Why care about efficiency? It is not, admittedly, a sexy concept. Efficiency typically doesn’t inspire passion or capture the imagination. Children don’t dream of growing up to be efficiency experts. Increasing efficiency might help a company earn greater profits, but it seems like the purview of factory supervisors, middle managers, or accountants, not something of pressing concern to our day-to-day lives. In some cases, pursuing efficiency can even appear socially destructive, with cost reductions creating higher profits for big corporations at the expense of lost jobs, lower quality, and worse service. Who among us doesn’t pine for the (real or imagined) days when products were made in the US and built to last, instead of being made in China out of cheap plastic? This perspective, while perhaps not entirely mistaken, misses the larger picture. Finding ways to produce goods and services with fewer resources—improving what we’ll call production efficiency—is the force behind some of the largest and most consequential changes in human history. Efficiency is the engine that powers human civilization. (Location 38)

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This is how the story is often told—as a tale of scientific discovery, in which some combination of serendipity and persistence resulted in an important breakthrough that changed the world. But that story is radically incomplete. In actuality, Penicillium notatum, the species of fungus the scientists used to produce penicillin, only generated the substance in miniscule amounts. In fact, over the course of an entire year, the researchers had gathered such a small amount of penicillin that they exhausted their supply during the initial trial, and the police officer they had treated relapsed and died.7 Yes, penicillin was a miracle drug—but without a way to produce it in large quantities, it was of little use. (Location 66)

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In one researcher’s sample of 1,000 strains of penicillium molds, only one other was found to produce penicillin.15 After looking through tens of thousands of strains, scientists eventually identified the ideal candidate on a moldy cantaloupe. This strain was not only capable of growing while submerged in fermentation tanks that could hold thousands of gallons of solution, but it also produced much more penicillin than earlier strains.16 Scientists were able to further improve the cantaloupe strain by cultivating naturally occurring mutants of it and deliberately inducing mutations via X-ray and radiation bombardment. This process ultimately resulted in the Wisconsin Q-176 strain, which produced up to 100 times more penicillin than Fleming’s original and became the antecedent to all major industrial strains.17 (Location 91)

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According to Emory School of Medicine professor Robert Gaynes, “In 1941, the United States did not have sufficient stock of penicillin to treat a single patient. At the end of 1942, enough penicillin was available to treat fewer than 100 patients. By September 1943, however, the stock was sufficient to satisfy the demands of the Allied Armed Forces.”18 Penicillin production reached 80 million units per month in 1943. By early 1944, it had risen by a factor of 200 to over 18 billion units per month. By 1945, manufacturers around the world were producing 5 tons of penicillin annually.19 And as production volumes rose, the price of penicillin fell. In 1943, a 600-milligram vial of penicillin cost $200; by 1952, the same vial cost just $1.30.20 As a result of the widespread availability of penicillin, Allied forces eliminated an estimated 75 to 80 percent of battlefield infection deaths.21 And the production advancements didn’t stop after the war. Between 1950 and 1980, better manufacturing technology boosted productivity by a factor of three, while additional strain enhancement increased productivity by a factor of 16. By 1982, penicillin production had reached 12,000 tons annually—2,400 times the amount produced in 1945. Over that same period, the inflation-adjusted price of penicillin dropped by a factor of 1,000.22 These gains in efficiency, along with the subsequent development of other antibiotics, brought about widespread reduction in death and suffering from infection. Prior to the emergence of antibiotics, bacterial illnesses were responsible for approximately 20 percent of all deaths in the US.23 Between 1936 and 1952, deaths from bacterial illnesses in the US dropped by nearly 70 percent. (Location 99)

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The US began as an agrarian nation, and as late as 1880, 50 percent of the labor force worked in agriculture, a state of affairs not so different from medieval Europe.28 Today, however, farm employment comprises just 1.2 percent of the workforce, and the US has fewer people working on farms today than it did in 1820.29 Yet the US produces vastly more food than it did in the 19th century. Between 1866 and 2018, potato production in the US increased by a factor of 6.8, wheat production increased by a factor of 11, and corn production increased by a factor of nearly 20.30 And modern farming requires not only less labor but also less land: Producing a bushel of wheat requires just 20 percent of the land today that it did in 1866, while a bushel of corn requires just 10 percent of the land. This increase in production has been accompanied by a steep decrease in price. Depending on the crop in question, between 1866 and today, the price has fallen by as much as 50 to 85 percent.31 (Location 131)

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Prior to the Industrial Revolution, textiles were incredibly time-consuming and labor-intensive to produce, largely because they required an enormous amount of thread, which itself was tedious and laborious to make. A 100-square-meter Viking sail, for instance, took about 60 miles of thread, while a Roman toga used about 25 miles.35 Before the late 1700s, this thread would have been made by hand, using either a drop spindle or, later, a spinning wheel. Even the fastest spinners were only able to spin about 90 to 100 meters of thread an hour on a spinning wheel, while drop spindles produced closer to half that rate. At these production speeds, a Roman toga required roughly 900 hours of labor simply to spin the thread for it and another 200 hours to weave it.36 To produce the sail for a Viking ship, 385 days of labor were needed to spin the thread, and another 600 days were needed to shear the sheep and prepare the wool.37 Preindustrial societies, therefore, devoted an enormous amount of time and effort to spinning thread, with anywhere from eight to 20 spinners supplying thread for a single weaver.38 As Virginia Postrel notes in her book The Fabric of Civilization, “Whether Aztec mothers, orphans in the Florentine Ospedale degli Innocenti, widows in South India, or country wives in Georgian England, women through the centuries spent their lives spinning.”39 In 1770, on the eve of the Industrial Revolution, England had on the order of 1 to 1.5 million spinners, out of a total workforce of around 4 million. (Location 154)

As of 2018, the US consumed roughly 35 kilograms of textiles per person each year.43 Assuming a preindustrial spinner could produce on the order of 100 pounds of fiber a year, supplying enough thread for US consumption using preindustrial methods would require on the order of 230 million people just to spin the thread.44 Of course, modern thread is not spun by hand but made in highly automated spinning mills staffed by a small number of employees. These mills can manufacture upward of 75,000 pounds of fiber per person per year—750 times what a preindustrial spinner could produce. (Location 175)

In Western Europe in the 14th century, manuscripts were produced at an estimated rate of about 20,000 to 30,000 per year, and there were likely fewer than half a million books in all of England—less than a single large bookstore might have today.47 They were also expensive: For the amount it cost to produce a single volume in 1450, a person could buy two cows, a dozen sheep, or 10 weeks of labor from a farmhand.48 (Location 188)