Risk compensation (Peltzman’s effect) during the COVID-19 pandemic: A narrative review

Year 2024, Volume: 22 Issue: 3, 317 - 326

Abdel-hady El-gilany , Hala Abou-elwafa

https://doi.org/10.20518/tjph.1480335

Abstract

Objective: The implementation of a safety measure can have counterproductive effects on other protective measures and people engage in risk compensatory behavior (fewer safety behaviors). It is essential to summarize different researches to better understand the dynamics of risk compensation during COVID-19 pandemic in order to develop evidence-based interventions. Mass vaccination and public use of facemasks, among others, had been widely adopted to halt COVID-19 pandemic. Given marked variability in vaccines effectiveness and the lack of evidence of facemask efficiency in preventing spread of infection, all preventive measures should be used as a single package. People might feel false sense of safety when engaging in any of these COVID-prevention behaviors, as predicted by risk compensation theory. this review aims to address the ongoing debate about risk compensation during COVID-19 pandemic; to summarize the findings of previous studies about it; and to provide new evidence base of the effects of a specific preventive measure on the other measures.

Methods: A structured search on PubMed and Google Scholar on January 8, 2024 for ever published articles in English using keywords in different combinations (“Peltzman effect” OR ‘risk compensation’ OR ‘risk homeostasis’) AND (‘COVID19’ OR ‘COVID-19’ OR ‘covid19’ OR ‘covid-19’ OR ‘SARS CoV2’ OR ‘SARSCoV-2’ OR‘SARS-CoV-2’ OR ‘SARS-COV2’) AND (‘face mask’ OR ‘face cover’) AND (“distancing” OR social distancing”) AND (“Vaccines’ OR “Vaccination”) AND (‘hand hygiene’) AND (‘Sanitizers’). The search included various study designs including both observational and experimental studies.

Results: Studies showed conflicting results and no definite conclusion can be drawn about the risk compensation during COVID-19 pandemic.  

Conclusion: Current literature failed to provide a solid evidence of risk compensation during the current pandemic. More community-based intervention studies are needed to provide solid bases for future pandemics.

