# Wrong Tools Cost Lives

An episode of [Cautionary Tales with Tim Harford](https://invisiblenetwork.ai/podcast/1484511465), 21 May 2021, 34 min.

Audio: https://podtrac.com/pts/redirect.mp3/pdrl.fm/18db03/tracking.swap.fm/track/SxlTEPDY7xDg35RXkASs/traffic.omny.fm/d/clips/e73c998e-6e60-432f-8610-ae210140c5b1/c0ae8c6e-22f0-4e9b-ac1c-ae390037ac53/0d8cc2fe-30dd-4b2a-9a03-ae390039c773/audio.mp3?utm_source=Podcast&in_playlist=7f5a4714-6b10-4ccf-a424-ae390037ac70

The British Government promised to create a "world-beating" system to track deadly Covid 19 infections - but it included an outdated version of the off-the-shelf spreadsheet software Microsoft Excel. The result was disastrous. When under pressure or lacking in expertise we can all be tempted to use a tool unsuitable for the job in hand. But whether fitting shelves or trying to halt a pandemic, we need to accept that cutting corners comes at a cost. Read more about Tim's work at http://timharford.com/ Learn more about your ad-choices at https://www.iheartpodcastnetwork.com See omnystudio.com/listener for privacy information.

## Transcript

[0:15] Speaker 1: Pushkin, we will have a test track and trace operation
[0:27] Speaker 1: that will be world beating. That's Boris Johnson, the British
[0:36] Speaker 1: Prime Minister, speaking to Parliament with a typical jingoistic flourish
[0:40] Speaker 1: in May twenty twenty. The UK, he promised, would have
[0:44] Speaker 1: a world beating contact tracing system within a few days.
[0:48] Speaker 1: The first wave of the pandemic was slowly receding, but
[0:52] Speaker 1: the cost had been brutal. That spring, the country had
[0:56] Speaker 1: suffered one of the deadliest outbreaks of COVID anywhere in
[1:00] Speaker 1: the world, and so the British Prime Minister decided to
[1:04] Speaker 1: cheer up the nation as only he could, by boasting
[1:08] Speaker 1: of a contact trace system that would be better than
[1:11] Speaker 1: anything Johnny Foreigner would have. A contact tracing system for
[1:16] Speaker 1: COVID has three key elements. First, you need to be
[1:20] Speaker 1: able to identify who's infected and isolate them. Then you
[1:25] Speaker 1: need to trace the recent contacts of the infected person. Finally,
[1:30] Speaker 1: you need to be able to persuade those contacts to
[1:32] Speaker 1: isolate themselves as well to avoid any further spread. It's
[1:37] Speaker 1: not easy, but if you get it right, you can
[1:40] Speaker 1: keep the virus contained while allowing everyone else to relax
[1:44] Speaker 1: a little and go about their lives. Taiwan managed this,
[1:48] Speaker 1: so did South Korea and Vietnam and Japan. Anyway, the
[1:54] Speaker 1: UK system didn't need to beat the world, just needed
[1:57] Speaker 1: to beat the virus. In the summer of twenty twenty,
[2:01] Speaker 1: there seemed to be every chance of doing that. Infections
[2:05] Speaker 1: had been beaten back by a long, strict and lockdown.
[2:10] Speaker 1: Every day there was just a handful of deaths and
[2:13] Speaker 1: a quarter of a million. Daily tests were revealing just
[2:17] Speaker 1: a few hundred cases, surely few enough for the contact
[2:21] Speaker 1: tracers to manage. But by September there were alarming signs
[2:26] Speaker 1: that the virus was coming back. Cases rose. There were
[2:31] Speaker 1: a thousand a day, then two thousand, then three thousand.
[2:36] Speaker 1: The testing system was struggling to keep up. More than
[2:40] Speaker 1: ninety percent of people weren't getting test results back the
[2:43] Speaker 1: next day. There's not much point in contact tracing if
[2:47] Speaker 1: it takes days to even figure out who was infected.
[2:51] Speaker 1: And then on Sunday of the fourth of October, my
[2:54] Speaker 1: cell phone rang. On the line was a researcher from
[2:58] Speaker 1: the UK's most influential news program. She told me that
[3:02] Speaker 1: something very odd had happened and they wanted me to
[3:05] Speaker 1: figure it out and then come on the show the
[3:07] Speaker 1: next morning to help them explain it and what exactly
[3:11] Speaker 1: had happened. Nearly sixteen thousand positive cases had disappeared completely
[3:17] Speaker 1: from the contact tracing system. Sixteen thousand people who should
[3:22] Speaker 1: have been warned that they were infected and a danger
[3:24] Speaker 1: to others. Sixteen thousand cases in which the contact tracers
[3:28] Speaker 1: should be hurrying to figure out where that infected person went,
[3:32] Speaker 1: who they met, and who else might be at risk.
