European countries started in late December 2020, after which the rise of cases was seen. Thus, people’s complacency and a false sense of increased security after vaccination may have been the possible reasons for people to abandon protective and preventive behavioural strategies.

Author(s): Karthikeyan P Iyengar1, Ish2, Botchu3, Kumar Jain4, Vaishya5

Publication Date: April 2021

Publication Site: BMJ Journals

Life expectancy in U.S. dropped by almost two years between 2018 and 2020



Life expectancy in the United States between 2018 and 2020 decreased by 1.87 years (to 76.87 years), which is 8.5 times the average decrease in other high-income nations. What’s more, decreases in life expectancy among Hispanic and non-Hispanic Black people were about two to three times greater than in the non-Hispanic White population, reversing years of progress in reducing racial and ethnic disparities. The life expectancy of Black men (67.73 years) is the lowest since 1998.

Those are key findings of a study conducted by researchers at the Virginia Commonwealth University School of Medicine, the University of Colorado Population Center and the Urban Institute in Washington, D.C., and published in The BMJ — a peer-reviewed medical trade journal of the British Medical Association.

Author(s): Michael Popke

Publication Date: 28 June 2021

Publication Site: Benefits Pro

Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data




Results Between 2010 and 2018, the gap in life expectancy between the US and the peer country average increased from 1.88 years (78.66 v 80.54 years, respectively) to 3.05 years (78.74 v 81.78 years). Between 2018 and 2020, life expectancy in the US decreased by 1.87 years (to 76.87 years), 8.5 times the average decrease in peer countries (0.22 years), widening the gap to 4.69 years. Life expectancy in the US decreased disproportionately among racial and ethnic minority groups between 2018 and 2020, declining by 3.88, 3.25, and 1.36 years in Hispanic, non-Hispanic Black, and non-Hispanic White populations, respectively. In Hispanic and non-Hispanic Black populations, reductions in life expectancy were 18 and 15 times the average in peer countries, respectively. Progress since 2010 in reducing the gap in life expectancy in the US between Black and White people was erased in 2018-20; life expectancy in Black men reached its lowest level since 1998 (67.73 years), and the longstanding Hispanic life expectancy advantage almost disappeared.

Conclusions The US had a much larger decrease in life expectancy between 2018 and 2020 than other high income nations, with pronounced losses among the Hispanic and non-Hispanic Black populations. A longstanding and widening US health disadvantage, high death rates in 2020, and continued inequitable effects on racial and ethnic minority groups are likely the products of longstanding policy choices and systemic racism.

BMJ 2021; 373 doi: (Published 24 June 2021)Cite this as: BMJ 2021;373:n1343

Author(s): Steven H Woolf, Ryan K Masters, Laudan Y Aron

Publication Date: 24 June 2021

Publication Site: bmj