A human bypassed the former two to run the latter globally by hand.
(blog referenced: blog.cloudflare.com/cloudflare-out…)
Someone who hasn't internalized that config files are code. That's most of us, btw.
Corollary: you should invest a lot into making the default PATH fast and easy.
One tool. One very well tested, documented, highly optimized, trustworthy tool.
But again: it MUST be fast. Or shortcuts will bloom to get around it.
"Wait 30 min just to test a config change that doesn't even DO anything? That would blow the rest of my afternoon!"
... aaand now you're in the NYT for taking down the internet.
How?
Every time there's an outage, explain how it was caused by deploy tooling or contributed to the impact.
Amplify some less dramatic costs, too. Like the time someone spends babysitting a deploy, or waiting on it, or queueing up, or if multiple changesets go out at once (😱😱😱).
So make them visible. Help your management make better informed decisions.
This is a ruby shop, y'all.