Healthcare by numbers

摘要

It'w a startling fact that the Black Death killed about one-third of Europeans in the three years between 1347 and 1350. Had epidemiological surveillance been what it is today, that episode of bubonic plague would have generated some fabulous statistics. And had we known what we know now about plague and how it spreads, it would have been quite clear what we should have done about it. But this is an exceptional case. In public health, it is rare for absolute numbers to suggest a defensible course of action. This is spectacularly illustrated by the current debate in the US over smallpox inoculations. The risk of terrorists carrying out a smallpox attack seems small. Yet there is more to it than that when it comes to deciding what action to take. The mere possibility of an attack, however unlikely, provokes great fear. The public response to an attack or the imminent threat of one is likely to be hysterical, for the consequences for those infected would be horrific. So rather than take the minuscule risk at face value, the US government has chosen to deploy a national system of bioterrorism monitoring equipment and inoculate some 10 million medical workers to guard against it.