Olivia Willis, Carl Smith and Joel Werner (and colleagues Cheyne Anderson, James Bullen, Jane Lee, Tim Jenkins, and Nakari Thorpe) won the 2021 Eureka Prize for Science Journalism for their eight-part podcast series Patient Zero, on ABC Radio National, which tells the stories of disease outbreaks: where they begin, why they happen and how we found ourselves in the middle of a really big one.

Where did the idea for Patient Zero come from?
Joel: We’d actually had a different show commissioned – a big series – and we were weeks away from rolling it out: a big team, reporters traveling all around the country, an in-the-field documentary-style show. And then the first wave hit, and that show got put on ice, so there was an opportunity to pitch in to the RN Presents feed.
I wanted to do a show that was ‘true crime but for disease outbreaks’. I’m not a big fan of true crime but I recognise how popular it is, and they’re popular for a reason; the way that true crime podcasts approach story is really compelling. They have all the nifty narrative tricks that hook you in and keep you listening.
So we were like, ‘let’s do that for a medical documentary’. My big boss loved the pitch and commissioned it and away we went.

“I wanted to do a show that was ‘true crime but for disease outbreaks’”

Joel Werner

Patient Zero doesn’t launch straight into the COVID pandemic – you don’t get to it until episode four. What was the rationale for that?
Olivia: We always knew in season one that we wanted to address COVID, because that is the elephant in the room if we’re going to be talking about disease outbreaks.
But we felt like it actually made sense to build towards it, so to look back at the past, at different outbreaks, epidemics, pandemics, and the lessons that they’ve taught us, their history, and then how we got to this point.

Joel: There was also a practical reason that was the fourth episode, because it was happening in real time, and we were living through this pandemic, and stuff was changing. So to have COVID come right at the end of the run meant that the production gap between making it and it going to air would be super-close, so there was less chance that any facts had gone out of date by the time we went to air.

How did you choose which pandemics/epidemics/outbreaks to focus on?
Olivia: In both seasons, that was a process where we came together, we talked about the goals of the season, what the show is about. Then myself and the other producers went away for two weeks and did a whole bunch of research and came back with some really excellent ideas, then we slowly whittled those down to get to our top ones.
It’s a big ‘kill your darlings’ process, because everyone is fighting for the idea that they come to the table with and they’re all great. There’s so much to choose from.
A big learning through season one was the story is so important. The characters and the people who are there are in some ways just as important as the impact of that epidemic.
It’s also how they all fit together. So there were some that we loved, but we felt they were perhaps too similar to others that we’ve covered before, or we just don’t have the narrative arc there to tell that in a way that I think is really engaging. They’re important, and we want people to know about them, but we also want to keep them engaged and tell a great story.
To me, it’s about meeting both those things: this is a worthy, important story to tell, but we’re making great radio.

“A big learning through season one was the story is so important. The characters and the people who are there are in some ways just as important as the impact of that epidemic.”

Olivia Willis

Carl: In terms of trying to figure out which episodes that we wanted, there are some pretty obvious criteria, and some less obvious criteria.
The obvious one is, how close can we actually get to a patient-zero? That was actually much harder to figure out in a lot of cases than you might imagine. Another big thing that we were looking for in that format was the mystery reveals; the big ‘Aha!’ moments are there in the story.
We were also thinking about, who are the voices are going to tell it and does this fit that bill for something that is uniquely Australian or uniquely in our turf?

Joel: We would tell each other the stories a lot. A way that I work through story, and I think how we develop working through the story as a team, is just you keep telling the story over and over, and some scenes or people really stand out or some people really stand out.
We’d get together as a group and you just start talking. Like the start of Hendra with the horse autopsy, we just kept talking about how wild that was that that actually happened and it was blowing our minds.

How did you find those key characters and stories?
Carl: We wanted to make sure that we had some sort of Australian connection, otherwise why are we dipping into this big thing?
In those two weeks, we were setting up with different stories, we went and contacted a lot of people, often in very remote parts of the world. I remember that polio episode where we had people right across the Pacific on incredibly ropey lines in very remote parts of the world.

Joel: My palms are sweating, just thinking of the logistics of that.

Carl: And trying to figure out how we can get close to patient zero and who can give us a solid story without the line breaking halfway through.
We were lucky that with a lot of the stories, we stumbled across these great characters. Like the Hendra episode, where we have Peter Reid, who was there on the scene, and Helen Thomas, the reporter who was there. We found the Queensland Health Worker who was charged with taking over the scene.
Because of the format and the lens that we were using, we often found all these characters who hadn’t necessarily been super-prominent.

Joel: But then coming back to those group sessions that we were having, we were interrogating, ‘sure, we can get this person and they know how to use the mobile phone, and it’s not a bad connection, but are they right? Are they the right person? Will they fulfil this role in the format we needed to make the stories work?’
It was really difficult to reject some people as well. But for this series, we were determined to go the extra mile and get the best people. And I think we did.