[3:35] Speaker 1: None of that was happening. And why had the cases disappeared? Well,
[3:42] Speaker 1: this was the real eye opener. Apparently Microsoft Excel had
[3:48] Speaker 1: run out of numbers. I'm Tim Harford, and you're listening
[3:54] Speaker 1: to cautionary tales. You cannot see a crow in a
[4:19] Speaker 1: bowl full of milk. This is Francesco di Marco d'attini.
[4:25] Speaker 1: He's a textile merchant who lives near Florence in Italy.
[4:30] Speaker 1: I should probably tell you that courtesy of Iris Orego's
[4:34] Speaker 1: book The Merchant of Prato, I've taken you back in time.
[4:40] Speaker 1: It's thirteen ninety six and Dattini is furious you could
[4:46] Speaker 1: lose your weight from your nose to your mouth. What
[4:50] Speaker 1: was going on? Well, D'ttini's business associates were bungling the numbers.
[4:56] Speaker 1: It was a common enough problem for any businessman. At
[4:59] Speaker 1: the end of the thirteen hundreds, Italian commerce was becoming complicated.
[5:04] Speaker 1: Merchants were no longer mere traveling salesman able to keep
[5:08] Speaker 1: track of profits by patting their purses. They were in
[5:11] Speaker 1: charge of complex operations. The Teeney, for example, ordered wool
[5:17] Speaker 1: from the island of Mayorka two years ago before the
[5:20] Speaker 1: sheep had even grown. It That wool would eventually be
[5:24] Speaker 1: processed by numerous subcontractors before becoming beautiful rolls of dyed cloth.
[5:30] Speaker 1: The supply chain between shepherd and consumer ranged across Barcelona, Pisa, Venice, Valencia,
[5:37] Speaker 1: North Africa, even back to Mayorka itself. It would be
[5:41] Speaker 1: four years between the initial order of wool and the
[5:44] Speaker 1: final sale of cloth. No wonder, the Teeney insisted on
[5:49] Speaker 1: absolute clarity both about where the product was at any
[5:54] Speaker 1: moment and his money. How did he manage this simple spreadsheets?
[6:03] Speaker 1: The Teeny, of course, did not use Microsoft Excel back
[6:07] Speaker 1: in thirteen ninety six, but he did use its direct predecessor,
[6:12] Speaker 1: sheets of paper laid out according to the system of
[6:16] Speaker 1: double entry book keeping otherwise known as book keeping a
[6:20] Speaker 1: la vanetziana. In double entry book keeping, every entry is
[6:27] Speaker 1: made twice the clues in the name. For example, if
[6:32] Speaker 1: you spend a hundred florins on wool, that's recorded as
[6:35] Speaker 1: a credit of a hundred florins in your cash account
[6:39] Speaker 1: and the debit of a hundred florins worth of wool
[6:42] Speaker 1: in your assets account. This extra effort makes it much
[6:47] Speaker 1: easier to detect if a mistake has been made, the
[6:50] Speaker 1: books won't balance. Double entry bookkeeping became an essential method
[6:56] Speaker 1: for keeping track of who, of what to whom, foreign
[7:00] Speaker 1: exchange transactions, profits, losses, everything. It helped merchants such as
[7:07] Speaker 1: deteining ensure that, no matter how incompetent their associates, nothing
[7:13] Speaker 1: was lost. A century later, the master of double entry
[7:18] Speaker 1: bookkeeping was a man named Luca Paccioli. He was a
[7:24] Speaker 1: serious mathematician, a friend of Leonardo da Vinci, but he's
[7:27] Speaker 1: best known today as the most famous accountant who ever lived.
[7:32] Speaker 1: He literally wrote the book on the double entry method
[7:36] Speaker 1: back in fourteen ninety four. Paccioli once advised, if you
[7:41] Speaker 1: cannot be a good accountant, you will grope your way
[7:44] Speaker 1: forward like a blind man, and may meet great losses.
