Johan-Mackenbach-1109-14-1600×1066
Johan Mackenbach, Professor of Public Health (Erasmus MC).

“It was a very special experience,” says Mackenbach. Initially, he wanted to teach his farewell lecture on campus, because back in June, it seemed as though normal life was on its way back. Some 130 socially distanced persons would fit into the Auditorium. “But then the restrictions were tightened, and the maximum number was reduced to thirty. And [Prime Minister] Rutte said not to take any risks. So it would have been strange for me as an Erasmus MC employee to take such a big risk anyway, with an audience in an auditorium.”

And so Mackenbach delivered a lecture in front of an empty auditorium two Fridays ago. But the great thing about that was that it was easy for a large number of people to watch the lecture online – much easier than for a large number of people to attend a regular on-campus farewell lecture. “Normally, if people appreciate what you have done as a lecturer, a few hundred people will attend your farewell lecture.” His pre-recorded farewell lecture was streamed on Friday afternoon and was viewed live by nine hundred people. That is the advantage of teaching lectures online.

No drinks session

Afterwards, the lecture was posted on YouTube, as well, where it has already garnered nearly two thousand views. “Those numbers are overwhelming. I did miss one thing, though – the contact between all the people attending the post-lecture drinks session. Family, colleagues, friends. There was none of that this time around.” Nevertheless, there were two pleasant surprises: a royal distinction and the Erasmus MC medal.

The emeritus professor hired a special agency to help him record the lecture. The recording looks slick: the doors to the Auditorium open, and the professor, wearing his gown, enters the empty auditorium in slow motion. Music by Händel plays in the background, and once Mackenbach reaches the stage, his farewell lecture commences.

https://youtu.be/364GyURJbw0

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Mackenback explains in the lecture that he had already completed his most recent book, on the rise and fall of diseases and their causes and consequences, when the coronavirus outbreak began. He actually wrote in the book that many people were warning that a pandemic caused by influenza or some such virus might break out any time, but that so far, that was yet to happen. By the time he taught his farewell lecture, the situation had changed completely.

In his lecture, Mackenbach takes the viewer on a journey through the age of diseases. He explains how diseases came into being (among other reasons, because of increased prosperity) and how they were eliminated by public healthcare. He emphasises the importance of a broader, more inclusive approach, not just for our species – humankind – but also for animals and biodiversity. “They are paying the price for our prosperity, and our health and life expectancy, as well.”

Biodiversity and COVID-19

Mackenbach thinks that the willingness to pay for the fight against COVID-19 is unprecedented, he told us on the phone after his lecture. “The unique thing about this pandemic is that society has never been so willing before to pay to eliminate a disease. Thankfully, Wopke Hoekstra (the Finance Minister – ed.) has deep pockets. But if you calculate how much we’re paying for each year a person is allowed to keep on living, you’ll see that we’re paying a tremendous price. And there are several things involved that don’t get mentioned a lot in the discussion on the coronavirus.”

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He wishes to point out three ‘unpleasant facts’ that will probably receive more attention later, once we look back on our approach to this pandemic. First and foremost: the costs and yield of the measures imposed to eliminate the coronavirus and deal with the social impact of the lockdown are distributed unequally. “All this is increasing socioeconomic inequality, and it’s mainly young people who are paying the price, with loans that will have to be repaid later, even though most of the people saved are elderly.” Secondly: all this could have been prevented. “We chose to ignore warnings that this might happen. We knew that it might happen and even so, we scaled down our public healthcare system.”

Renaissance-era hospitals

And last but not least, the money in Hoekstra’s deep pockets, which is currently being spent on the fallout of the coronavirus pandemic, should have been used for other purposes. “It’s needed for our climate change policy and the preservation of biodiversity, which were in serious jeopardy even before the coronavirus crisis.” Those are the main challenges we will face in the future, and tackling them will require a great deal of money. “We will only come out of this safely if we use this crisis to expedite the switch to a more sustainable society, instead of deferring it, and if these expenses will benefit us in the long run.”

Now that he has retired, he hopes to spend some time trying to figure out how to make the healthcare system more inclusive, albeit only on a part-time basis. In addition, he has a few other interests, such as the history of art. “I find medieval and Renaissance-era hospitals very interesting. They were quite different from today’s hospitals: less focused on medicine, more focused on social aspects, and with a religious approach. They have wonderful architecture, as well as beautiful works of art on the walls. I’d like to write a book on that someday.”

Beadle: ‘We no longer have any other options’

In a regular year, Beadle (University Master of Ceremonies) Marleen van Kester and her colleagues organise five to ten farewell lectures. This year things have been quite different, due to the coronavirus crisis. “By now pretty much the only choice we have is either to do it online, or not to do it at all. We haven’t been able to do anything on campus for a while now, so we have a bit of a backlog. We can no longer put these lectures off until life returns to normal.” Mackenbach was the first to teach his farewell lecture online, and no other online farewell lectures have been scheduled yet. “I’m trying to advertise the idea,” the Beadle says with a grin. “It’s a solid alternative, provided that people are aware it exists. We no longer have any other options.”

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