Keywords

Peltzman Effect, Risk Compensation, Risk Homeostasis, COVID-19

References

• WHO Director-General’s opening remarks at the media briefing on COVID19 -March 2020. Available at: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---21-december-2020 Accessed: January 8, 2024 Accessed: January 8, 2024.
• Hedlund J. Risky business: safety regulations, risks compensation, and individual behavior. Inj Prev. 2000;6:82-90.
• Peltzman S. The effects of automobile safety regulation. Journal of Political Economy. 1975;83:677-725.
• Traeger MW, Cornelisse VJ, Asselin J, Price B, Roth JN, Willcox J, et al; PrEPX Study Team. Association of HIV preexposure prophylaxis with incidence of sexually transmitted infections among individuals at high risk of HIV infection. JAMA. 2019;321:1380-1390.
• Golub SA, KowalczykW, Weinberger CL, Parsons J. Preexposure prophylaxis and predicted condom use among high-risk men who have sex with men. J Acquir Immune Defic Syndr. 2010;54:548-55.
• Pless B. Risk Compensation: Revisited and Rebutted. Safety 2016; 2:16.
• Luckman A, Zeitoun H, Isoni A, Loomes G, Vlaev I, Powdthavee N, Read D. Risk Compensation During COVID-19: The Im-pact of Face Mask Usage on Social Distancing. Journal of Experimental Psychology: Applied. 2021;27(4):722–738.
• Hall P, Meng G, Sakib M, Quah A, Agar T, Fong G. Do the vaccinated perform less distancing, mask wearing and hand hy-giene? A test of the risk compensation hypothesis in a representative sample during the COVID-19 pandemic. 2023;41:4027–4030.
• Radun I, Radun J, Esmaeilikia M, Lajunen T. Risk compensation and bicycle helmets: A false conclusion and uncritical cita-tions. Transportation Research Part F: Traffic Psychology and Behaviour, 2018;58:548–555.
• Phillips O, Fyhri A, Sagberg F. Risk compensation and bicycle helmets. Risk Analysis. 2011;31(8):1187–1195.
• Marcus J, Glidden D, Mayer H, Liu Y, Buchbinder P, Rivet Amico K, et al. No evidence of sexual risk compensation in the iPrEx trial of daily oral HIV preexposure prophylaxis. PLOS ONE, 2013;8(12), Article e81997.
• McCarthy P, Talley W. Evidence on risk compensation and safety behaviour. Economics Letters, 1999;62(1):91–96.
• Underhill, K. Study designs for identifying risk compensation behavior among users of biomedical HIV prevention technol-ogies: Balancing methodological rigor and research ethics. Social Science & Medicine. 2013;94:115–123.
• Wu N, Joyal-Desmarais K, Ribeiro PAB, Vieira AM, Stojanovic J, Sanuade C, et al. Long-term effectiveness of COVID-19 vaccines against infections, hospitalizations, and mortality in adults: findings from a rapid living systematic evidence syn-thesis and meta-analysis up to December, 2022. Lancet Respir Med. 2023;11(5):439-452.
• Trogen B, Caplan A. Risk Compensation and COVID-19 Vaccines. Ann Intern Med. 2021;174(6):858-859.
• Desrichard O, Moussaoui L, Ofosu, N. Reduction of Precautionary Behaviour following Vaccination against COVID-19: A Test on a British Cohort. Vaccines 2022, 10,936.
• Bernal J, Nick Andrews N, Gower C, Robertson C, Stowe J, Tessier E, et al. Effectiveness of the Pfizer-BioNTech and Ox-ford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. BMJ 2021;373:n1088
• Ioannidis J. Benefit of COVID-19 Vaccination Accounting for Potential Risk. npj Vaccines 2021;6:99.
• Mitze T, Kosfeld R, Rode J, Walde K. Face masks considerably reduce COVID-19 cases in Germany. Proc Natl Acad Sci USA 2020;117:32293–301.
• Karaivanov A, Lu SE, Shigeoka H, Chen C, Pamplona S. Face masks, public policies and slowing the spread of COVID-19: evidence from Canada. J Health Econ 2021;78:102475.
• Howard J, Huang A, Li Z, Tufekci Z, Zdimal V, van der Westhuizen HM. An evidence review of face masks against COVID-19. Proc Natl Acad Sci USA2021;118(4):e2014564118
• WHO. Coronavirus Disease 2019 (COVID-19): How to protect yourself & others. Centers for Disease Control and Preven-tion. 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Accessed January 8, 2024.
• Greenhalgh T, Schmid MB, Czypionka T, Bassler D, Gruer L. Face masks for the public during the covid-19 crisis. BMJ 2020;369(m1435)
• Moosa I. The effectiveness of social distancing in containing Covid-19. Appl. Econ. 2020;52(58):6292–6305.
• Setti L, Passarini F, De Gennaro G , Barbieri P, Perrone M, Borelli M. Airborne transmission route of covid-19: why 2 me-ters/6 feet of inter-personal distance could not be enough. Int. J. Environ. Res. Public Health 2020;17(8):2932.
• Sewpaul R, Mabaso M, Cloete A, Dukhi N, Naidoo I, Davids A. Social distancing behaviour: avoidance of physical contact and related determinants among South Africans: twelve days into the COVID-19 lockdown, Psychology, Health Medi-cine.2023;28(1):260-278.
• Prakash N, Srivastava B, Singh S, Sharma S, Jain S. Effectiveness of social distancing interventions in containing COVID-19 incidence: International evidence using Kalman filter. Economics and Human Biology 2022;44:101091
• UNICEF. Preventing a ‘lockdown generation’ in Europe and central Asia Building resilient societies with young people in the era of COVID-19.2020 United Nations Children’s Fund (UNICEF) and European Training Foundation (ETF). 2020 https://www.etf.europa.eu/en/publications-and-resources/publications/preventing-lockdown-generation-europe-and-central-asia Accessed: January 8, 2024
• Atalan A. Is the lockdown important to prevent the COVID-19 pandemic? Effects on psychology, environment and econ-omy-perspective. Ann Med Surg (Lond). 2020;56:38-42.
• Houvèssou G, de Souza T, da Silveira M. Lockdown-type containment measures for COVID-19 prevention and control: a descriptive ecological study with data from South Africa, Germany, Brazil, Spain, United States, Italy and New Zealand, February – August 2020. Epidemiol. Serv. Saude, Brasília, 2021;30(1):e2020513.
• Yang X. Does city lockdown prevent the spread of COVID-19? New evidence from the psynthetic control method. Global Health Research and Policy. 2021;6:20.