[7:50] Speaker 1: If you can't keep your spreadsheets straight, you may meet
[7:53] Speaker 1: great losses. Remember that. Let's jump forward nearly five hundred
[8:00] Speaker 1: years to nineteen seventy eight. We're at Harvard Business School
[8:06] Speaker 1: and a student named Dan Bricklin is sitting in classroom
[8:10] Speaker 1: watching his accounting professor filling in rows and columns on
[8:13] Speaker 1: the blackboard. The professor makes a change and then works
[8:17] Speaker 1: across and down the grid, erasing and rewriting other numbers
[8:21] Speaker 1: to make everything add up. This erasing and rewriting is
[8:25] Speaker 1: happening every day, millions of times a day, all over
[8:30] Speaker 1: the world, as accounting clerks adjust the entries in what
[8:33] Speaker 1: they call their spreadsheets, big sheets of paper spread across
[8:38] Speaker 1: two pages of an accounting ledger. Adjustments take a lot
[8:42] Speaker 1: of work. But Dan Bricklin was a computer geek, a
[8:47] Speaker 1: former programmer, who immediately thought, I can do this on
[8:51] Speaker 1: a computer. You would put a number in and hit return,
[8:55] Speaker 1: and everything would recalculate, and you could watch it. You
[8:57] Speaker 1: could watch the number change. Bomb bomb bomb, It made
[9:00] Speaker 1: a sound. I had a real prototype. The rest is history.
[9:10] Speaker 1: Bricklin and a friend called their spreadsheet program VisiCalc. It
[9:15] Speaker 1: went on sale on the seventeenth of October nineteen seventy nine.
[9:19] Speaker 1: It was a smash hit, soon followed by Lotus one,
[9:23] Speaker 1: two three, and then in due course by Microsoft Excel itself.
[9:30] Speaker 1: For accountance, digital spreadsheets were revolutionary, replacing hours of painstaking
[9:36] Speaker 1: work with a tap on a keyboard. But some things
[9:40] Speaker 1: did not change. Accountants still had their professional training and
[9:45] Speaker 1: their double entry system. But for the rest of us, well,
[9:50] Speaker 1: Excel became ubiquitous, an easily accessible tool, a flexible tool
[9:56] Speaker 1: like a Swiss Army penknife, sitting in your digital back pocket.
[10:01] Speaker 1: Any idiot could use it, and we did. Oh goodness me,
[10:06] Speaker 1: we did. Nobody really knows what happened to the fifteen thousand,
[10:16] Speaker 1: eight hundred and forty one positive COVID cases that disappeared
[10:20] Speaker 1: from the spreadsheet. Public Health England, a government agency responsible
[10:25] Speaker 1: for the process, hasn't published anything very informative on the issue.
[10:30] Speaker 1: I asked them about it. The suggestion that any cases
[10:33] Speaker 1: were lost is simply incorrect. Oh, no cases were missed.
[10:38] Speaker 1: There was a delay in referring cases for contact tracing
[10:41] Speaker 1: and reporting them in the national figures. That delay was
[10:46] Speaker 1: often four or five days. But experts will tell you
[10:50] Speaker 1: that you really need to track contacts within forty eight hours.
[10:53] Speaker 1: A five day delay renders the test results almost useless. Look, guys,
[11:00] Speaker 1: if you lose the positive cases for four or five days,
[11:04] Speaker 1: you lose them. But how did they lose them? Somewhere? Somehow?
[11:12] Speaker 1: Public Health England had used the wrong Excel file format
[11:17] Speaker 1: XLS rather than the more recent XLSX and XLS spreadsheets
[11:23] Speaker 1: simply don't have that many rows to to the power
[11:26] Speaker 1: of sixteen about sixty four thousand. That meant that during
[11:31] Speaker 1: some automated process cases had vanished off the bottom of
[11:35] Speaker 1: the spreadsheet and nobody had noticed. The idea of simply
[11:41] Speaker 1: running out of space to put the numbers was rather amusing.
