‘Peltzman effect’

The term “Peltzman effect” first popped up when health and medical experts offered this theory on the possible cause of the global resurgence of the coronavirus disease 2019 (COVID-19) pandemic. Even after having rolled out massive vaccination in their respective countries, Brazil, France, India, South Korea – just to name some of them – have reported newest waves of rising COVID-19 cases.

France, in fact, went to its third national lockdown starting last March 31. This was a few days after President Rodrigo Duterte imposed anew the enhanced community quarantine (ECQ) in the entire national capital region (NCR), Bulacan, Cavite, Laguna, and Rizal due likewise to resurgence of COVID-19 cases in these areas collectively called as NCR Plus.

The two-week ECQ lapses today as approved yesterday by President Duterte. Based on the inputs of the Inter-Agency Task Force on the Management of Emerging and Infectious Diseases (IATF-MEID), the President downgraded this to modified ECQ effective April 12-30.

From Google search, the “Peltzman effect” is a theory which states that people are more likely to engage in risky behavior when security measures have been mandated. It is named for Sam Peltzman’s postulation about mandating the use of seatbelts in automobiles would lead to more road accidents. This is because of driver’s perception that this car safety gadget will protect him from serious injury even if he exceeds speed limit, or make risky maneuvers on the road.

The “Peltzman effect” is being applied in our current pandemic situation to explain the unintended consequences of a number of health care interventions, one of which is inoculation of people with anti-COVID vaccines. If the “Peltzman effect” is over-confidence after obtaining a shield from danger like getting anti-COVID vaccine, then getting inoculated could both spread and prevent COVID-19 at the same time.

Even while all the anti-COVID-19 vaccines are still being developed under phase 3 clinical trials, the World Health Organization (WHO) had given the emergency use authorization (EUA) in order to control the spread of the pandemic. The WHO also delegated to each country’s Food and Drug Administration (FDA) to pass upon EUA applications of anti-COVID vaccines.

At this stage, the WHO has not endorsed any particular anti-COVID vaccine as most safe and effective. Except for Jenssen that is good for one dose only, most of the anti-COVID vaccines like AstraZeneca, Coronavax of Sinovac, etc. require two doses of inoculation.

The Philippines so far secured a total of 2.525 million vaccine doses since last month. Of this total, China donated one million doses of Coronavax from Sinovac. Our Department of Health (DOH) purchased an additional one million doses of Coronavax. And 487,000 doses of AstraZeneca donated from the WHO COVAX facility subsequently arrived here.

As of April 6, the DOH reported a total of 922,898 doses of Coronavax and AstraZeneca vaccines were administered based on the vaccination priority list of people drawn up by the WHO. Those who got their jabs from Coronavax last month have undergone their second doses already after 28 days from the first dose.

But the biggest concern now is whether those who got their first dose of AstraZeneca will surely get their second dose from COVAX amid the “vaccine export ban” by the European Union (EU).

Ostentatiously, our FDA temporarily suspended for two weeks the inoculation of people, aged 59 years and below. Actually, our own FDA took this action belatedly even after the reported AstraZeneca-related blood clotting were declared “rare” cases only, or one in a million probability that it can occur. Is the FDA just buying time while our next batch of donated AstraZeneca vaccine arrives here?

For now, we are told that the best vaccine is the one injected to your arm.

According to doctors and epidemiologists, the anti COVID-19 vaccines are the best defense of people from getting severe and critical cases and likely to prevent death. But as of this time, none of the vaccines can claim definitively a guarantee of immunity from getting COVID-19 infection.

Off-the-cuff, DOH Secretary Dr. Francisco Duque III candidly admitted it is “still nebulous” if one gets immune and can no longer infect others once inoculated with anti-COVID vaccine. As co-chairman of IATF, the DOH Secretary maintains the vaccines are only added safeguards to protect the people from the fatal complications related to COVID-19 infection.

Thus, it is best advised even if you got vaccinated already, you must still continue to follow quarantine protocols. These include but not limited to wearing face masks, washing or cleansing hands with alcohol, physical distancing, avoiding crowded and enclosed places. These are counter-measures to avoid getting COVID-19 infection, the total eradication of which remains uncertain up to now.

The most affected by the vaccine shortage are the low-income countries like us here in the Philippines. One of the most often quoted quip among world leaders is “no one is safe unless everyone is safe.” Certainly, this sounds nice. But how could this be achieved if the “vaccine nationalism” denies us access to global supply?

Worrisome also are reported cases the anti-COVID vaccine may be useless to variants that can still infect us. Much more transmissible than the original COVID-19 infection – severe acute respiratory syndrome-(SARS-COV-2) – variants are emerging due to rapid mutations.

So far, the mutations already detected here in our country include the variants that originated from the United Kingdom (UK), South Korea, and Brazil. Our Philippine Genome Center have discovered another mutation it calls as P-3 variant detected so far only from COVID-19 cases in our country, the bulk of which recorded at the NCR Plus.

Another “Peltzman effect” could be attributed to complaisance among Filipinos when the COVID-19 cases in our country have palpably lessened. Whatever quarantine level to slowly and safely reopen the economy amid the COVID-19 pandemic is another case of “Peltzman effect.” Damn if you do, damn if you don’t.