What were the things that grabbed your attention initially for these stories?
Joel: For the HIV story in season one, Cheyne Anderson was doing a background interview for the COVID episode, and the virologist, John Gerrard – he’s an infectious disease expert – he just dropped in that he discovered the first HIV patient in Australia. She came back and told us and we were all just like, ‘wait a minute, what!?? Slow down, forget COVID, what’s that story?’. It was like a trial of ideas as a group: we were interrogating the ideas together, which I think is quite powerful.

Olivia: The same situation came about in season two with the fungal meningitis outbreak. That came through one of our talent interviewing Marion Kainer about something else, and she said, “I’ve actually worked on this interesting outbreak in the United States back in 2012” and told us a bit about that.
Even in season one, we actually did just put in calls to infectious disease experts, epidemiologists and said, ‘Hey, we’re working on this new series, and we’re really interested in looking at different outbreaks, are there any that are on your radar that you think haven’t been told or are interesting or important and or have interesting stories about them?”.

How hard was it to pull this together during the pandemic?
Olivia: Carl and the other producers on the show did all the legwork in wrangling talent, and that’s such a big time-consuming thing.
It was a lot of back and forth with talent in terms of setting up tape-syncs, studios overseas, making sure you get the best phone line. In some situations, we would employ freelance producers to go and record people. In other cases, we could get them into a studio if they were affiliated with a university.
At this point, we couldn’t go into the office, so in season one, James Bullen – our producer – came over to my house and set up my mics.

Carl: I think Liv did an amazing job of developing rapport to help people tell their very personal stories without being able to see them face-to-face most of the time.
That is such a skill. We didn’t even have video chats up for most of these. Peter Reid cried at one point in the middle [of the Hendra episode]. I was there in the room, helping to get him set up, and I was watching on and he was very clearly emotional. Getting that level of emotion in an interview when you’re not there face-to-face is very hard.

How did reporting on epidemics and pandemics while living through one affect you?

Carl: there are a couple of moments where it hit me that we were making the show about viruses, epidemics, pandemics, and so on, while we’re in our own pandemic.
One of those was taking Peter Reid out to the tree where he saw the first horse sick with Hendra virus. Standing there underneath this tree in what is now suburbia, in the middle of a playground with houses all around you, and then being outside the stables where the first horses started dying, and then people started dying.
To be there next to these sites in the middle of our very own pandemic and thinking about how badly this could have gone. We were just lucky that it didn’t spread a lot to humans.
And also the Papua New Guinea stuff [for the polio episode], we were calling people in PNG, and trying to arrange interviews. Often we were calling the very stretched public health staff who were busy dealing with exploding hospitals – they had case numbers going through the roof, they had very limited health staff and health facilities. These people were telling us, ‘I’m working 18 hour days, and I can’t do the interview right now’. Some people just couldn’t do the interview at all, because they were in the middle of dealing with their own pandemic.
But I definitely found it weirdly comforting, understanding there was this longer lens on how humans have dealt with diseases. We wanted to unmask the deadly diseases of the world for the audience, so they have a better understanding of how this works, and also how we work when we’re combating them.
I feel in general, when you understand something better than it’s less scary for you. The more I understood about disease outbreaks and how we have developed new ways of combating them, understanding them and pushing back and hopefully learned some lessons along the way – and hopefully, we’ll learn some out of COVID, too – I think that for me was slightly comforting.

Olivia: We started working on Patient Zero right in that first lockdown, and it was so scary and overwhelming at that time. I feel like one of our purposes with the show was, how do we bring context to this moment and help people reflect on what’s happening and how they’re feeling and what this experience is.
As a health reporter, and prior to that being on daily COVID reporting, it was therapeutic, in a sense, stepping away from the daily demanding deadlines of COVID and thinking about the bigger picture, and all the things that have led us to this point
When we did the COVID story and Carl Zimmer said something to the effect ‘you’ve got your head in the sand if you don’t think the next pandemic is barrelling towards us’. That’s quite a confronting thing to hear.

Joel: We were in another interview, and Liv mentioned being in the Google doc at 2am on deadline, but reflected that she really liked that time. I really liked that as well. When you’re on deadline, and the adrenaline’s rushing, and you’re in that zone, it’s kind of rewarding. I think it distracted me from the craziness of the early days of the pandemic. It gave me something really cool to focus on.

“I definitely found it weirdly comforting, understanding there was this longer lens on how humans have dealt with diseases. We wanted to unmask the deadly diseases of the world for the audience, so they have a better understanding of how this works, and also how we work when we’re combating them.”

Carl Smith

How did you strike a balance between scientific explanations and story?
Olivia: I think you’re always trying to strike the balance – that’s just a challenge in science journalism generally – around how technical you get compared to how digestible you make it. Because we’re all science journalists, we didn’t want to shy away from the really hard science stuff. I think that’s one of the things that actually made the series really interesting and appealing to people who are maybe not big science journalism consumers. If you break it down it’s not that complicated at all.
We didn’t want to skim over those details because they’re often are really essential to telling the story, particularly with something like polio. In order to explain the challenge, we had to go into the science of it otherwise the story doesn’t make sense.