[11:45] Speaker 1: The Fact that Microsoft was never anyone's idea of cool
[11:48] Speaker 1: simply added to the hilarity. Do you suffer from having
[11:52] Speaker 1: to organize and analyze a small set of numbers? Is
[11:56] Speaker 1: the undue function on a calculator frustrating the underpowered for
[11:59] Speaker 1: your calculations needs? Do you want to dabble in recreational mathematics,
[12:04] Speaker 1: then spreadsheets maybe for you. That's a satirical advert from
[12:09] Speaker 1: the comedy and mathematics YouTube channel Stand Up Maths. Please
[12:14] Speaker 1: speak to your database developer before deciding if spreadsheets is
[12:17] Speaker 1: right for you. Common side effects include accidentally sorting some
[12:20] Speaker 1: but not all of the data, slight cell loss when
[12:23] Speaker 1: selecting numbers, hashtag name, question mark, losing key medical data
[12:28] Speaker 1: during a pandemic and endangering lives, and being fired. Spreadsheet
[12:33] Speaker 1: is intended for short term use only. Stop using spreadsheets
[12:36] Speaker 1: if you find yourself in charge of a government database
[12:38] Speaker 1: with life and death ramifications. Spreadsheets from the makers of
[12:42] Speaker 1: word art. A few weeks after the data loss scandal,
[12:47] Speaker 1: by a strange twist of fate, I found myself able
[12:50] Speaker 1: to ask Bill Gates himself about what had happened. Bill
[12:56] Speaker 1: Gates no longer runs Microsoft, and I was interviewing him
[12:59] Speaker 1: about vaccines for a BBC program called How to Vaccinate
[13:03] Speaker 1: the World, but the opportunity to have a bit of
[13:05] Speaker 1: fun quizzing him about XLS and xlsx it's too good
[13:09] Speaker 1: to miss. I expressed the question in the nerdiest way possible,
[13:14] Speaker 1: and Gates's response was so straight laced I had to
[13:17] Speaker 1: smile to myself. Yeah, I guess the older format. You know,
[13:22] Speaker 1: they overran the sixty four thousand limit, which is not
[13:26] Speaker 1: there in the new format, So you know, it's good
[13:31] Speaker 1: to have people double check things, and I, you know,
[13:34] Speaker 1: I'm sorry that happened. Exactly how the outdated XLS format
[13:39] Speaker 1: came to be used is unclear. Public Health England sent
[13:42] Speaker 1: me an explanation, but it was rather vague. I didn't
[13:46] Speaker 1: understand it, so I showed it to some members of
[13:49] Speaker 1: use Brig, the European Spreadsheet Risks Group. They spend their
[13:53] Speaker 1: lives analyzing what happens when spreadsheets go rogue. They're my
[13:57] Speaker 1: kind of people. But they didn't understand what Public Health
[14:01] Speaker 1: England had told me either. It was all a little
[14:04] Speaker 1: light on detail. The basic problem was that whatever like
[14:09] Speaker 1: Health England had done wrong, they didn't have the right
[14:12] Speaker 1: checks and controls to flag up problems. But I can
[14:16] Speaker 1: just imagine what the merchant of Prato, Francesco DiMarco D'ttini,
[14:21] Speaker 1: might have said. You could lose your way from your
[14:23] Speaker 1: nose to your mouth. We'll explore how Excel became so
[14:31] Speaker 1: error prone after this message. Doctor Felina Herman's is a
[14:40] Speaker 1: researcher who studies spreadsheets. A few years ago, she realized
[14:44] Speaker 1: that there was a wonderful source of spreadsheets that she
[14:47] Speaker 1: could study in their natural habitat. That source was a
[14:51] Speaker 1: bankrupt energy company called Enron. Enron used to be huge,
[14:57] Speaker 1: but two decades ago it collapsed and various Enron executives
[15:01] Speaker 1: were convicted of financial crimes. Regulators extracted a large digital
[15:06] Speaker 1: pile of half a million emails from and run servers,
[15:10] Speaker 1: and those emails are publicly available. Importantly, for doctor Herman's,
[15:16] Speaker 1: thousands of those emails had spreadsheets attached. She started digging
[15:22] Speaker 1: through them. Looking at nearly ten thousand spreadsheets with calculations
[15:26] Speaker 1: in them, she found that a quarter of them had
[15:29] Speaker 1: at least one obvious error. The errors even seemed to multiply.
[15:35] Speaker 1: If a spreadsheet had any mistakes at all, on average,
[15:38] Speaker 1: it contained more than seven hundred and fifty How can
[15:43] Speaker 1: a spreadsheet acquire so many errors? I asked my friend
[15:47] Speaker 1: Matt Parker, the man who literally wrote the book about
[15:50] Speaker 1: mathematical mishaps and their consequences, a book with a delightful
[15:55] Speaker 1: title Humble Pie Imagine Cautionary Tales, only with more jokes
[16:00] Speaker 1: and more equations. One spreadsheet problem is simple human error.
[16:06] Speaker 1: For example, the time when candidates for a job in
[16:09] Speaker 1: policing were listed alongside a column containing their scores on
[16:13] Speaker 1: a test. When one column was resorted and the adjacent
[16:17] Speaker 1: one was not, the test scores were effectively scrambled all
[16:23] Speaker 1: the time that the investment bank JP Morgan lost six
[16:27] Speaker 1: billion dollars. And when I say lost, I mean they
[16:31] Speaker 1: lost the money, not that they misplaced it for five days.