• Fuss F, Weizman Y, Tan A. COVID-19 Pandemic: How Effective Are Preventive Control Measures and Is a Complete Lock-down Justified? A Comparison of Countries and States. COVID 2022;2:18–46.
• Musoke D, Nalinya S, Lubega GB, Deane K, Ekirapa-Kiracho E, McCoy D (2023) The effects of COVID-19 lockdown measures on health and healthcare services in Uganda. PLOS Glob Public Health 2023;3(1):e0001494.
• Girum T, Lentiro K, Geremew M, Migora B, Shewamare S, Shimbre M. Optimal strategies for COVID-19 prevention from global evidence achieved through social distancing, stay at home, travel restriction and lockdown: a systematic Review. Archives of Public Health 2021;79:150.
• Yanovskiy M, Socol Y. Are Lockdowns Effective in Managing Pandemics? Int. J. Environ. Res. Public Health 2022;19:9295.
• Alandry G. Frequent hand washing with soap is one of the most effective ways to stop the spread of coronavirus (COVID-19). WaterAid. 2020. Available from: https://washmatters.wateraid.org/water-and-hygiene-against-coronavirus Ac-cessed: January 8, 2024
• CDC. Coronavirus Disease 2019 (COVID-19): How to protect yourself & others. Centers for Disease Control and Preven-tion. 2019 Available at: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Accessed: January 8, 2024
• WHO. Mask use in the context of COVID-19: interim guidance. Report No.: WHO/2019-nCoV/ IPC_Masks/2020.5. World Health Organization, 2020. https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak. Access: January 8, 2024
• Rachel A. Leslie, S. Steve Zhou , David R. Macinga Inactivation of SARS-CoV-2 by commercially available alcohol-based hand Sanitizers. American Journal of Infection Control 2021;49:401−402.
• Dhama K, Patel S, Kumar R, Masand R, Rana J, Yatoo M, Tiwari R. The role of disinfectants and sanitizers during COVID-19 pandemic: advantages and deleterious effects on humans and the environment. Environmental Science and Pollution Research 2021;28:34211–34228
• Prajapati P, Desai H, Chandarana C. Hand sanitizers as a preventive measure in COVID-19 pandemic, its characteristics, and harmful effects: a review. Journal of the Egyptian Public Health Association 2022;97:6
• Chen L, Tung TH, Zhang X, Wang G. Applicability of risk compensation to the relationship between health behaviors and COVID-19 vaccination among inpatients in Taizhou, China. Z Gesundh Wiss. (Journal of public health) 2023; March 15:1-7.
• Yang M, Wang L; Xu L; Ke M, Sun L. Health Behaviours among Travellers Regarding Risk Compensation Following COVID-19 Vaccination in Taizhou, China. Can J Infect Dis Med Microbiol 2023:1329291.
• Hale T, Angrist N, Goldszmidt R, Kira B, Petherick A, Phillips T. A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker). Nat Hum Behav. 2021;5(4):529-538.
• Wambua J, Loedy N, Jarvis C, Wong K, Faes C, Grah R et al. The influence of COVID-19 risk perception and vaccination status on the number of social contacts across Europe: insights from the CoMix study. BMC Public Health 2023;23:1350
• Wright L, Steptoe, A.; Mak, H.W.; Fancourt, D. Do People Reduce Compliance with COVID-19 Guidelines Following Vac-cination? A Longitudinal Analysis of Matched UK Adults. J. Epidemiol. Community Health 2022;76:109–115.
• Hwang J, Hwang S, Kim H, Lee J, Lee J. Testing Risk Compensation: Evidence from COVID-19 Vaccination. June 12, 2023. HKUST Business School Research Paper No. 2023-104. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4404558. Accessed: January 8, 2024
• Agrawal V, Sood N, Whaley CM. The ex-ante moral hazard effects of COVID-19 vaccines. Technical report, National Bu-reau of Economic Research. NBER Working Paper No. 30602. October 2022. https://www.nber.org/system/files/working_papers/w30602/w30602.pdf Accessed: January 8, 2024
• Oliver M. Facemask Wearing and Social Distancing: A Test of Risk Compensation Theory. Virginia Journal of Business, Technology, and Science. 2021;1(1).
• Seres G, Balleyer A, Cerutti N, Danilov A, Friedrichsen J, Liu Y, et al. Face masks increase compliance with physical dis-tancing recommendations during the COVID-19 pandemic Journal of the Economic Science Association 2021;7:139-158.
• Aranguren M. Face mask use conditionally decreases compliance with physical distancing rules against COVID-19: gender differences in risk compensation pattern. Ann. Behav. Med. 2022;56:332–346.
• Kovacs R, Dunaiski M, Tukiainen J. The effect of compulsory face mask policies on community mobility in Germany. Scand. J. of Economics 2023;125(4):1027–1055.
• Wadud Z, Rahman SM, Enam A. Face mask mandates and risk compensation: an analysis of mobility data during the COVID-19 pandemic in Bangladesh. BMJ Global Health 2022;7:e006803.
• Jorgensen F, Lindholt M, Bor A, Petersen M. Does face mask use elicit risk-compensation? Quasi-experimental evidence from Denmark during the SARS-CoV-2 pandemic. Eur J Public Health 2021;31(6):1259-1265.
• Yan Y , Bayham J, Richter A, Fenichel E. Risk compensation and face mask mandates during the COVID-19 pandemic. Sci-entific Reports 2021:11:3174
• Aranguren M, Cartaud A, Cisse I, Coello Y. People interact closer when a face mask is worn but risk compensation is at best partial. European Journal of Public Health,2023:33(3):1177–1182.
• Guenther B, Galizzi MM, Sanders JG. Heterogeneity in risk-taking during the COVID-19 pandemic: Evidence from the UK lockdown. Front Psychol 2021;12:643653.
• Henk K, Rosing F, Wolff F, Frenzel S, van Dick R, Erkens V, et al. An examination and extension of the Peltzman effect during the Covid-19 pandemic. Current Research in Ecological and Social Psychology. 2023;4:100091
• Kim JH, Marks F, Clemens JD. Looking beyond COVID-19 vaccine phase 3 trials. Nat Med. 2021;27:205-211.
• Iyengar K, Ish P, Botchu R, Jain V , Vaishya R. Influence of the Peltzman effect on the recurrent COVID-19 waves in Europe Postgrad Med J 2022;98:e110–e111.