Carl: This is a story-driven show, a documentary that’s about compelling characters, about the format of getting closer to that patient zero through that mystery reveal format. That means, we need the science in there obviously, to get through that formula, but only enough to get through each step of the mystery.

What was your formula for making this so compelling?
Joel: One thing that we tried to do in the early days of working out the structure to each story, was to see how long we could go before we revealed the disease. We wanted to keep it a mystery for as long as we could because then the listener is caught up in that mystery as well.
If you look at the show notes, if you look at the episode titles, the disease isn’t mentioned anywhere there, so there’s no spoiler material. If you create that unknowingness, not only do you empathise with the patient who you’re hearing about, but also you want to know what’s going on. It’s just a natural human curiosity, you want to keep listening until you find out.
We were hoping that then you kind of want to find out how they figured it out. So there’s this flip in each episode as well, where you go from telling the patient’s story to telling the story of the epidemiologists who are tracking down the disease origins.

Carl: We know that we want someone who was personally affected and has that core personal story and is quite close to the patient zero. We wanted to start with them and build that emotional attachment for the listener, but then we wanted to move the spotlight on to the people who were doing that detective work; the term Joel often uses is the shoe-leather epidemiologist. We wanted the focus to be on the character solving stuff and then the scientist kind of slotted around that. I don’t think we ever let the spotlight drift entirely away from the characters at any point.

Do you each have a favourite episode?
Joel: From a craft perspective, I think Hendra is the best documentary. If I was coming at it from a purely ‘where were we flexing our documentary craft the strongest’, I think Hendra is a really great piece.
My favourite guest was the cholera guy Jonathan Katz. His raw tape was just incredible; he’s such good talent.

Carl: I would agree to some extent on Hendra. It was almost like that outbreak was designed to fit Patient Zero in a lot of ways and so it just all slotted together so neatly.
But I still think the one that, in my heart, it feels like the best episode was the episode on smallpox 1789 around Sydney. I’ve never worked harder on anything that I’ve ever made. That was such a complicated, difficult documentary to pull together, and there were so many ways that we could have screwed that up completely. I’m just so happy that through perseverance, and a lot of great teamwork and a lot of phone calls, we figured out where all the landmines were, we figured out how to navigate our way through and pull it together in a way that I think was a really compelling documentary.

Olivia: I think it’s probably the COVID episode, just because I love the pace-iness of it, and the people that we interviewed. If people haven’t listened to any patient zero, it’s the episode I would suggest as the first one.
It’s followed very closely by the HIV episode. I just found that episode really moving; the experiences of the people who’ve lived through it. Because it felt like such a uniquely Australian story and also a part of Australia’s public health history that we should be really proud of, I loved being able to tell that and felt it was a perfect story for the ABC to tell. We were able to use all this fantastic ABC archive audio.

What did you learn from putting together this series?
Carl: If you find a really good format, it makes such a big difference for how you approach shows and what you can do with the show. Of course, sometimes format can get stale if you’re expecting what’s to come every time. But I think in this instance, and because we’re only two seasons and eight episodes in, I think that format has just served us so well for setting us up.
That comes down to Joel’s original pitch. We knew exactly what we wanted to do and why it was going to be compelling for the listeners. If you get that format really nutted out early on, then it’s sort of easy: you can have a bit of a cookie-cutter model for how you go forward from there.

Joel: The format thing for me was really big. Straight away, you can say ‘it’s true crime but for disease outbreaks’ and people understand.
As science journalists, you can get into a bit of a rut where you just make the same documentary over and over, or you write the same article over and over. I think looking for inspiration for format outside of how we work as science journalists is really important.
Creating multidisciplinary teams, not just thinking that a team of science journalists is going to be able to do this job, but if we want to do something that’s true crime-y, let’s go and get a great true crime producer and bring them into the team, and let’s get a sound engineer who’s made those shows to come in and show us the sound design tricks that make those shows work as well.

Olivia: I think my biggest learning throughout the process was the importance of story. I think in the first season, I was really focused on what’s the impact of this pandemic and what’s the biggest public health lesson, because my background is in reporting than in more narrative-based stuff.
So I was reminded of how important it is and how much it can make a difference by having a really compelling personal story help you tell something that is important.
The other lesson was more just the joy of collaborating with colleagues. That was the thing I loved most about this project; assembling on both seasons a team of really talented and hardworking people who all have really different skills. It was a joy to work with people who have different interests, different ideas, different ways of telling stories and different things they wanted to get out of the show and bringing that all together to create what we did.

Olivia Willis, Carl Smith and Joel Werner spoke to Bianca Nogrady.