[16:34] Speaker 1: They lost this six billion dollars after several spreadsheet errors,
[16:39] Speaker 1: notably one in which a risk indicator in a spreadsheet
[16:42] Speaker 1: was being divided not by an average of two numbers
[16:45] Speaker 1: but by their sum. That made the risks look half
[16:48] Speaker 1: as big as they should have done. But Excel is
[16:52] Speaker 1: happy to introduce errors without any help from US humans.
[16:56] Speaker 1: Matt Parker told me that one common set of problems
[16:59] Speaker 1: is produced by the auto correct function. Excel loves to autocorrect.
[17:06] Speaker 1: Type in an international phone number, and Excel will strip
[17:10] Speaker 1: off the leading zeros. They're mathematically redundant, but if you
[17:14] Speaker 1: want to make a phone call, you'll find that they're
[17:16] Speaker 1: not redundant at all. Or if instead you type in
[17:20] Speaker 1: a twenty digit serial number, Xcel will decide those twenty
[17:25] Speaker 1: digits are a huge quantity and round them off, turning
[17:29] Speaker 1: the last few digits into zeros. If you're a genetics
[17:34] Speaker 1: researcher typing in the name of a gene such as
[17:37] Speaker 1: march f one or sept in one are generally abbreviated
[17:40] Speaker 1: to march one or sept one. Well, you can imagine
[17:46] Speaker 1: what Xcel does with them. It turns those gene names
[17:49] Speaker 1: into dates, and one study estimated that twenty percent of
[17:56] Speaker 1: all genetics papers had errors caused by Xcel's autocorrection. Microsoft's
[18:04] Speaker 1: response to the genes problem is that Xcel's default settings
[18:08] Speaker 1: are intended to work in most day to day scenarios,
[18:10] Speaker 1: which is the polite way of saying, guys, Excel was
[18:15] Speaker 1: designed for accountants, not genetics researchers. But it's understandable that
[18:20] Speaker 1: scientists picked up Excel and started to use it. It's
[18:24] Speaker 1: right there on every computer. It's powerful, it's flexible, it's ubiquitous.
[18:30] Speaker 1: The problem with ubiquitous tools is that we tend to
[18:33] Speaker 1: use them even when they aren't the right tool for
[18:35] Speaker 1: the job, even when we don't really know what we're doing.
[18:39] Speaker 1: Come to think of it, especially when we don't know
[18:42] Speaker 1: what we're doing. I said earlier that Microsoft Excel is
[18:46] Speaker 1: like a Swiss army knife. As a boy, I was
[18:50] Speaker 1: absolutely fascinated by these beautiful little red multi tools, a
[18:55] Speaker 1: pen knife with a can opener and three kinds of screwdriver,
[18:58] Speaker 1: and a bottle opener, and a wire stripper and a
[19:00] Speaker 1: tiny saw and some tweezers and even a toothpick. What
[19:04] Speaker 1: a world of miracles and wonders. But as an adult
[19:08] Speaker 1: Gig struggles to put up a bookshelf straight even. I've
[19:12] Speaker 1: noticed something about people with practical skills, people such as plumbers, electricians,
[19:18] Speaker 1: and carpenters. They don't use a Swiss army knife. They
[19:23] Speaker 1: bring a toolkit with professional tools. Microsoft Excel is a
[19:28] Speaker 1: professional enough tool if you're an accountant. Excel wasn't designed
[19:33] Speaker 1: to run the entire contact tracing infrastructure of a wants
[19:37] Speaker 1: proud nation any more than a Swiss army knife was
[19:40] Speaker 1: designed to help you put up a set of shelves.
[19:43] Speaker 1: The experts I've spoken to have different views about the
[19:46] Speaker 1: deeper problem here. Some of them reckon that using Excel
[19:49] Speaker 1: itself for contact tracing was the original sin, that a
[19:53] Speaker 1: different sort of software tool, a database, would have been
[19:57] Speaker 1: much more appropriate. Others say no, if you use Excel
[20:01] Speaker 1: professionally with proper controls, it can easily handle the task
[20:05] Speaker 1: of contact tracing. And a well designed database would have
[20:08] Speaker 1: taken time to implement. XCEL was right there. Professional carpenters
[20:14] Speaker 1: don't use a Swiss army knife. But if the shelves
[20:16] Speaker 1: need to be put up immediately and you don't have
[20:18] Speaker 1: a toolbox, why not give the Swiss army knife a try.
[20:22] Speaker 1: You just have to be aware of its limitations and
[20:25] Speaker 1: perhaps to redo the job properly when you have the
[20:28] Speaker 1: tools to do so. Not long ago, I asked folks
[20:35] Speaker 1: on Twitter if they could recommend some good books about
[20:38] Speaker 1: the eradication of smallpox. Most people instead recommended books about
[20:44] Speaker 1: Edward Jenna back in seventeen ninety six, when he first
[20:48] Speaker 1: demonstrated an effective smallpox vaccine. That's revealing because I'd asked
[20:54] Speaker 1: about the eradication of smallpox, and smallpox wasn't eradicated in
[20:58] Speaker 1: seventeen ninety six, not even close. And while eradication would
[21:04] Speaker 1: have been impossible without a highly effective vaccine, it also
[21:08] Speaker 1: required highly effective use of information, or, as the merchant
[21:13] Speaker 1: Francesco di Marco d'atini might have said, it required not
[21:17] Speaker 1: losing your way from your nose to your mouth. Unlike COVID,
[21:23] Speaker 1: smallpox infections are easy to detect. For the awful reason
[21:27] Speaker 1: that smallpox does so much damage to the human body.
[21:31] Speaker 1: Bill Fagy, one of the leaders of the fight against smallpox,
[21:34] Speaker 1: says that you can even follow your nose. On at
[21:38] Speaker 1: least two occasions, smell alone alerted me to the presence
[21:42] Speaker 1: of small pox. As I walked down a hospital hallway
[21:46] Speaker 1: in India, the dead animal odor stopped me in my tracks.
[21:51] Speaker 1: Following the smell, I located a smallpox patient. Another time,
[21:57] Speaker 1: as I walked down an alley in an urban slim
[22:00] Speaker 1: in Pakistan, the same smell hit me. There are competing
[22:05] Speaker 1: smells in such places, but again one smells stood out.
[22:11] Speaker 1: Knocking on doors, I found two siblings with smallpox. Ever
[22:19] Speaker 1: since the vaccine for smallpox was demonstrated in seventeen ninety six,
[22:24] Speaker 1: people dreamed of eradicating the disease, but those dreams kept
[22:29] Speaker 1: failing to come true. The vaccinators would never manage to
[22:33] Speaker 1: reach quite enough people in poorer countries, smallpox would linger
[22:38] Speaker 1: in isolated rural communities or neglected slums. A generation of
[22:42] Speaker 1: babies would be borne without any immunity, and soon enough
[22:47] Speaker 1: the disease would be back. In the mid nineteen sixties,
[22:51] Speaker 1: smallpox was still killing two million people a year. This
[22:56] Speaker 1: was the same number as died of COVID. In twenty twenty,
[23:00] Speaker 1: the World Health Organization announced that it would redouble its
[23:04] Speaker 1: efforts to eradicate the disease, and it planned to do
[23:07] Speaker 1: so by intensifying the mass vaccination campaign. Bill Fegi was
[23:12] Speaker 1: part of those efforts to fight smallpox. Fegi would show
[23:16] Speaker 1: up in a village in eastern Nigeria, all six foot
[23:19] Speaker 1: seven of him, and the local elders would put out
[23:22] Speaker 1: the word come and see the tallest man in the world,
[23:27] Speaker 1: and people would come, and Bill Fegy reckons he wants vaccinated.
[23:31] Speaker 1: Eleven thousand, six hundred people in a single day. It
[23:36] Speaker 1: wasn't enough. Still, The outbreaks came late in nineteen sixty six.
[23:43] Speaker 1: Vegi received a radio message. This is a message for
[23:46] Speaker 1: doctor Fagi, A message for doctor Segy Veggie speaking what
[23:52] Speaker 1: is it? We'll hear that message and why information matters
[23:58] Speaker 1: if you want to eradicate smallpox. After the break, This
[24:10] Speaker 1: is a message for doctor Pegi. A message for doctor
[24:14] Speaker 1: Segy Veggie speaking what is it? The radio operator told
[24:19] Speaker 1: doctor Bill Fegi that there had been an outbreak of
[24:22] Speaker 1: smallpox in a village about one hundred miles away. He
[24:26] Speaker 1: traveled there, found five cases and vaccinated everyone they'd been
[24:30] Speaker 1: in contact with. The handy thing about the smallpox vaccine
[24:34] Speaker 1: is that it often still works even if you vaccinate
[24:37] Speaker 1: someone a few days after they've been exposed to the virus.
[24:41] Speaker 1: Standard practice then would be to vaccinate everyone for miles around,
[24:45] Speaker 1: but Vega's team just didn't have enough doses with them,
[24:49] Speaker 1: so instead he used radio and the local network of
[24:52] Speaker 1: missionaries to try to work out where to use the vaccine.
[24:56] Speaker 1: Every evening at seven o'clock they'd switch on the radio
[25:00] Speaker 1: and put the word out, this is doctor Bill Fegy
[25:04] Speaker 1: speaking here. Doctor Pegi, which send out and we have
[25:12] Speaker 1: all the information you requested. That's amazing news. So are
[25:18] Speaker 1: there any new cases? Cases were identified in just four
[25:23] Speaker 1: more villages. Vega and his team quickly raced to the
[25:27] Speaker 1: scene and administered the vaccine. The hope was that the
[25:30] Speaker 1: vaccines would act like a firebreak the disease wouldn't find
[25:34] Speaker 1: anyone to spread to, and it worked. Repeating the tactic,
[25:39] Speaker 1: Vega's team eliminated smallpox from eastern Nigeria within six months,
[25:45] Speaker 1: just in time for the catastrophic civil war of nineteen
[25:49] Speaker 1: sixty seven. Despite the chaos and enormous bloodshed of that war,
[25:54] Speaker 1: smallpox did not return. The secret to the success was
[26:00] Speaker 1: to worry less about the blanket coverage that was never
[26:03] Speaker 1: quite good enough, and worry more about quickly finding exactly
[26:07] Speaker 1: where each outbreak was. Eradication was all about information, and
[26:13] Speaker 1: up until that point information had been very patchy. As
[26:18] Speaker 1: the WHO teams looked more closely, they realized they were
[26:21] Speaker 1: missing the vast majority of the cases. Instead of one
[26:25] Speaker 1: hundred thousand cases a year around the world, there were
[26:29] Speaker 1: ten million. Public health workers could beat smallpox by figuring
[26:34] Speaker 1: out quickly where the outbreaks were and swiftly controlling the situation,
[26:39] Speaker 1: isolating people with the disease and vaccinating their contacts. The
[26:44] Speaker 1: strategy became known as a ring vaccination, and it has
[26:48] Speaker 1: a lot in common with COVID contact tracing. In both cases,
[26:53] Speaker 1: you need to rapidly isolate infected people and find their
[26:56] Speaker 1: recent contacts. Ring vaccination worked, and it didn't take long.
[27:03] Speaker 1: The last gasp of smallpox in the wild was in
[27:07] Speaker 1: Somalia late in nineteen seventy seven. Ali Mayaw Marlin, twenty
[27:13] Speaker 1: three years old, a cook and part time vaccinator, had
[27:17] Speaker 1: astonishingly not been vaccinated himself. One day, he was asked
[27:23] Speaker 1: for directions to the local hospital by a man driving
[27:26] Speaker 1: a jeep with two sick children in the back. Soon enough,
[27:30] Speaker 1: he started to feel unwell. He was wrongly diagnosed first
[27:35] Speaker 1: with malaria and then with chicken pox. He wasn't isolated
[27:39] Speaker 1: or treated until a friend of his, a nurse, made
[27:42] Speaker 1: the correct diagnosis. Ali had the awful smallpox. His ninety
[27:49] Speaker 1: one friends and contacts were isolated and vaccinated. None of
[27:54] Speaker 1: them contracted the disease. Ali himself recovered and devoted his
[28:00] Speaker 1: life to the fight against polio. I tell them how
[28:04] Speaker 1: important these vaccines are. I tell them not to do
[28:07] Speaker 1: something foolish like me. And the vaccines were important, essential
[28:12] Speaker 1: in fact, but so was quickly identifying and tracing contacts
[28:18] Speaker 1: at risk. Smallpox had survived nearly two centuries of vaccination,
[28:25] Speaker 1: but it couldn't survive a well run system that targeted
[28:29] Speaker 1: outbreaks and tracked potential cases with hindsight. It seems so
[28:34] Speaker 1: easy and simple in a way it was, But of
[28:38] Speaker 1: course keeping track of things is harder than it might
[28:41] Speaker 1: first appear. Francesco di Marco D'ttini could have told you
[28:45] Speaker 1: that so could Bill Gates. If you really want proof
[28:52] Speaker 1: that contact tracing works, how would you get it? If
[28:56] Speaker 1: you were a mad scientist, praised with power and unchained
[29:00] Speaker 1: by conventional ethics, You'd do an experiment. You'd hack into
[29:05] Speaker 1: a country's contact tracing system. Then you'd delete some of
[29:08] Speaker 1: the positive case, making sure that some regions lost a
[29:12] Speaker 1: lot of cases and some lost very few. Then you'd
[29:15] Speaker 1: compare what happened in the places where the contact tracing
[29:18] Speaker 1: system was still running smoothly to the places where thousands
[29:22] Speaker 1: of cases had gone missing. If you weren't an evil genius,
[29:27] Speaker 1: of course, you wouldn't dream of doing such a thing. Instead,
[29:31] Speaker 1: you'd keep an eye out for it happening by accident
[29:34] Speaker 1: because somebody bungled the formatting of Excel spreadsheets. Two economists,
[29:41] Speaker 1: Timo Fetzer and Thomas Graber did just that. They decided
[29:46] Speaker 1: that no catastrophe should be allowed to occur without trying
[29:50] Speaker 1: to learn some lessons, which is very much in the
[29:53] Speaker 1: spirit of cautionary tales. They combed through the evidence from
[29:58] Speaker 1: Public Health England's mishap, and by comparing the different experiences
[30:02] Speaker 1: of different regions, they concluded that the error had led
[30:06] Speaker 1: to one hundred and twenty five thousand additional infections. The
[30:11] Speaker 1: story about Excel running out of numbers just seemed so
[30:15] Speaker 1: funny at first. Do you suffer from having to organize
[30:18] Speaker 1: and analyze a small set of numbers? And Bill Gates's
[30:23] Speaker 1: straight faced, straight laced response seemed funny too. Yeah, I
[30:27] Speaker 1: guess the older format. You know, they overran the sixty
[30:31] Speaker 1: four thousand limit, which is not there in the new format.
[30:35] Speaker 1: You know, it's good to have people double check things,
[30:37] Speaker 1: and you know, I'm sorry that happened. But of course
[30:42] Speaker 1: it was Gates who'd seen through the joke on the
[30:44] Speaker 1: surface to what lay beneath. He wasn't laughing, not because
[30:49] Speaker 1: he had no sense of humor, but because he understood
[30:52] Speaker 1: that this wasn't a comedy. It was a tragedy. The
[30:57] Speaker 1: economists Fetza and Graber have calculated a conservative estimate of
[31:02] Speaker 1: the number of people who died unknown victims of the
[31:06] Speaker 1: spreadsheet error. They think the death toll is at least
[31:10] Speaker 1: fifteen hundred people. So the next time there's a pandemic,
[31:17] Speaker 1: let's make sure we have our spreadsheets in order. After all,
[31:22] Speaker 1: As Leonardo da Vinci's friend, the father of accounting, Luca
[31:25] Speaker 1: Paccioli warned us more than five hundred years ago, if
[31:30] Speaker 1: you cannot be a good accountant, you will grope your
[31:34] Speaker 1: way forward like a blind man and may meet great losses.
[31:39] Speaker 1: Fifteen hundred people dead, great losses indeed. Key sources for
[32:03] Speaker 1: this cautionary tale include Planet Money episode six h six, Spreadsheets,
[32:09] Speaker 1: Matt Parker's YouTube video whence Spreadsheets Attack, and Bill Feggy's
[32:15] Speaker 1: book House on Fire. For a full list of our sources,
[32:19] Speaker 1: see Tim Harford dot com. Cautionary Tales is written by
[32:26] Speaker 1: me Tim Harford with Andrew Wright. It's produced by Ryan
[32:30] Speaker 1: Dilley and Marilyn Rust. The sound design and original music
[32:35] Speaker 1: are the work of Pascal Wise. Julia Barton edited the scripts.
[32:40] Speaker 1: Starring in this series of Cautionary Tales are Helena Bonham,
[32:44] Speaker 1: Carter and Jeoffrey Wright, alongside Nazar Alderazzi, Ed Gochen, Melanie Gutteridge,
[32:51] Speaker 1: Rachel Hanshaw, cobnor Holbrook, Smith, Reg Lockett, Missiamunroe and Rufus Wright.
[32:59] Speaker 1: The show would not have been possible without the work
[33:01] Speaker 1: of Mia LaBelle, Jacob Weisberg, Hella Fane, John Schnarz, Carlie mcgliori,
[33:08] Speaker 1: Eric Sandler, Emily Rostock, Maggie Taylor, Daniella Lakhan, and Maya Kane.
[33:14] Speaker 1: Cautionary Tales is a production of Pushkin Industries. If you
[33:19] Speaker 1: like the show, please remember to share, rate, and review.

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